White Spots on Gums That Hurt: Causes, Treatment and Prevention

Understanding White Spots on Gums That Hurt

White spots on the gums can be concerning. After all, the appearance of new spots or lesions in the mouth often raises questions about what’s causing them and whether they’re signs of something more serious. If you have a white spot on your gums that hurts, you may be wondering what it is and what to do about it.

The good news is that in most cases, white spots on gums are benign. Often, they’re simply canker sores—small, painful ulcers that can pop up inside the mouth. Canker sores are very common, affecting about 20 percent of people. They’re usually nothing to worry about and clear up on their own within a couple of weeks.

But occasionally, white spots and lesions on the gums can indicate something more serious. That’s why it’s important to monitor them closely and see a dentist or doctor if they don’t go away within a few weeks. Let’s take a closer look at some of the potential causes of white spots on gums.

Canker Sores

Canker sores are one of the most common reasons for white spots on the gums that cause pain and discomfort. These small white or yellowish ulcers with reddened bases tend to develop on soft tissues in the mouth, including the gums, inner cheeks, lips, and tongue.

Canker sores first appear as a burning or tingling sensation. Within a day or two, they form into round or oval ulcers with white or grayish centers surrounded by a red margin. The sores may be quite painful and can make eating, drinking, and talking uncomfortable.

Researchers aren’t entirely sure what causes canker sores. Potential triggers include:

Stress
Hormonal changes
Food sensitivities
Nutritional deficiencies
Minor mouth injuries
Toothpastes and mouthwashes

Canker sores usually heal on their own within 7-10 days without scarring. Rinsing the mouth with salt water may help relieve pain and speed healing. Over-the-counter pastes and gels containing active ingredients like benzocaine or hydrocortisone can temporarily numb pain.

Oral Thrush

Oral thrush is a yeast infection caused by an overgrowth of Candida fungus in the mouth. It appears as white patches or spots on the gums, inner cheeks, tonsils, tongue, lips, and roof of the mouth. These spots may bleed if scraped.

Thrush can cause irritation, a cottony sensation in the mouth, loss of taste, and pain. It tends to develop in people with weakened immune systems, diabetes, poor oral hygiene, dry mouth conditions, or those using inhaled corticosteroids.

Anti-fungal medications like nystatin or fluconazole are used to treat thrush. Practice good oral hygiene, avoid sugary foods, control chronic conditions like diabetes, and address causes of dry mouth to help prevent oral thrush from recurring.

Leukoplakia

Leukoplakia appears as white patches, spots, or plaque deposits on gums, cheeks, or tongue. These thick, raised lesions can’t be scraped off and sometimes develop after irritation. Leukoplakia is associated with excessive smoking and alcohol use.

Most cases of leukoplakia are harmless. But approximately 5 percent of lesions show early precancerous changes in cells. Leukoplakia also sometimes develops along with oral lichen planus, another condition that affects the skin and mucous membranes.

Since precancerous changes are possible, it’s important to have a dentist evaluate any unusual white spots on gums. Leukoplakia lesions that have precancerous properties may be removed. Quitting tobacco, limiting alcohol use, and improving dental care habits may help reduce leukoplakia.

Oral Lichen Planus

Oral lichen planus is a chronic condition that causes white or gray lines, spots, or patches on the inner cheeks, gums, tongue, lips, or roof of the mouth. These lesions may resemble lace. They are usually bilateral, meaning they develop on both sides of the mouth.

Oral lichen planus sometimes causes a burning sensation or pain. Severe cases can make eating and tooth brushing difficult. The condition may occur alone or alongside skin lesions.

Doctors aren’t sure what triggers lichen planus, but immunity issues may play a role. There’s no cure, but steroid medications, topical gels, anti-inflammatory drugs, and other treatments can provide relief.

Leukoedema

Leukoedema refers to a harmless condition that causes white patches or spots on the mucous membranes of the mouth, often on the inner cheeks. These thin, grayish white lines, spots, or cloudy patches represent epithelial cells packed with keratin.

Leukoedema is painless and requires no treatment. It’s sometimes mistaken for early signs of cancer. Biopsies of leukoedema lesions show benign changes in epithelial tissues.

While leukoedema may look alarming, it’s not dangerous and poses no health risks. But it’s still a good idea to point out any unusual spots on gums to your dentist so they can be evaluated and monitored.

