Shapes and what they mean
The appearance of the lesion largely reflects the risk. Smooth, or flat, leukoplakia looks like a smooth, whitish area without elevations and often remains stable for years. The verrucous form is raised above the mucosa and has a warty or folded surface. Erosive combines white areas with cracks and painful erosions. Heterogeneous leukoplakia, in which white alternates with red, is of particular concern: such lesions degenerate noticeably more often. Separately, spots are identified on the bottom of the mouth and on the lower surface of the tongue - this localization is considered the most dangerous.
- Flat: smooth white spot, lower risk
- Verrucous: raised warty surface
- Erosive: cracks and painful erosions
- Heterogeneous with red areas: highest risk
- Localization at the bottom of the mouth and under the tongue is especially alarming
Causes and risk factors
The main factor is tobacco in any form. Smoking affects the mucous membrane with smoke and temperature, and chewing tobacco and nasvay come into contact with one area for a long time, causing changes there. Alcohol enhances the effect of tobacco and facilitates the penetration of harmful substances into the mucous membrane. Constant trauma from a sharp tooth edge, a chipped filling, or an uncomfortable denture maintains chronic irritation. Additionally, the risk of human papillomavirus, weakened immunity and, for lesions on the lip, prolonged sun exposure increase the risk.
- Smoking cigarettes, hookah, pipes
- Chewing tobacco and nasvay
- Strong alcohol
- Sharp edges of teeth, fillings and dentures
- Human papillomavirus
- Immunodeficiency, including HIV infection
- Solar irradiation of the red border of the lips
Symptoms: why they miss it
Leukoplakia usually does not hurt or interfere, so it is often found by a dentist during a routine examination or by the person himself by accident. Sometimes there is a feeling of roughness, tightness of the mucous membrane, and a change in taste. Pain, burning and bleeding appear already with the erosive form or with the development of complications. It is precisely because of the scanty complaints that regular oral examinations are important, especially for smokers and those who use nasvay.
- White or grayish stain that cannot be removed with a spatula
- Feeling of roughness on the tongue
- Feeling of tightness of the mucous membrane
- Change in taste sensations
- Pain and bleeding with erosive form
Diagnostics
The doctor examines the entire oral cavity, assesses the size, boundaries, surface and density of the lesion, and checks the lymph nodes of the neck. Next, he eliminates obvious irritants and schedules a follow-up examination after two to four weeks: if the spot has disappeared, it was a reaction to injury. A persistent lesion requires a biopsy with histological examination - this is the only way to determine the extent of cell changes and exclude cancer. The material is taken from the most suspicious area; in case of extensive damage, from several points.
- Examination of the oral cavity and palpation of lymph nodes
- Elimination of the traumatic factor and control after two to four weeks
- Biopsy with histological examination
- Sampling of material from several areas with a large outbreak
- Consultation with an oncologist for a suspicious picture
- Exclusion of candidiasis and lichen planus
Treatment and observation
The first condition is to completely give up tobacco and nasvay and sharply limit alcohol: in some patients the lesion decreases or disappears as a result. At the same time, the injury is eliminated: sharp edges are polished, fillings are changed, and the prosthesis is adjusted. Foci with signs of pronounced cell changes, as well as verrucous and erosive forms, are removed surgically, by laser or cryodestruction; The method is chosen by the doctor. Even after removal, regular monitoring is necessary, because leukoplakia may reappear in the same or another area. Cauterization, self-medication with ointments and folk remedies are unacceptable.
- Complete cessation of tobacco, nasvay and hookah
- Sharp restriction of alcohol
- Removal of sharp tooth edges and correction of dentures
- Professional oral hygiene
- Surgical removal or laser destruction of the lesion
- Regular follow-up examinations according to the doctor’s schedule
- Protecting lips from the sun if the red border is affected
