Leukoplakia

Leukoplakia is a condition in which thick, white or greyish patches form on the inside of the mouth — usually on the cheek, tongue, or gums. Most patches are harmless, but some can be precancerous. Leukoplakia is an important warning sign in India because its leading causes — tobacco use, especially smokeless tobacco (gutka, khaini, paan masala with tobacco) — are very common.

Symptoms

• White or grey-white patches in the mouth that cannot be wiped off
• Sometimes red patches mixed in (erythroplakia) — these have a higher cancer risk
• Patches may be slightly raised, irregular, or "hairy" looking
• Usually painless

Why it matters

A small but significant proportion of leukoplakia patches can turn into oral cancer. Because smokeless tobacco use is widespread in India, early detection saves lives. Any white patch in the mouth that doesn't go away after 2 weeks should be seen by a doctor or dentist.

Causes and risks

• Smokeless tobacco (gutka, khaini, zarda, paan masala with tobacco) — the leading cause in India
• Smoking (cigarettes, bidis, cigars)
• Alcohol, especially with tobacco
• Chronic irritation — rough teeth, ill-fitting dentures
• Weakened immunity, including HIV (oral hairy leukoplakia is specific to HIV and severe immunosuppression)

What to do

• See a dentist or doctor about any persistent white patch in the mouth
• A biopsy is usually done to check for pre-cancerous or cancerous changes
• The most important treatment is stopping the cause — quit all forms of tobacco; reduce alcohol
• Regular follow-up, because lesions can change over time