The appearance of painless white lesions on the lining of the mouth may be a sign of leukoplakia. An update on the risk factors and the treatment of this precancerous condition with Dr. Christophe Lequart, dental surgeon and spokesperson for the French Union for Oral Health.
What is oral leukoplakia?
This disease is characterized by the formation of whitish lesions in the mouth . They can appear on the tongue, gums, inside of the cheeks and on the palate. “If leukoplakia is considered a precancerous lesion , this does not mean that it will systematically progress to cancer” , specifies Dr. Christophe Lequart.
What are the symptoms ?
It is most often asymptomatic . But it can be manifested by:
→ The appearance of one or more more or less large white spots on the mucous membranes, and which do not disappear by scratching.
→ These marks can be homogeneous or inhomogeneous: in the first case, the lesions are smooth and painless, while inhomogeneous leukoplakias reveal lesions with an irregular surface .
→ In rare cases, leukoplakia can occur on the mucous membranes of the female genitals.
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What are the causes ?
In the vast majority of cases, it is caused by smoking : the chemical components contained in tobacco attack the mucous membranes and cause lesions . If alcoholism is associated with smoking, it increases the risks. Poor hygiene and vitamin deficiencies are also risk factors for leukoplakia. “There are also special cases, such as oral hair leukoplakia due to infection with the Epstein-Barr virus or the Herpes virus 4. It is rare and develops in particular in people who are immunosuppressed, particularly following HIV. Finally, a repeated injury by a damaged tooth is also a contributing factor “ specifies Dr. Lequart.
What is the evolution of oral leukoplakia?
Leukoplakia does not systematically progress to cancer, and not for about ten years. “All forms of leukoplakia, however, must be a diagnosis and a monitor. The inhomogeneous leukoplakia are most likely to turn into cancerous lesions” , our expert recommends.
When and who to consult?
As soon as these lesions appear in the mouth, it is advisable to consult your dentist. If necessary, he will refer you to a surgeon.
What is the diagnosis?
It is based on questioning the patient’s lifestyle and observing the lesions. If in doubt, a biopsy will be performed.
What are the treatments ?
First of all, hygiene of life: with stopping smoking and alcohol , it is possible to see the lesions disappear on their own. “Otherwise, if they are large and if they are likely to develop into cancer, the dental surgeon will perform an excision, that is to say an ablation of the lesions, in part. Cryotherapy is an alternative to surgery, “ says the dentist.
Any treatment must be accompanied by hygiene measures to avoid recurrence:
- stopping alcoholconsumption .
- stopping smoking,
- compliance with the rules of oral hygiene,
- scalingand reconstruction of teeth if necessary.