What Is Oral Leukoplakia?

Oral leukoplakia refers to plaque-like lesions of white or off-white keratinized lesions that occur only on the oral mucosa. It is a common non-infectious chronic disease that can occur in all parts of the oral mucosa. . In addition to white color, white spots can also appear as red and white damage. Histopathological changes are characteristic of precancerous lesions-abnormal epithelial hyperplasia. Patients are more common in middle-aged and elderly men.

Basic Information

Also known as

Oral leukoplakia

English name

oralleukoplakia, OLK

Visiting department

Stomatology

Multiple groups

Middle-aged and elderly men

Common causes

Smoking

Common symptoms

Plaque, granular, wrinkled, wart

Causes of oral white spot disease

Local irritation factors play a very important role in the occurrence of white spot. Smoking is a common cause. 80% to 90% of patients with white spot have a smoking habit, and the incidence is mostly consistent with the irritation of smoke. Other stimuli such as chewing betel nut, wine, bad restorations, residual crowns, residual roots can also cause white spots. Among systemic factors, Candida albicans infection, vitamin B ₁₂ and folic acid deficiency, syphilis, radiation, and xerostomia are all closely related to white spots.

Oral white spot clinical manifestations

Plaque

White or off-white, homogeneous, hard plaques appear on the oral mucosa, with tight texture, varying shapes and areas of damage, mild bulging or unevenness. It is worth noting that there is no parallel relationship between the size of the damage and the possibility of canceration, and sometimes canceration has occurred even at the size of rice grains.

2. granular

Also known as granule-nodular leukoplakia, mucosa in the corner of the mouth is more common. The damage is often triangular, with the bottom edge at the corner of the mouth; the color of the damage is red and white, and the red area is atrophic red spots; the surface of the red spots is dotted with nodular or granular white spots. Candida albicans infection can be found in most of this type of white spot.

3. Crumpled paper

It is more common in the bottom of the mouth and the abdomen of the tongue, also known as white spots at the bottom of the mouth and keratosis under the tongue. This disease can occur at the bottom of the mouth and the abdomen at the same time, or it can occur alone at the bottom of the mouth or at the bottom of the mouth or at the bottom of the mouth. The damage varies and can even affect the lingual gums. The surface is undulating like a white crumpled paper, the base is soft, and "peak-shaped protrusions" like crumpled paper can be seen. Except for the rough discomfort, there were no obvious symptoms at first.

4. Verrucous

The lesions are uplifted, the surface is uneven, with papillary or burrlike protrusions, and palpation is slightly hard. Except in the gums or palate, there is no obvious sclerosis in the base, and the rough area of the lesion is obvious. Pain usually occurs due to the formation of ulcers.

The above types can be called "ulcer type" when ulcer occurs. Ulcers are essentially precancerous lesions. Second, the clinical diagnosis of various types must be verified by pathological examinations as the basis for selecting a treatment method.

Oral white spot diagnosis

Leukoplakia is the oral mucosa of cheeks, back of tongue, abdomen of tongue, lips, palate, floor of mouth, gums, etc., but it can also occur in other parts. Some types have more specific parts: granular white spots are more common in the buccal mucosa of the corner of the mouth; wrinkled white spots are more common in the bottom of the mouth and tongue and abdomen; warty white spots are more common in the gums. The location of white spot is different from that of keratosis, and there is nothing in common in morphology and texture. From the location of the disease and the damage to the texture and the sharpness of the boundary, it can be distinguished from white keratosis. In addition to microabscess and abnormal epithelial hyperplasia of Candida albicans, periodic acid Schiff staining or culture can be used to identify pathogens in the tissue, and the histological examination is more specific.

Oral white spot disease differential diagnosis

White edema

Middle-aged men are more common than women, and those with full cheeks are more likely to occur. White edema has fewer symptoms, so it is rare to see it. The buccal mucosa on both sides was translucent pale, resembling the skin of a finger soaked in water. It is soft and tender without palpation. White edema generally does not require treatment.

2. White Folding Gingival Stomatitis

The disease already exists at birth, but it is not obvious. It starts to develop rapidly during puberty, but does not worsen with age. Folding gingivostomatitis is a rare autosomal dominant genetic disease that can occur in the nasal cavity, anus, and vulva in addition to the oral mucosa.

3. White keratosis

Mucosal white keratinized plaques caused by long-term mechanical or chemical stimulation. The clinical manifestations are gray-white or white-unclear plaques or plaques, no higher or slightly higher than the mucosal surface, smooth and supple. After the stimulus is removed, the lesions gradually become thinner, and eventually they can completely disappear. Histopathology was hyperkeratosis of the epithelium, the epithelial layer was slightly thickened or not thickened, and the lamina propria had no inflammatory cells or mild inflammatory cell infiltration.

4. In addition, it should be distinguished from labyrinthosis, white cavernous nevus, lichen planus, submucosal fibrosis, and syphilis mucosa.

Oral white spot treatment

1. The first measure is to remove irritating factors, such as quitting smoking, banning alcohol, eating hot and spicy foods, residual roots, residual crowns, and bad restorations. It is strictly prohibited to treat cavities with caustic drugs such as phenols and silver nitrate.

2. For those who have corrected the harmful habits such as smoking and the damage has not disappeared, they can consider the use of medications and further find the causative factors.

3. Oral vitamin A, headache, dizziness may occur when first taking, the dosage can be reduced, usually after a few days to adapt. Common side effects include dry lips and hair loss. Coronary heart disease, liver and kidney dysfunction and hyperlipidemia are contraindicated. 0.2% retinoic acid solution is suitable for topical application, but not for damage accompanied by congestion and erosion. When applying, dry the saliva first, apply the finest pen with a small amount of solution and apply it along the white area. Do not apply on the red lips and mucous membrane.

4. Long-term use of cod liver oil can be used to rub the white spots, 2 to 3 times a day, 1 to 2 months as a course of treatment, but not too hard. Cod liver oil can also be taken orally, or with vitamin A. Follow up closely during conservative treatment.

5. For those who do not heal for a long time and do not subside after treatment, when cleft palate, ulcers or hardened basal area are found in the white spot area, the surface thickening is obvious, or it has been proved to have precancerous changes, and it should be removed early.