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Linea alba - Oral Mucosal Lesion
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Linea alba - Oral Mucosal Lesion

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Contributors: Carl Allen DDS, MSD, Sook-Bin Woo MS, DMD, MMSc
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Synopsis

The linea alba ("white line") is a defined, linear area of hyperkeratosis and leukoedema that is caused by chronic very mild topical frictional injury and is located where the upper and lower teeth meet, on the buccal mucosa. Therefore, it is only seen where teeth are present.

It is present to a greater or lesser extent in every one but is more prominent in some persons.

Patients are generally unaware of its presence.

It may be accentuated in patients who have a chronic cheek biting habit. Extent of involvement is what divides a very prominent linea alba from chronic bite injury.

It is considered normal anatomy of the buccal mucosa and is present for years usually without progression.

Codes

ICD10CM:
L81.8 – Other specified disorders of pigmentation

SNOMEDCT:
280591001 – Linea alba

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Chronic cheek chewing (chronic bite injury) is a more extreme form of linea alba and generally shows accentuation of the linea alba as well as shaggy, irregular white papules and plaques that extend for several centimeters superiorly and inferiorly to the linea alba. It may also involve the lateral borders of the tongue and the lower labial mucosa.
  • Lichen planus has a reticular morphology and would not be confined to where the teeth meet.
  • Leukoplakia does not generally have such a clearly defined linear morphology.
  • Candidiasis does not generally have such a clearly defined linear morphology.

Best Tests

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Management Pearls

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Therapy

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References

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Last Updated: 01/04/2017
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Linea alba - Oral Mucosal Lesion
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Linea alba : Linear configuration, Oral white plaque
Clinical image of Linea alba
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