It is a white patch in the oral cavity that cannot be rubbed or scraped off and caused and caused by tobacco(.image ) it is a pre-cancerous lesion, however, in  0.4 to 10 %, it might turn out to be cancerous.

The term leukoplakia originates from 2 Greek words LEUKO means white and PLAKIA means patch.

Causes of leukoplakia

Tobacco – the main cause of leukoplakia is tobacco. Tobacco is widely used in two forms

• Smokeless tobacco (chewable tobacco and snuff )
• Smoking tobacco (cigar, cigarette, pipe)

Smokeless tobacco –when tobacco is chewed harmful chemicals like tar is leached out.all these chemicals and the alkaline pH of snuff act as local irritants and cause damage to the oral mucosa. Smokeless tobacco often leads to tobacco pouch keratosis rather than actual leukoplakia.

Smoking tobacco –smoking tobacco is harmful as this smoke contains irritants like carbon monoxide, nicotine etc.The heat produced by the smoking tobacco plays a major role in causing the damage. Because of continuous exposure to heat and  and irritants  red and white striations are formed . These  striations increase keratin formation.

Other causes

• Alcohol –the incidence of leukoplakia is more in individuals who are chronic drinkers as compared to non drinkers.
• Chronic irritation – continuous irritation to the oral cavity is also believed to be a causative agent. E.g  ill fitting denture , sharp broken tooth etrc.
• Candidiasis

• Nutritional deficiency
• Dry mouth
• Certain drugs

(all the above-mentioned other causes do not directly;ly cause leukoplakia however they are predisposing factors for leukoplakia)

Signs and symptoms

• Usually affects the older age group and is more common in males

• It usually affects the buccal mucosa, commissures of the mouth, lips, tongue, palate, gums, and floor of mouth.
• It is a whitish or yellowish lesion.
• The surface usually appears wrinkled and feels rough on feeling it. With fingers.
• In some patients, there might be ulcerations, burning sensation, and thickening of the mucosa.

Usually, leukoplakia is a pre-cancerous condition but the risk of it becoming cancerous is high if

• The lesion is persistent since many years
• The lesion is placed at the base of the tongue, and floor of the mouth.
• In case of a female patient.

Management

• The most important step in managing the lesion is STOP SMOKING TOBACCO IMMEDIATELY.
• If it is because of an ill-fitting denture or any other chronic irritant, remove the cause of irritation.
• Conservative treatment involves vitamin therapy, anti-oxidant therapy etc.
• Surgical intervention might be required.