Precancerous changes in the mouth and oropharynx
Three different medical conditions can cause abnormal areas in the mouth or throat. They are harmless to begin with but, if left untreated, can turn into cancer in a small number of people. They are:
- leukoplakia
- erythroplakia
- erythroleukoplakia
What is leukoplakia?
Leukoplakia is a white patch in the mouth.
What is erythroplakia?
Erythroplakia is a red area in the mouth that bleeds easily.
What is erythroleukoplakia?
Erythroleukoplakia is an area of red and white patches in the mouth.
Can leukoplakia, erythroplakia or erythroleukoplakia turn into cancer?
These patches might be harmless. But they can also be precancerous and contain abnormal cells. These abnormal cells are called dysplasia. Dysplasia is not cancer. But if untreated, these might go on to develop into cancer.
Your doctor will take a sample of the cells (biopsy). This is sent to the laboratory where a 
looks for abnormal cells to find out what the patches are. The information from the biopsy helps them decide who might need treatment.
Precancerous changes are more common in erythroplakia and erythroleukoplakia than in leukoplakia. Most leukoplakia patches are not precancerous.
You should see your GP or dentist if you have a white patch or red area in your mouth that does not go away.
What causes leukoplakia, erythroplakia and erythroleukoplakia?
Risk factors for leukoplakia and erythroplakia are smoking, chewing tobacco and alcohol. It is also linked with badly fitting dentures that constantly rub your gums, or the inside of your mouth or tongue. In most cases, the cause is unknown (idiopathic).
People who have long term exposure to mouth infections, such as oral thrush, may also be at a higher risk of developing leukoplakia.
Treatment
No treatment
You might not need treatment. Your doctor will advise you to stop smoking and drinking alcohol. The patches may go away or get smaller if you stop smoking and reduce how much alcohol you drink.
Surgery and laser treatment
You might need treatment if you have dysplasia. This is because there is a risk that the patches might develop into mouth cancer. Your doctor might suggest surgery or laser treatment to remove the patches.
Regular checks
Patches that have no dysplasia, or mild dysplasia might not need treatment. Your doctor checks the area regularly, sometimes for many years. They look for:
- changes in the appearance of the patches
- new patches
You might need to have more biopsies.
Clinical trials
Your doctor might suggest taking part in a clinical trial.
More information
To decide what treatment you need, your doctor looks at the type, grade and stage of your cancer.
