The white spots on gums that may have left you worried bear the name of leukoplakia patches. Our gums cover the alveolar part of the mandibular and the lower part of the teeth. It is one of the most important tissues in our body, yet it is often neglected. Because of this, we may develop several dental conditions throughout our lives, some more serious than others.
You may be asking, “What are the white spots on my gums?” In this article, we will expand on the subject of leukoplakia, going through the symptoms, causes, treatment, and prevention measures. Although they are more often not dangerous, these white spots may point to a life-threatening underlying condition. The risk may lie in some harmful habits which we must eliminate as soon as possible.
What Are These White Spots on Gums?
The white spots on gums that some people develop are symptoms of oral leukoplakia. The word itself – leukoplakia – means “white patch”. This condition is not limited only to the oral cavity (inner cheek, tongue, and gums). These areas of keratosis (a growth of keratin) may appear in gastrointestinal tract mucosal sites or on the mucosal surfaces of the genitals and the urinary tract.
These white spots on gums can occur at any time, but it is more likely for senior adults to develop them. Most cases are found in men, but women can suffer from leukoplakia as well. The condition is relatively uncommon in individuals under the age of 40, but it has been observed in younger people as well.
The discolored patches are one of the symptoms of leukoplakia. They can be white or grey and can appear as a thick, raised surface.
Some people develop hairy leukoplakia. This form of the condition is mostly found with HIV or AIDS patients. Specialists believe that it may be one of the first signs of HIV infection. Although it is more common among people with HIV, it was also found among chemotherapy patients, transplant recipients, or people with other immunodeficiency issues. Consequently, it is often viewed as a sign that the person’s immune system is weakening. People with hairy leukoplakia may face a higher risk for a more threatening infection than those with the non-hairy form.
Why Do the White Spots Appear?
The white or gray patches appear as a symptom of leukoplakia. This condition is quite mysterious, in the sense that specialists have yet to grasp the mechanisms behind it fully. The exact causes of leukoplakia are still unknown. However, the generally accepted concept links the condition to tobacco use. Smoking tobacco is the most common cause of leukoplakia, but chewing the product can have the same consequences.
Heavy use of alcohol is also thought to be a risk factor for these white spots on gums. Heavy drinkers stand a higher chance to develop leukoplakia than non-drinkers. To lower your chances of developing serious health conditions, do not drink more than the recommended daily limit for alcohol consumption. This means 3 to 4 units of alcohol for men and 2 to 3 units of alcohol for women.
A common cause of white spots on gums is Canker sores. Although they usually start as red bumps, canker sores have a yellow or white spot at the center which is surrounded by a red border. They are accompanied by stinging pain, which can be aggravated when eating or drinking, especially if it is something acidic.
Other possible causes include frictional keratosis (caused by misaligned teeth or poorly fitted dentures), oral lichen planus (a non-infectious rash), oral candidiasis (also known as oral thrush), and vitamin A or B deficiency. The human papillomavirus is currently being investigated as a possible risk factor, as some specialists suggest it may cause leukoplakia.
How Can We Diagnose the Condition?
Leukoplakia is clinically diagnosed by a specialist during an oral exam by looking at the lining of the mouth. The doctor will also review the patient’s medical history and ask questions regarding their lifestyle.
Oral Leukoplakia Types
Based on their malignant potentials, clinically, oral leukoplakia is divided into two categories:
- Homogenous oral leukoplakia consists of uniform white patches, prominent in the lining of the mouth and is usually not malignant.
- Verrucous oral leukoplakia is small white nodules on smooth, red tissue of tongue, cheek, palate, or gums. This condition is rare and is a transition between leukoplakia and erythroplakia (or erythroplasia), which is more prone to become malignant.
Many people tend to mistake the white spots on gums for oral thrush. Also called oral candidiasis, thrush is an infection of the mouth that causes white patches inside the mouth similar to those of leukoplakia. However, they are usually softer and may bleed easier. This is why it is important you consult a doctor to determine if you have leukoplakia or another infection of the oral cavity.
To confirm the diagnosis, the specialist may recommend running a few tests to determine a possible cause. If the white patches look suspicious, the doctor will do a biopsy and send the tissue sample to the pathologist. This is done to rule out the possibility of oral cancer.
