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Of all the various lumps, bumps and general deformities that can potentially develop inside your mouth, leukoplakia is one of the most mysterious, and is poorly understood by many people. Leukoplakia presents itself as a white or grey patch that appears on the the tongue or inside the cheeks, but while the condition is painless, it can signify the appearance of other conditions, some of which are far less benign.

What is leukoplakia?

The white or grey patch that signifies leukoplakia is actually an abnormal growth of keratin, and can feel rough and rigid to the touch. Keratin is a tough, fibrous protein that your body uses to create hair and fingernails, but when it appears in the mouth in this way, it usually appears in response to irritation of the fragile mucous membranes that line the inside of the mouth. Leukoplakia often disappears by itself within a couple of weeks -- however, if you are suffering from leukoplakia that does not start to fade or disappear within a fortnight you should schedule a dental appointment as soon as possible, as it may be symptom of a more serious, underlying condition.

How is leukoplakia diagnosed?

If you suspect you have leukoplakia, and visit your dentist for an examination, the first thing they will do is eliminate other possible causes of white discolouration in the mouth -- common conditions such as thrush, oral lichen planus (a non-infectious, benign skin rash) or vitamin deficiency. To achieve this, your dentist will probably take a tissue biopsy by cutting away a small piece of the leukoplakia-affected tissue and conducting various tests on it. This tissue sample is taken under local anaesthetic and is usually painless.

What can cause leukoplakia?

In some cases, leukoplakia can appear and disappear without any apparently reason (this is known as idiopathic leukoplakia) but in most cases it appears in response to prolonged irritation of the mucous membranes inside the mouth. Sources of irritation include:

• Smoking - Smoking or chewing tobacco causes persistent irritation to the tissues inside the mouth, often causing large, diffuse patches of leukoplakia to appear.
• Excessive drinking - This can also cause irritation to the mucous membranes, and is often exacerbated by dehydration as a result of heavy drinking sessions.
• Misaligned teeth or jaw - Frictional leukoplakia generally appears inside the cheeks, and is caused by improperly aligned teeth rubbing against the inside of the cheek. Frequent cheek biting due to stress can also be a culprit.
• Poorly fitted dental work - Misaligned dentures, damaged fillings and prominent crown work can all cause irritation to the tongue and cheeks.
• Excessive UV exposure - Prolonged, unprotected exposure to sunlight can sometimes cause leukoplakia to appear on the lips.
• Oral cancer - Though it is a very rare symptom, leukoplakia can be the first sign of a cancerous growth in your mouth, particularly under the soft palate.
• HIV/AIDS - Leukoplakia caused by HIV/AIDS has a distinctive, 'furry' appearance, and is caused by an unusual form of Epstein-Barr virus only present in HIV/AIDS sufferers. This form of leukoplakia is extremely rare.