Removal of persistant leukoplakia can be done with a laser without too much discomfort, and in some people this will resolve the issue... in others it comes back again. As to why, no one knows for sure. If you are not going to go this route, routine short time span exams I think are a must. Not all leukoplakias continue transformation into malignancies, but some do. An oral surgeon would be the doc to see if you want it lasered off. The laser takes off the top few layers of cells, and there is no real stiching, the wound caused by it heals by what they call " secondary intent," meaning it just developes new tissue on top all on it's own.

Brian, stage 4 oral cancer survivor. OCF Founder and Director. The first responsibility of a leader is to define reality. The last is to say thank you. In between, the leader is a servant.