Oral Leukoplakia Symptoms
Providing Patient Care In The San Francisco
Bay Area Since 1996
Leukoplakia is a white patch on the oral mucosa that cannot be rubbed of nor attributed to any other condition.
Yes, oral leukoplakia is classified as a precancerous condition.
The most common type of oral cancer: Oral squamous cell carcinoma
The risk of malignant transformation has been reported as ranging from 0.13% to 2.2% per year in community-based cohorts in developing nations (Napier and Speight, 2008), while higher risks have been reported from studies done in hospital-based tertiary clinics in developed countries, with 1.1% to 17.5% of patients with leukoplakia developing OSCCA over varying follow-up periods (Napier and Speight, 2008). The overall risk has been estimated to be about 1 % per year (Petti S, 2003, Van Der Vaal, 2009), however certain clinical features increase the risk for malignant transformation, including older age, longer duration, female sex, site (floor of mouth and lateral tongue are high-risk sites), speckled, nodular or verrucous appearance, greater size, and absence of risk factors such as smoking (Napier and Speight, 2008, Van Der Vaal, 2009).
Typically oral leukoplakia does not cause any discomfort, and in many cases can completely asymptomatic. However in some cases, it may cause some degree of discomfort including sensitivity to spicy or acidic foods.
There is no proven safe and effective drug treatment for leukoplakia (Lodi G et al., 2002).
a. You should quit tobacco use, betel nut use and gutka use
b. Limit alcohol intake
c. Increase intake of fruits and vegetables
d. You should also follow the additional recommendations from the American Institute of Cancer Research for prevention of cancer.
a. Oral leukoplakia is managed with regular oral examinations and if feasible, surgical excision. The purpose of regular oral examination is to enable early diagnosis of oral squamous cell carcinoma. Surgical excision currently is the most commonly used treatment approach for oral leukoplakia. Surgical approaches include use of a scalpel for excision and/or use of a laser for excision and/or vaporization [eg. Carbon dioxide(CO2) laser (wavelength 10.6 micrometer), Nd: YAG laser (wavelength 1064 nm), KTP laser (wavelength 532 nm)].
CO2 lasers produce minimal thermal damage to underlying tissue, and have the advantage of decreased damage to adjacent structures as compared to the other laser wavelengths. The advantages of CO2 laser excision include a bloodless field preserving visibility, precise control, and improved healing with less scarring, and therefore this is a popular treatment approach for management of leukoplakia.
A successful outcome following leukoplakia excision is healing of the surgical site with normal appearing mucosa. Post surgical recurrence occurs when the surgical site heals in with leukoplakia.
Yes, there is a risk the lesion may recur or develop at another site in the oral cavity. Therefore regular oral examinations are necessary.
Dr. Nita Chainani-Wu has extensive experience in the diagnosis and management of oral leukoplakia including monitoring for changes over time, use of toluidine blue staining as an adjunct to the clinical exam, and use of carbon dioxide laser for excision/vaporization of oral lesions.
View Dr. Chainani-Wu’s publications on Leukoplakia:
Click Citations For More Information:
Chainani-Wu N, Purnell DM, Silverman S Jr. A case report of conservative
management of extensive proliferative verrucous leukoplakia using a carbon
dioxide laser. Photomed Laser Surg. 2013 Apr;31(4):183-7. doi:
10.1089/pho.2012.3414. Epub 2013 Mar 8. PubMed PMID: 23473346.
Chainani-Wu N, Silverman S Jr. Lesion characteristics and responses after CO2
laser vaporization in five patients With gingival leukoplakia. J Calif Dent
Assoc. 2013 Oct;41(10):759-62, 765. PubMed PMID: 24340428.
Nita Chainani-Wu, Crystal Chang, Chelsia Sim, Timothy C Wu, Darren Cox, Davud Sirjani, Sol Silverman Jr
Oral Squamous Cell Carcinoma Mimicking Peri-Implantitis
Clin Adv Periodontics
. 2016 May;6(2):83-88. PMID: 31535489
Nita Chainani-Wu, Dustin Lee, Erin Madden, Chelsia Sim, Kornelia Collins, Sol Silverman Jr
Clinical predictors of oral leukoplakia recurrence following CO₂ laser vaporization
2015 Nov;43(9):1875-9. PMID: 26364762
N Chainani-Wu, E Madden, D Cox, H Sroussi, J Epstein, S Silverman Jr
Toluidine blue aids in detection of dysplasia and carcinoma in suspicious oral lesions
. 2015 Oct;21(7):879-85. PMID: 26173924