Precancerous conditions of the mouth

Precancerous conditions of the mouth are changes to cells of the mouth that make them more likely to develop into cancer. These conditions are not yet cancer. But if they aren't treated, there is a chance that these abnormal changes will become oral cancer.

The most common precancerous condition of the mouth is oral epithelial dysplasia.

Oral epithelial dysplasia is an abnormal change in the lining of the mouth (the oral mucosa). This condition can look like white or grey patches (called leukoplakia) or red patches (called erythroplakia). These patches may be a harmless change in your mouth. But they may also be dysplasia or they may be a sign that cancer has developed in the mouth.

Leukoplakia is a white or grey area in the mouth that is not easily scraped off. It can develop on the tongue, the inside of the cheek, the gums or the floor of the mouth.

Erythroplakia is a smooth or raised red area or group of red spots that easily bleeds if scraped. It can develop on the tongue, inside of the cheek or floor of the mouth.

A combination of erythroplakia and leukoplakia is also possible. This mixture of red and white patches on the lips or in the mouth is called erythroleukoplakia.

Anyone can develop dysplasia in their mouth. Smoking tobacco heavily, chewing tobacco and excessive alcohol use all increase your risk.

Oral epithelial dysplasia is usually diagnosed by a punch or incisional biopsy. A punch biopsy uses a sharp tool called a punch to remove cells from an abnormal area, while an incisional biopsy uses a surgical knife (scalpel). The cells are looked at under a microscope to find out more about them. Find out more about a punch biopsy and an incisional biopsy.

The risk of dysplasia becoming oral cancer is based on how different the abnormal cells are in shape, size and appearance compared to normal mouth cells. It is graded as mild, moderate and severe. Sometimes it is graded as high grade or low grade.

Leukoplakia and erythroplakia are usually removed by surgery. They are sometimes managed by active surveillance. This means that your healthcare team watches your condition closely for any changes. They will use regular tests, such as a biopsy, and exams to find any cancerous change early.

To reduce your risk that oral epithelial dysplasia will develop into oral cancer, you can avoid using tobacco and avoid drinking alcohol.

The following are less common precancerous conditions of the mouth. These are usually diagnosed after an oral exam or biopsy. Treatment will depend on the symptoms, the type of precancerous condition and the risk that it will become cancer.

Oral submucous fibrosis is a thickening of the oral mucosa that may cause it to feel hard and stiff. It is most often caused by chewing betel quid (areca nut).

Proliferative verrucous leukoplakia (PVL) is a rare type of leukoplakia that can cause white or grey areas throughout the mouth that may look like warts. It is usually removed by surgery.

Oral graft-versus-host disease (GVHD) can happen after an allogeneic stem cell transplant. An allogeneic transplant uses stem cells from someone else (a donor) instead of your own stem cells. The stem cells from the donor develop into a new immune system that will identify and destroy cancer cells. But it can also attack your healthy cells and damage tissues and organs. Oral GVHD can cause sores, dry mouth and pain in the mouth.

Lichen planus is an inflammatory condition that can affect the mouth. It shows up as white lines that look like branches throughout the affected area. Sometimes it can also cause painful sores in the mouth. Corticosteroids and medicated mouthwashes are used to treat oral lichen planus.