Leukoplakia

Diagnosis

Most often, your doctor, dentist or other healthcare professional will find out if you have leukoplakia by:

• Looking at the patches in your mouth.
• Trying to wipe off the white patches.
• Talking about your medical history and risk factors.
• Ruling out other possible causes.

Testing for cancer

If you have leukoplakia, your doctor will likely test a sample of cells in your mouth for early signs of cancer, called a biopsy:

• Oral brush biopsy. In this test, cells are removed from the surface of the patch with a small, spinning brush. This test does not always give a definite diagnosis.
• Excisional biopsy. In this test, a small piece of tissue is removed from the leukoplakia patch. If the patch is small, the entire patch may be removed. An excisional biopsy usually results in a definite diagnosis.

If the biopsy shows cancer and your doctor removed the entire leukoplakia patch with an excisional biopsy, you may not need more treatment. If the patch is large or if all of it could not be removed, you may need to see an oral surgeon or ear, nose and throat (ENT) specialist for treatment.

Hairy leukoplakia

If you have hairy leukoplakia, you'll likely be checked for conditions that may cause a weakened immune system.

Treatment

Leukoplakia treatment is most successful when a patch is found and treated early, when it's small. Regular checkups are important. So is checking your mouth regularly for changes to your cheeks, gums and tongue.

For most people, getting rid of the source of irritation — such as stopping tobacco or alcohol use — clears the condition.

When these lifestyle changes do not work or if the patch shows early signs of cancer, the treatment plan may include:

• A surgery to remove the leukoplakia patches. Patches may be removed using a small surgical knife. A laser, a tool that uses heat, or a tool that uses extreme cold also can remove the patch and destroy cancer cells.
• Follow-up visits to check the area. Once you've had leukoplakia, it's common for it to come back.

Treating hairy leukoplakia

Usually, you do not need treatment for hairy leukoplakia. The condition often causes no symptoms and is not likely to lead to mouth cancer.

If your doctor or other healthcare professional recommends treatment, it may include:

• Medicine. You may take pills, such as antiviral medicines. These medicines can keep the Epstein-Barr virus, the cause of hairy leukoplakia, under control. Treatment that is put directly on the patch also may be used.
• Follow-up visits. Once you stop treatment, the white patches of hairy leukoplakia may come back. Your doctor may recommend regular follow-up visits to look for changes in your mouth.

Preparing for your appointment

You're likely to start by seeing your doctor, dentist or other healthcare professional. You may be referred to an oral surgeon or an ear, nose and throat (ENT) specialist for diagnosis and treatment.

What you can do

To get ready for your appointment, make a list of:

• Your symptoms, even if they do not seem related to your condition.
• Key medical and dental information, such as past symptoms and treatment, if any.
• All medicines, vitamins, herbal remedies and other supplements that you take, including the doses.
• Questions to ask to make the most of your appointment time.

Some basic questions to ask include:

• What is likely causing my condition?
• Are there other possible causes for my condition?
• Do I need special tests?
• Is my condition likely short-term or long-term?
• What treatments are there? Which do you recommend?
• Are there other options than the approach that you're suggesting?
• Are there any restrictions I need to follow?
• Do you have any printed materials that I can have? What websites do you recommend?

Feel free to ask other questions during your appointment.

What to expect from your doctor

Your doctor or other healthcare professional is likely to ask you questions, including:

• When did you first notice these changes in your mouth?
• Do you have any pain or bleeding from the problem area?
• Do you smoke?
• Do you use chewing tobacco?
• How much alcohol do you drink?
• Do you have any trouble swallowing?
• Have you noticed any lumps or bumps in your neck?
• Do you have any pain?
• Do you have any areas of numbness on your tongue or lip?