Diagnosis

Most often, your doctor diagnoses leukoplakia by:

  • Examining the patches in your mouth
  • Attempting to wipe off the white patches
  • Discussing your medical history and risk factors
  • Ruling out other possible causes

Testing for cancer

If you have leukoplakia, your doctor will likely test for early signs of cancer by:

  • Oral brush biopsy. This involves removing cells from the surface of the lesion with a small, spinning brush. This is a non-invasive procedure, but does not always result in a definitive diagnosis.
  • Excisional biopsy. This involves surgically removing tissue from the leukoplakia patch or removing the entire patch if it's small. An excision biopsy is more comprehensive and usually results in a definitive diagnosis.

If the biopsy is positive for cancer and your doctor performed an excisional biopsy that removed the entire leukoplakia patch, you may not need further treatment. If the patch is large, you may be referred to an oral surgeon or ear, nose and throat (ENT) specialist for treatment.

Hairy leukoplakia

If you have hairy leukoplakia, you'll likely be evaluated for conditions that may contribute to a weakened immune system.

Treatment

Leukoplakia treatment is most successful when a lesion is found and treated early, when it's small. Regular checkups are important, as is routinely inspecting your mouth for areas that don't look normal.

For most people, removing the source of irritation ― such as stopping tobacco or alcohol ― clears the condition.

When this isn't effective or if the lesions show early signs of cancer, the treatment plan may involve:

  • Removal of leukoplakia patches. Patches may be removed using a scalpel, a laser or an extremely cold probe that freezes and destroys cancer cells (cryoprobe).
  • Follow-up visits to check the area. Once you've had leukoplakia, recurrences are common.

Treating hairy leukoplakia

Usually, you don't need treatment for hairy leukoplakia. The condition often causes no symptoms and isn't likely to lead to mouth cancer.

If your doctor recommends treatment, it may include:

  • Medication. You may take a pill that affects your whole system (systemic medication), such as antiviral medications. These medications can suppress the Epstein-Barr virus, the cause of hairy leukoplakia. Topical treatment may also be used.
  • Follow-up visits. Once you stop treatment, the white patches of hairy leukoplakia may return. Your doctor may recommend regular follow-up visits to monitor changes to your mouth or ongoing therapy to prevent leukoplakia patches from returning.

Preparing for your appointment

You're likely to start by seeing your dentist or primary care professional. However, 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 seem unrelated to your condition
  • Key medical and dental information, such as prior instances of symptoms and treatment, if any
  • All medications, vitamins, herbal remedies and other supplements that you regularly take
  • Questions to ask your doctor to make the most of your appointment time

Some basic questions to ask your doctor include:

  • What is likely causing my condition?
  • Are there other possible causes for my condition?
  • Do I need special tests?
  • Is my condition likely temporary or long term (chronic)?
  • What treatments are available? Which do you recommend?
  • What are the alternatives to the primary approach you're suggesting?
  • Are there any restrictions I need to follow?
  • Do you have any printed materials that I can take with me? What websites do you recommend?

Don't hesitate to ask other questions during your appointment.

What to expect from your doctor

Your doctor is likely to ask you a number of questions, including:

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