White line( linea alba )
This is a white line that extends from the corner of the mouth to the back teeth. This white line can occur because of pressure, friction or irritation. Linea alba occurs along the chewing surface of the teeth on both the cheeks. This condition may disappear spontaneously in some.
Frictional white plaque
Also known as frictional keratosis, the condition is related to mechanical irritation due to an identifiable source like rough or maladjusted dentures or sharp cusps and edges of broken teeth.The lesion resolves on removal of the offending agent.
Cheek chewing is common in people who are under stress or in psychological situations in which cheek and lip biting becomes habitual. The traumatised area becomes thickened and appears paler then the surroundings. Most people are aware of the habit but do not associate it with their lesions. For those unable to stop the chewing habit, but desiring treatment, a plastic occlusal night guard may be fabricated.
Chemical injuries in the mouth
Agents like aspirin, silver nitrate, formacresol, sodium hypochlorite, paraformaldehyde, hydrogen peroxide, denitrifies and mouthwashes containing alcohol and chlorhexidine can cause burning of the mouth. These injuries appear as a thin layer of white coating that can be painful. Most superficial burns heal in 1-2 weeks time.
Solar Kertosis ( cheilitis )
This lesion occurs due to prolonged exposure to sun and usually occurs on the lower lip. The surface is crusted and rough to touch. Generally a harmless lesion, regular followup with a health care professional is required.
Snuff dipper’s keratosis or Tobacco pouch keratosis
Also called smokeless tobacco keratosis, habitual chewing of tobacco leaves or dipping snuff results in a white patch in the area of tobacco contact. Smokeless tobacco contains many cancer causing agents. The duration of exposure is critical in causing the damage to the soft tissues. Snuff ( fine powdered tobacco ) causes more damage than chewing tobacco. Tobacco chewing also causes cavities in the roots of teeth due to the loss of gum levels in the mouth. This is not a serious condition and the cessation of the habit makes the damaged area normal. However regular examination is recommended as the risk of the lesion becoming cancerous in chronic users is high.
Nicotine stomatitis or Smoker’s palate
Nicotine stomatitis is also called stomatitis nicotine palate or smoker’s palate. This is a diffuse white or grey discolouration of the hard and soft palate. This condition is relatively harmless because this condition is more due to the heat generated in smoking cigarettes or pipe rather than the chemicals in cigarette. “Reverse smoking” ( placing the burning end of the cigarette in the mouth ) is definetly dangerous. This condition is totally reversible once the habit is discontinued. The lesions resolve in 2 weeks of cessation of smoking. Follow up with a health care professional is recommended.
Sanguinaria induced white patch
Sanguinaria extract, obtained from the common bloodroot plant is used in the preparation of tooth pastes. Typically, the white patch is velvety, wrinkled or corrugated. Disuse of the products containing this chemical will reverse the lesion.