Leukoplakia is a condition where thick white or grey patches develop in the mouth.

They usually appear on the tongue, inside the cheeks, or on the gums.

Smoking is the most common cause, but other things can irritate the mouth and lead to these patches.

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What does leukoplakia look like?

Patches can vary, but they are often:

• White or grey in colour.
• Thick or hard.
• Slightly raised.
• Rough in texture.
• Sometimes with small red areas (less common).

A type called hairy leukoplakia may look fuzzy or “hair-like”.

Leukoplakia patches cannot be wiped away.

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What causes leukoplakia?

The exact cause is not always clear, but it is strongly linked to mouth irritation.

Common causes include:

• Smoking or using tobacco.
• Drinking a lot of alcohol.
• Biting the inside of the cheek.
• Sharp or rough teeth.
• Poorly fitting dentures.
• Long-term inflammation in the body.

Some studies have looked at a possible link with HPV (human papillomavirus), but there is not enough strong evidence yet.

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What is hairy leukoplakia?

Hairy leukoplakia is linked to the Epstein–Barr virus (EBV).

• EBV stays in the body after infection.
• It can become active if the immune system is weak.
• It is more common in people with HIV or other immune conditions.

Hairy leukoplakia usually does not turn into cancer.

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How is leukoplakia diagnosed?

A dentist or doctor will examine your mouth.

Leukoplakia can look similar to oral thrush, but:

• Thrush patches are softer.
• Thrush can often be wiped away.
• Thrush may bleed when wiped.

If a patch looks unusual, a biopsy may be needed. This means removing a small piece of tissue to test in a lab.

This helps check for:

• Oral cancer.
• Other infections or conditions.

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Is leukoplakia serious?

Most leukoplakia patches are not dangerous and may go away once the irritation is removed.

However, having leukoplakia can increase your risk of oral cancer, especially if you smoke or drink heavily.

Always get unusual mouth patches checked.

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How is leukoplakia treated?

Many patches improve without treatment once the cause is removed.

This may include:

• Stopping smoking or tobacco use.
• Reducing alcohol intake.
• Fixing sharp teeth.
• Adjusting dentures.

If a biopsy shows early cancer changes, the patch may be removed using:

• Laser treatment.
• Minor surgery.
• Freezing treatment.

Hairy leukoplakia usually does not need to be removed. Antiviral medicines may be used if needed.

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When should I seek help?

See a dentist or doctor if you notice:

• A white or grey patch that does not go away after two weeks.
• A patch that becomes sore or changes in appearance.
• Red and white mixed patches.

Early checks are important for keeping your mouth healthy.