Causes Although the cause of leukoplakia is unknown, chronic irritation, such as from tobacco use, including smoking and chewing, appears to be responsible for most cases. Often, regular users of smokeless tobacco products eventually develop leukoplakia where they hold the tobacco against their cheeks. Other causes may include chronic irritation from: Jagged, broken or sharp teeth rubbing on tongue surfaces Broken or ill-fitting dentures Long-term alcohol use Your dentist can talk with you about what may be causing leukoplakia in your case. Hairy leukoplakia Hairy leukoplakia results from infection with the Epstein-Barr virus (EBV). Once you've been infected with EBV, the virus remains in your body for life. Normally, the virus is dormant, but if your immune system is weakened, especially from HIV/AIDS, the virus can become reactivated, leading to conditions such as hairy leukoplakia. Risk factors Tobacco use, particularly smokeless tobacco, puts you at high risk of leukoplakia and oral cancer. Long-term alcohol use increases your risk, and drinking alcohol combined with smoking increases your risk even more. Hairy leukoplakia People with HIV/AIDS are especially likely to develop hairy leukoplakia. Although the use of antiretroviral drugs has reduced the number of cases, hairy leukoplakia still affects a number of HIV-positive people, and it may be one of the first signs of HIV infection.