How Do We Treat Leukoplakia?
The treatment for leukoplakia depends on the result of the biopsy. If the results do not indicate abnormal cells, the following measures must be taken to get rid of the white spots on gums. Remember that any form of treatment is most successful when the symptoms are found early on. This is why it is important not to neglect signs such as white spots inside the mouth. Address your dentist and start the treatment as soon as possible.
Smokers and tobacco users must break these bad habits. This is the most effective treatment for leukoplakia caused by nicotine addiction. Not only will giving up tobacco clear the patches on the gums, but it may also lower the risk of developing mouth cancer.
Another form of treatment means giving up alcohol. This may reduce the size of the white spots on gums, and it may even help eliminate them completely. This, too, can reduce the risk of having the condition progress into mouth cancer. Those who find it hard to moderate their drinking can rely on counseling services. A general practitioner can also offer solutions to help patients quit drinking and smoking.
A doctor may also recommend the following more invasive methods of treating leukoplakia:
If the specialist believes that the patches may result in malignant transformation and increase your risk of developing oral cancer, then having surgery to remove them is the best solution. By removing the abnormal cells in the gum and other areas that may have been affected, the risk of cancer may be greatly reduced.
Dentists use various techniques to remove the white patch, including the traditional scalpel, or laser and cryotherapy. All procedures require using a local anesthetic, thus are not painful.
After the surgery, the area should heal quickly. However, be aware of the possible risk of infection. Proper dental hygiene is crucial. Your dentist will most likely schedule a series of follow-ups to check for possible signs of recurrence.
While there is yet a specific medicinal treatment for leukoplakia, some specialists may recommend a few alternatives. Some patients receive antifungal medicines. They may help eliminate the infection within the white spots on gums in patients where leukoplakia is associated with Candida.
Some doctors proposed retinoids and vitamin A-containing medicines, but there is not enough evidence to point to their effectiveness.
Oral hairy leukoplakia is usually cured with antiviral medicine. These help the patches disappear. Antiviral drugs include valacyclovir and famciclovir, both preventing the Epstein-Barr virus from reproducing. Specialists may recommend topical ointments with retinoic acid to reduce the size of the patch. These ointments include tretinoin and podophyllum resin solution.
However, once stopping the treatment, these hairy patches may return. Because of this, your doctor may recommend frequent follow-up visits to monitor the changes and prevent the symptoms from reappearing.
What Is the Outlook?
Leukoplakia is not life-threatening as long as it is not related to oral cancer or HIV and AIDS. The white spots on gums do not damage the oral cavity, and the lesions usually heal on their own once you eliminate the source of irritation (such as alcohol and tobacco). Most cases are curable, but it has also been documented that one in three lesions will eventually grow back. Which is why we recommend periodic re-evaluation.
There is no evidence that leukoplakia ultimately leads to mouth cancer, but the risk factors for this condition are the same risk factors for mouth cancer. Consequently, it is not unlikely for leukoplakia to form alongside oral cancer.
How Can We Prevent Oral Leukoplakia?
Unfortunately, oral leukoplakia is not always preventable. However, many cases may be prevented by simply making some behavioral changes. As already discussed, stopping tobacco use and reducing the alcohol intake are the first steps in both treating and preventing the condition. But there are other ways we can try to stop the development of leukoplakia.
Seek correction for poorly fitting dentures. They may irritate the gums and can cause white spots.
Additionally, eat antioxidant-rich foods because they can help deactivate the irritants responsible for the lesions. Common foods rich in beta-carotene include carrots, squash, spinach, pumpkin, cantaloupe, and other orange, dark yellow, and green vegetables and fruits.
Last but not least, have regular check-ups because a specialist can point to the health conditions you may begin forming early on.
Contact your dentist as soon as you see white spots on the gums or other tissue inside the mouth. This is a sign of leukoplakia. The sooner you find the condition, the better the chances to keep the discolored patches from getting worse. Once cured of leukoplakia, it is crucial you make follow-up appointments. The chances of recurrence are high, which is why you must take all the prevention measures required to stop the condition from recurring.