Actinic Cheilitis

Actinic cheilitis primarily affects the lower lip, but may also cause white patches and spots on the gums. This precancerous condition is caused by long-term sun exposure and tends to appear like chapped lips that don’t heal.

It causes scaling, flaking, erosions, and roughness on the vermilion border between the lip and gums. Actinic cheilitis can progress to squamous cell carcinoma without treatment, so see your healthcare provider about any stubborn lip or gum lesions.

Necrotizing Ulcerative Gingivitis

Necrotizing ulcerative gingivitis (NUG), also called trench mouth, causes painful, bleeding gums, bad breath, and white patches or spots on the gums that may resemble ulcers. NUG is an infection, usually triggered by high stress, poor nutrition, and lack of sleep.

Along with white spots on the gums, NUG can also lead to redness, swelling, and pain. Telltale signs include gums that bleed easily and halitosis. NUG is treated with antibiotics, antiseptic mouth rinses, and improved oral hygiene habits.

Oral Cancer

In rare cases, white spots, patches, or lesions on the gums may indicate oral cancer. Oral cancer can develop on the lips, gums, inner cheeks, tongue, palate, tonsils, or throat. The condition is linked to tobacco use and frequent alcohol consumption.

Early oral cancer may be painless. Later, it can cause soreness, numbness, or tenderness in the mouth. Other signs include sores, lumps, rough spots, or tissue changes on the lips, gums, or cheek lining.

See a dentist or doctor immediately if you notice any unusual spots, especially those that linger for more than 2 weeks. Catching oral cancer early greatly improves treatment success.

When to See a Healthcare Provider

While white spots on the gums are usually harmless canker sores, it's important to monitor them closely. See a dentist, doctor, or oral medicine specialist promptly if you notice any of the following:

Spots or lesions that don't start healing within 2 weeks
Spots that worsen or grow larger over time
White, gray, or red patches that can't be wiped away
Chronic pain, bleeding, or inflammation in the mouth
Numbness or swelling in the mouth that persists
Sensitive spots that don't respond to antiseptic rinses or OTC remedies
Digestive issues like trouble swallowing or pain while eating

Severe, widespread symptoms may require a biopsy to check for cancer. Quickly diagnosing and treating any underlying condition can help prevent progression and long-term complications.

Preventing White Spots on Gums

While white spots and lesions in the mouth sometimes arise spontaneously, you can take steps to keep your gums healthy and lower your risk of developing sores or patches:

Practice good oral hygiene: Brush teeth twice a day, floss daily, and rinse with antiseptic mouthwash to remove debris and plaque that could cause gum irritation.
Have professional cleanings: Get dental checkups and cleanings every 6 months to keep gums free of tartar that can lead to disease.
Monitor oral health: Routinely check your gums and mouth for any abnormal spots, growths, or color changes and point these out to your dentist.
Quit smoking tobacco: Tobacco use is a risk factor for leukoplakia, gum disease, and oral cancer.
Limit alcohol: Heavy alcohol consumption is linked to precancerous mouth lesions.
Manage stress: Chronic stress can make you more prone to canker sores and gum infections.
Eat a balanced diet: Proper nutrition supports immune health and keeps your gums in good condition.

Talk to your dentist about any concerns you have about spots on your gums. With their help, you can keep your mouth healthy and catch any problems early. Prompt treatment can resolve gum lesions before they progress.

FAQs

What causes white spots to appear on my gums?

The most common causes of white spots on the gums are canker sores, oral thrush, leukoplakia, and other benign conditions. More serious causes like oral cancer are rare. See your dentist if spots don't heal within 2 weeks.

Are white spots on my gums something to worry about?

In most cases, white spots or patches on the gums are harmless canker sores that clear up on their own. But it's important to have a dentist examine any spots or lesions that linger to rule out precancerous changes.

How can I get rid of white spots on my gums?

For canker sores, rinse with warm saltwater and use OTC numbing gels until they heal. For fungal thrush, see your doctor for antifungal medication. Leukoplakia may be monitored or removed. See a dentist for proper diagnosis and treatment.

What does it mean if I have chronic white spots on my gums?

Recurring white spots could indicate an underlying condition like oral lichen planus. It may also signal habits like smoking or poor oral hygiene that contribute to leukoplakia or gum disease. See your dentist to determine the cause.

When should I see a dentist about white spots on my gums?

See a dentist promptly if you have spots that last longer than 2 weeks, are worsening, can't be wiped away, or cause chronic pain or discomfort. This allows early treatment of any underlying condition before it worsens.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.