The exact cause of leukoplakia is unknown but it may develop as a result of substances irritating the tissue inside the mouth.
Despite the lack of definitive evidence confirming the causes of leukoplakia, research has identified a number of risk factors for its development.
Tobacco
The leading risk factor for leukoplakia is tobacco use. Smokers are five times more likely to get leukoplakia than non-smokers.
There is an even higher risk factor for people who use tobacco products such as chewing tobacco and snuff (a powdered form of tobacco that is snorted up the nose).
A number of herbal stimulants that are popular in the developing world have also been linked to leukoplakia. These include:
- Betel nuts: a mild herbal stimulant that is often chewed in combination with tobacco and is popular in Taiwan and north-east India.
- Khat: a herbal stimulant that is widely used in Somalia.
Studies have shown that regular users of betel nuts are 25 times more likely to develop leukoplakia than non-users.
Alcohol
After tobacco, the second leading risk factor for leukoplakia is heavy alcohol use. Heavy drinkers are eight times more likely to develop leukoplakia than non-drinkers.
Diabetes
People with diabetes (both type 1 and 2) are three times more likely to develop leukoplakia than people without diabetes. The reasons for this are currently unclear.
