If for a long time an irritant acts on the mucous membrane in the mouth, a person has a greater chance of developing oral leukoplakia. This ailment can be recognized by the strong keratinization of a particular area of the mucosa. The inner side of the lips, cheeks, hard and soft palate, tongue and the bottom of the oral cavity are involved in the pathological process. The lesion resembles a spot or several white spots with a clear border.
Despite the fact that this disease is not so common, the symptoms and treatment of oral leukoplakia deserve special attention. The fact is that this ailment is considered a harbinger of cancer. Leukoplakia itself is a benign disease, but under a number of conditions it can be prone to malignancy. The risk of malignant degeneration is highest in those patients in whom the focus of inflammation is localized on the back of the tongue or the bottom of the oral cavity. At risk, according to statistics, men are aged 35 to 70 years, which is explained by the greatest impact of hazardous factors, including bad habits, poor oral hygiene, and work with toxic or ionizing substances.
What causes leukoplakia
A favorable condition for the development of this disease are dental problems. Leukoplakia of the oral cavity often develops due to prostheses made in accordance with the individual parameters of the jaw, poor-quality fillings or sharp edges of the teeth damaged by caries. Interestingly, most dentists do not doubt the negative role of malocclusion in humans. Frequent electric shocks of small force that occur in the oral cavity due to the contact of fillings and prostheses made of different metals can cause leukoplakia.
Among the endogenous causes of the disease, the most common doctors consider:
- avitaminosis;
- unbalanced nutrition over a long period;
- the use of food that irritates the oral mucosa (salty, peppered, spicy, too hot dishes);
- infectious and inflammatory processes in the mouth;
- pathology of the gastrointestinal tract;
- smoking;
- alcohol abuse;
- hereditary predisposition;
- prolonged use of medications;
- anemia
- HIV or congenital immunodeficiency;
- endocrine system disorders;
- papillomatosis.
Types of disease
To date, five forms of leukoplakia of the oral cavity are known. The most positive prognosis is given to patients with a simple variety of the disease. Such leukoplakia proceeds latently and usually does not degenerate into a tumor, since it is not characterized by cellular atypia.
A much more common diagnosis is a flat form of the disease. With it, patients do not experience any pronounced symptoms and discomfort. According to reviews, patients found in themselves a rough surface area on the mucosa, which did not cause them any feelings. Flat oral leukoplakia is most often diagnosed during an unplanned preventive examination.
Another type of disease that affects mainly the mucous membrane of the cheeks and lips is called Pashkov's mild leukoplakia. The reason for its appearance, doctors call frequent biting of the mucous membranes of the mouth, so the disease is common in children and young people who express their nervous experiences by biting their lips, the inside of the cheeks.
Leukoplakia Tappeynera occurs in smokers with experience. The disease is called - leukoplakia smokers or nicotine leukoplakia. It develops against the background of regular smoking. The affected focus looks like a coarse fragment of the mucous membrane of the sky. Such a leukoplakia passes extremely rarely from a benign form to a malignant one. In addition, it can disappear without medical intervention, as soon as the patient abandons a bad habit.
Verrucous leukoplakia of the oral cavity, as a rule, is a complicated stage of a flat one and develops in the absence of adequate treatment and with the unremitting effect of the irritant on the mucosa. This kind of disease is considered very dangerous. A distinctive feature of verrucous leukoplakia is the formation in the foci of lesions of nodules resembling small warts.
The erosive form of leukoplakia of the oral mucosa is the next stage after verrucous. The likelihood of cancer with this type of ailment is highest. Often, erosion is considered as the initial stage of the tumor process.
Stages of the disease
In order to get a more detailed idea of how leukoplakia proceeds, it is necessary to understand the staged nature of pathological development. The disease goes through three main stages:
- An imbalance in the ratio of cellular elements at the level of the surface layers of the epidermis - basal and suprabasal. With mild leukoplakia of the oral cavity, atypia of cells is detected at the initial stage.
- Deepening of the lesion to the epithelial layers, keratinization of the surface, parakeratosis.
- Thickening and keratinization of tissues, the occurrence of erosive areas.
Is it possible to recognize leukoplakia yourself
Usually, patients do not pay attention to the first signs of this disease, since in most cases the symptoms of leukoplakia of the oral cavity are mild. Pathology makes its debut a mild inflammatory process, slight swelling in a limited area of the mucosa. Over time, the lesion becomes rougher, necrotic. On the surface of the mucosa, there may be several or only one. Itching, burning and a feeling of strong tightening in the mouth, as well as the roughness that is felt by the tongue, helps many to suspect pathology and consult doctors. These symptoms correspond to the second stage of leukoplakia. The chances of successful treatment for this disease largely depend on how timely the patient seeks help.
Signs of leukoplakia of various forms
With a simple variety of the disease without cell atypia, a barely noticeable white film appears on the affected area of the mucosa. It is very dense to the touch and has bright outlined borders. Leukoplakia of the oral cavity of a flat form is usually not accompanied by uncomfortable sensations. Sometimes patients noted unusual sensations of dry mouth and a weakening of taste buds if the focus of the pathology was located on the tongue.
If the disease proceeds in a simple form, the appearance of compacted whitish surfaces of the mucosa is possible. Damaged areas can peel off, they are covered with a gray secret. With simple leukoplakia, the risk of trauma to the weakened epithelium is especially high, so the patient does not have long ulcers in his mouth.
