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Currently, there is an increase in the number of cases of diseases involving the oral cavity. Among frequent lesions seen in the dental office, leukoplakia stands out.
Oral cancer is the most frequent neoplasm of the head and neck.as it is early of premalignant lesions, the most important action is to avoid its progression. The most frequent precancerous lesions are leukoplakia and erythroplakia; their presence increases the risk of oropharyngeal cancer.
The term, leukoplakia, comes from the Greek words “leuko”, meaning white and “plakos”, meaning plaque. Most oral leukoplakia is benign and not serious; however, together with red spots or erythroplakia, It can be an early sign of cancer. Hence the importance of seeing your dentist and general practitioner if you notice any unusual or persistent changes in the oral cavity.
WHAT IS LEUKOPLAKIA?
Leukoplakia is a condition involving white patches or spots inside the oral cavity that cannot be diagnosed like any other disease. It is considered the most frequent premalignant lesion of the oral cavity.
According to the World Health Organization, clinically speaking, leukoplakia is a predominantly white lesion in the oral mucosa, with a high tendency to develop into oral cancer. When all other known diseases have been ruled out, the patient may be diagnosed with oral leukoplakia.
These whitish lesions can be located anywhere in the oral cavity such as on the gums, the inside of the cheekbones, under the tongue, and sometimes on the surface of the tongue. However, the most frequent location will be the front mucosa under the teeth; in edentulous persons, it will be located on the mucosa of missing teeth.
RISK FACTORS
- Tobacco and alcohol: The exact cause of leukoplakia is not yet determined; however, tobacco and chronic trauma are considered to be the most common causes of the development of the lesions. Although alcohol alone is not recognized as a factor in the development of leukoplakia, its consumption together with tobacco appears to have a synergistic effect in causing lesions.
- Age and sex: Oral leukoplakia occurs in 1 to 2 % of the population. The presence of these lesions is 6 times more common in smoking patients between the fourth and seventh decade of life. It more predominant in males than in females.
- Location: Oral leukoplakias on the underside of the tongue, the floor of the mouth, and soft palate are more likely to have a tendency to malign and develop into oral cancer.
- Appearance: Some of the spots are not only white or grayish but will also have red, rough, warty spots and bumps. These are more likely to be precancerous.
- Other causes: Among other causes are the chronic irritation of the mucosa, perhaps in the presence of irregular, split, or sharp teeth, ill-fitting dentures, rough surfaces, and habits that injure the mucosa where the lesions appear These causal, are elements should be eliminated to help the lesion to diminish or disappear.
- Immunological: Other risk factors include a weakened immune system, personal or family history of cancer, and the use of immunosuppressive drugs.
SYMPTOMS
White patches may be found on the gums, inner cheeks, lower mouth, and tongue surface, although these lesions are usually painless and go unnoticed for long periods.
Generally, leukoplakia may present as:
- Grayish-white patches or spots that cannot be removed by cleaning the area.
- The patches may have a flat or irregular texture.
- Patches may present as thickened or hardened areas.
- In addition to white patches, you may find reddish spots or lumps, known as erythroplasia, which are more likely to show precancerous changes.
If your dentist or physician suspects that your white lesion is due to irritation, an attempt will be made to remove the source of the irritation, and you will be asked to return in a few weeks for a recheck. If the white area is still present at the next visit, a biopsy will probably be ordered.
COMPLICATIONS
Generally, leukoplakia does not cause permanent damage in the mouth, although there may be early signs of cancer,presenting different cancerous changes. Frequently, the different types of oral cancer develop near the white spots.
Tobacco is the most predisposing factor for developing oral leukoplakia. In addition, the consumption of tobacco and the areca nut together may be responsible for the development of these lesions. Studies from the National Institute of Dental and Craniofacial Research show that if there was no consumption of tobacco and/or areca nut, there would not likely be the development of these lesions.
Eliminating the suspected causes of leukoplakia can diminish or even cause the disappearance of these white patches; however, even after complete removal of the lesion, oral leukoplakia can recur, so it is important to evaluate the area at least twice a year.
PREVENTION
The first thing to do is to act on the factors that trigger or are associated with leukoplakia. In addition, elements that cause microtrauma and are related to the lesion should be eliminated.
- Habits: Although the most important factor in the development of leukoplakia is smoking, these lesions appear to have less malignant potential than leukoplakia not associated with this habit. The importance of tobacco consumption as an origin of leukoplakia is confirmed by the improvement and disappearance of the lesions with the cessation of the habit.
- Dentist visits: Frequent visits to the dentist, at least twice a year, can help prevent advanced stages of cancer since many types of oral cancer are painless until they are quite advanced. Thus, early diagnosis and cessation of smoking and drinking are the best prevention strategies. In addition, you should consult your dentist or healthcare professional if you have white spots, red spots, or sores in your mouth that do not heal for more than 2 weeks.
CONTACT US
If you have any questions about this or other topics, contact us at Channel Island Family Dental, as well as on our Facebook page. At Channel Island Family Dental, we will be attentive to your visit and make a timely diagnosis. In addition, our dentists in Oxnard, Santa Paula, Ventura, Newbury Park and Port Hueneme will guide you to the best treatment to give you back your best smile.
