White spots in the mouth: what causes them?

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Leukoplakia (white spots in the mouth) is a condition usually caused by excessive use of tobacco or alcohol. The term "leukoplakia" literally means "white spot" ( leuko means white and placia means spot).

In addition to leukoplakia, there are other causes of white patches in the mouth, such as a fungus in the mouth called thrush, canker sores, and various types of viruses.

White spots in the mouth caused by leukoplakia can turn cancerous. In fact, according to the Cleveland Clinic, after developing leukoplakia for about 15 years, nearly 3 to 17.5% of people will be diagnosed with a common type of skin cancer called squamous cell carcinoma .

Other major causes of white patches in the mouth may or may not be related to oral cancer.

Ian Hooton / Getty Images

Causes of white spots in the mouth

White spots can form in the mouth for many reasons, including various forms of leukoplakia, fungal infections, and various types of viruses.

Leukoplakia

Leukoplakia causes white patches in the mouth due to heavy smoking, chewing tobacco, or drinking alcohol. The two main types of leukoplakia are:

  • Homogeneous : Thin, uniform spot of uniform appearance, mostly white; it can be wrinkled, smooth or ribbed.
  • Heterogeneous : The spots are mostly white, red, and irregular. The spots can be flat, knotty, or raised. Heterogeneous spots may appear nodular (patchy) and ulcerated (open wound), and these qualities may indicate that the leukoplakia is more likely to become malignant than homogeneous.

HIV / AIDS virus

A condition known as " hairy leukoplakia of the mouth " includes white patches on the tongue or other areas of the mouth.

Oral hairy leukoplakia is associated with the Epstein-Barr virus , as well as other causes of a weakened immune system, such as the human immunodeficiency virus (HIV) .

The spots can appear hairy, hence the name. This type of leukoplakia is present throughout a person's life.

Oral lichen planus

Oral lichen planus is a chronic (long-term) inflammation that affects the lining of the mouth.

This type of oral patch may appear white, red, lacy, or appear as red inflamed tissue or lesions (open sores). Symptoms can include:

  • Fire
  • Pain
  • Discomfort at the site of the eruption.

Oral candidiasis

Oral yeast infection is caused by an overgrowth of fungus in the mouth. It is considered a type of yeast infection and is treated with oral antifungal medications.

Candidiasis is caused by the body Candida albicans, which can also cause vaginal infections and diaper rash. Symptoms of thrush include white patches that can look like a white coating in the mouth. Yeast infection can also cause a redness and a burning sensation in the mouth.

Stomatitis

Ulcers usually appear as a large white patch that may turn red around the white area of the patch.

There are several main causes of ulcers, including irritation from certain foods or beverages, tobacco use, accidental bite injuries to the cheek or lip, and other causes. The sores are usually painful, but in most cases they heal on their own.

Mouth cancer

There are several factors that affect whether leukoplakia causes cancer. Examples include:

  • Leukoplakia type
  • The size and shape of the leukoplakia.
  • The presence of abnormal cells in leukoplakia.
  • Location of white spots (there is conflicting evidence as to whether white spots on the bottom of the mouth or on the bottom of the tongue may pose an increased risk of cancer)
  • The presence of white or red masses (resembling pebbles).
  • The presence of ulcers, bleeding, or nodules.

Symptoms

Symptoms of leukoplakia include:

  • One or more white spots (which cannot be erased) on the tongue, under the tongue, or inside the cheeks.
  • No pain or other symptoms

Symptoms associated with other causes of white spots in the mouth include:

  • Redness around the white patch.
  • Pain
  • Burning sensation
  • Discomfort

Diagnostics

Leukoplakia is often first noticed when a person goes to the dentist or undergoes a routine medical exam. This is because leukoplakia has no signs or symptoms other than white patches in the mouth.

The diagnosis of leukoplakia involves ruling out other causes of white patches in the mouth, such as:

  • Friction / friction in the mouth caused by dentures (or other causes)
  • Biting the inside of the cheek repeatedly
  • Yeast infection (thrush in the mouth)
  • Lichen planus

If there is no underlying cause for the white spots, the doctor may take a tissue sample and perform a biopsy. If no causative factor is identified during the biopsy, leukoplakia may be the cause of the white patches in the mouth. This indicates that the white spots may turn cancerous.

Note: If the dentist is the first to find white patches in the mouth, the doctor will likely see the doctor for follow-up diagnosis and treatment (after ruling out other causes).

Watch out

Oral leukoplakia often resolves on its own after removing the offending irritation (such as tobacco or alcohol use). The leukoplakia goes away in a few weeks or months.

Leukoplakia treatment aims to prevent cancer. The white spots are often removed, but often reappear spontaneously. Other forms of intervention to treat leukoplakia include:

  • Preventive measures such as the cessation of all tobacco consumption and the abandonment of alcohol.
  • Diet changes, including adding different types of fruits and vegetables every day.
  • Taking topical vitamin A (retinoids)
  • Taking vitamin A and beta-carotene supplements by mouth (by mouth) (this often helps remove white spots, but these often reappear when vitamin A is no longer taken)
  • Isotretinoin supplements (synthetic derivative of vitamin A)
  • Surgical removal of rashes.
  • Laser or photodynamic removal of eruptions.
  • Cryotherapy
  • Electrocautery

Prophylaxis

Preventive measures to contain leukoplakia may include:

  • Stop using tobacco
  • Maintain good oral hygiene
  • Choosing the right toothbrush
  • See a doctor at the first appearance of white spots in the mouth.
  • Follow your doctor's instructions

Get the word of drug information

As with most cancers, early intervention is the key to effective treatment. If you notice white patches in your mouth, see your doctor as soon as possible.

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