In smokers, leukoplakia is expressed by inflammation of the oral cavity. The disease is characterized by a dense white coating with red blotches. It is impossible to eliminate this “coating” on one’s own; it seems as if it is soldered to the epithelium.
Complaints of discomfort and soreness can be heard from patients with verrucous leukoplakia of the oral cavity. It is easy to see in the photo that the affected areas are densified and have a typical white color. The upper epithelial layers are slightly elevated above the surface of the mucosa, so they are often injured, especially when eating solid food.
With an erosive form, the formation of ulcers and cracks is characteristic. If leukoplakia is localized in the corners of the mouth or on the side of the tongue, the patient has difficulty eating, talking, and swallowing. Erosion is constantly disturbing, and when eating annoying food, hot tea and coffee, the pain intensifies. It is possible to suspect malignancy with erosive leukoplakia on the surface of the spot, on which more and more non-healing ulcers appear. In addition, a specific seal appears at the base of the pathological focus. The inflamed area often bleeds and quickly grows in the oral cavity. Against the background of disease progression, an increase in lymph nodes is not excluded.
Survey
The primary diagnosis is to collect complaints, study history and visual inspection. In order to confirm the diagnosis, a sample of the affected tissue is taken from the patient and sent for histological examination. A biopsy helps not only to find out about the malignancy of the disease, but also to accurately determine the stage of the cancer process, if any. Diagnosis of cases of suspected oral leukoplakia requires differentiation with candidiasis, lupus erythematosus, syphilis and red lichen.
Leukoplakia Treatment
Since this disease often occurs due to poor teeth or prostheses, it is first necessary to eliminate the source of mucosal irritation. If the cause of leukoplakia is caries, an uncomfortable filling or dentures, you should immediately consult a dentist.
If leukoplakia of the oral mucosa is provoked by an internal disease, it is necessary to start its therapy. In addition, it is important to immediately take measures to improve the body and strengthen the body's immune forces, abandon bad habits and lead an active lifestyle. To choose the appropriate method for treating leukoplakia of the oral cavity, the doctor must take into account the nature of the symptoms, the form of the pathology, and its severity.
Therapy options
For productive treatment, hospitalization of the patient in the inpatient department will be required. The course of treatment includes taking medication and physiotherapy. With leukoplakia, such drugs are selected that are able to stop infectious processes and reduce inflammation. Mandatory is the local treatment of the oral cavity.
In order to speed up the start of regeneration processes, the affected surfaces of the lips and cheeks are treated with retinol-based oil solutions (vitamin A). These include "Carotoline" made from rose hips. Often, for the treatment of a simple form of the disease, its use is enough.
With verrucous and erosive leukoplakia, it rarely does without surgical intervention, which implies excision of the affected element, followed by sending the tissue for histology. Sometimes the removal operation is replaced by cryodestruction - freezing with the help of liquid nitrogen of the affected mucosa. With leukoplakia, other treatment methods are also used:
- Diathermocoagulation. This type of intervention allows you to rid the affected surface of keratinized plaques. On average, patients require about 10 procedures, after which the mucous membrane heals.
- Phototherapy. Atypical cells are destroyed at the time of exposure to a light wave.
How to treat tongue leukoplakia
When localizing an ailment in the tongue, first of all, the oral cavity is sanitized. Incorrectly installed prostheses and fillings are subject to correction or replacement, and teeth damaged by caries are subject to treatment and restoration. Affected areas of the mucosa are treated with antiseptic solutions and compounds that stimulate healing.
The flat form of leukoplakia of the oral cavity (in the photo above) is treatable. The characteristic plaque is disposed of with a laser or radio waves. If the disease is benign, then the course of treatment will consist of no more than 7-10 physiotherapy procedures. With malignant leukoplakia of the oral cavity, therapy is carried out in two stages - first, the patient is operated on, and then chemotherapy and radiation therapy are performed.
At the end of treatment, the patient should remain under the outpatient supervision of specialists for a long time. Leukoplakia is characterized by a recurring course, so the symptoms of the disease can appear over the next years.
Is it possible to cope with the disease at home
If you find signs of oral leukoplakia, treatment should be started immediately. The first step in the fight against this disease should be strict hygiene:
- You need to monitor not only the condition of the teeth, but also the health of the gums, tongue.
- You may need to change your toothbrush - its bristles should be of moderate stiffness.
- The cleaning itself must be carried out smoothly, without excessive intensity.
- After eating, it is advisable to always use mouthwashes with an antibacterial and regenerative effect.
Even if you do not have the opportunity to get an appointment with a doctor, antiseptic treatment of foci of leukoplakia will not harm you. Chlorhexidine can be used to irrigate the oral cavity, and Furacilin solution can be used to rinse.
In addition to the drugs prescribed by specialists, folk remedies can also be used. With leukoplakia, anti-inflammatory decoctions of chamomile, sage, and calendula help. Some patients advise using Kalanchoe juice or sea buckthorn oil to lubricate the affected areas. Such funds do not have side effects and contraindications, with the exception of individual intolerance.
Leukoplakia prognosis
In the first stages, the disease has a favorable prognosis. Patients in whom leukoplakia was diagnosed in a timely manner have a good chance of recovery, after which adequate treatment was passed. To permanently get rid of the disease, it is important to neutralize the main influencing factor.
The prognosis for cancer of the oral cavity is less optimistic, but in general the outcome depends on at what stage of the disease the patient sought help. According to statistics, patients with the first stage of oral cancer in 80% of cases overcome the five-year survival threshold.