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Other factors that might play a role in the development and progression of leukoplakia include: human papillomavirus (HPV), which might increase the riskof leukoplakia becoming oral cancer poor oral hygiene repeated cheek or tongue biting excessive alcohol use chewing certain nuts and leaves, such as betel leaf and areca nut Hairy leukoplakia, which is another type of leukoplakia, is common among people with weakened immune systems

High incidence of DNA ploidy abnormalities and increased Mcm2 expression may predict malignant change in oral proliferative verrucous leukoplakia

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