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Section Questions and Answers

White Patches in the Mouth

  1. Could the white patches in my mouth be caused by smoking?
  2. What can be done about the numerous red spots on a grey or white base, on my palate?
  3. What is leukoplakia?
  4. What are the white patches found in the mouths of tobacco chewers?
  5. What is lichen planus?
  6. What is the white spongy patch sometimes seen on the inside of the cheek?
  7. Are there any other white lesions that can occur?
  8. Should I worry about white patches in my mouth?

 
1. Could the white patches in my mouth be caused by smoking?

  • White patches on the palate, tongue or the inside of the cheeks can be caused by smoking, particularly pipe smoking.
    • This condition is called smokers' keratosis.
    • The patches may disappear if you give up smoking.
    • They may, however, also be pre-cancerous.

Click to enlarge
Smoker's keratosis

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2. What can be done about the numerous red spots on a grey or white base on my palate?

  • Give up smoking cigarettes, and the spots or papules, will go away.
    This condition is called stomatitis nicotina, and is caused by cigarette smoking.

Click to enlarge
Stomatitis Nicotina

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3. What is leukoplakia?

  • Leukoplakia presents as white patches in the mouth that cannot be wiped off.
    They may be present on the inside of the cheeks, on the floor of the mouth, or under the tongue.
    Some of these patches may become cancerous.

Click to enlarge
Leukoplakia

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4. What are the white patches found in the mouths of tobacco chewers?

  • This is a form of leukoplakia caused by chewing tobacco that is kept between the cheek and gum.
    It can be pre-cancerous.

Click to enlarge
Chewing tobacco lesion

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5. What is lichen planus?

  • This condition affects adult women more commonly than men.
    • It is mostly seen on the inner surface of the cheek in a lacy pattern of white raised areas.
    • The erosive or ulcerated form of this condition is rare, but can be pre-cancerous.
    • It is usually a benign condition and is not the same as leukoplakia.

Click to enlarge
Lichen Planus

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6. What is the white spongy patch sometimes seen on the inside of the cheek?

  • This is called a White Spongy Naevus.
    • It is an inherited condition.
    • It is benign and usually needs no treatment.

Click to enlarge
White Spongy Naevus

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7. Are there any other white lesions that can occur?

  • White lesions can be caused by:
    • Chemical burns from substances such as aspirin.
    • Infections such as thrush.
    • Some diseases that affect the entire body may cause white lesions

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8. Should I worry about white patches in my mouth?

  • All white lesions in the mouth must be examined by your dentist or doctor.
    • The sooner you have a white patch attended to the less you will have to worry about.
    • A neglected problem may not go away and may be cancerous.

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E. Pre-cancerous lesions in the mouth

  1. Can oral conditions become cancerous?
  2. How are pre-cancerous conditions treated?

 
1. Can oral conditions become cancerous?

  • It is very difficult, if not impossible, to predict which lesions will become malignant.
    Some oral conditions do have an increased risk of becoming cancerous.
    These include:
    • The white patches of leukoplakia.
    • Erosive lichen planus.
    • Submucous fibrosis.

Click to enlarge
Leukoplakia
Click to enlarge
Lichen Planus

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2. How are pre-cancerous conditions treated?

  • Specialists monitor these pre-cancerous conditions to see if there are any important changes in the cells.
    Sometimes the pre-cancerous lesion is removed surgically.

See Cancer of the Mouth

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Important note for this section on oral medicine and pathology:

  • It is essential to see you dentist regularly twice a year for a check-up, and immediately after any problems arise.
  • All conditions in this section should be diagnosed and treated by a dentist or medical specialist, not by you.

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