White Spots on Gums: Causes, Treatments, and When to See a Dentist

Have you noticed white spots or patches on your gums? While it can be alarming, many causes are common and treatable. This guide will help you understand the potential reasons for white spots on your gums, what to do about them, and when it’s essential to see a dentist.

Understanding Your Gums: Normal vs. Unusual

Healthy gums are typically pink and firm. While some natural pigmentation (brown or blackish spots) can be normal, especially in people with darker skin, distinct white spots or patches are usually a sign of an underlying issue. These can appear as:

• Small white dots or speckles
• Flat, whitish-gray patches
• A film or coating over the gums
• Raised white bumps or pimples

It’s important to note the size, shape, and duration of the spots, and whether they are painful. Any spot or sore that doesn't heal within two weeks should be examined by a dentist.

"Mouth sores or patches that don’t heal within two weeks should be examined by a dentist to rule out any serious condition." - American Dental Association (ADA)

Common Causes of White Spots on Gums

Several conditions can lead to white spots on the gums. Here is a video overview of what these spots might mean, followed by detailed explanations of the most common causes.

1. Oral Thrush (Candidiasis)

What It Is: A fungal infection caused by an overgrowth of Candida yeast. Appearance & Symptoms: Creamy white, cottage cheese-like patches on the gums, tongue, and inner cheeks. These patches can often be wiped off, revealing a red, raw area that may bleed. You might also experience a cottony feeling in your mouth or a loss of taste. Causes & Risk Factors: A weakened immune system, recent antibiotic use, uncontrolled diabetes, wearing dentures, smoking, and dry mouth. Treatment: Antifungal medications, such as mouth rinses, lozenges, or pills, are prescribed by a doctor or dentist. Maintaining good oral hygiene is also crucial.

• Learn More: Search for information on oral thrush on Mayo Clinic

2. Canker Sores (Aphthous Ulcers)

What It Is: Small, painful ulcers that form inside the mouth. They are not contagious. Appearance & Symptoms: Round or oval spots that are white or yellowish in the center with a red border. They are typically painful, especially when eating spicy or acidic foods. Causes & Risk Factors: Triggers include minor injuries (like biting your gum), stress, hormonal changes, nutritional deficiencies (iron, B12, folate), and sensitivity to certain foods or toothpaste ingredients (SLS). Treatment: Canker sores usually heal on their own in 1-2 weeks. To manage pain, you can use over-the-counter anesthetic gels or warm salt water rinses. For severe cases, a dentist may prescribe a steroid ointment or rinse.

3. Leukoplakia

What It Is: White or grayish patches in the mouth that cannot be scraped off. Leukoplakia is often a reaction to chronic irritation and can sometimes be precancerous. Appearance & Symptoms: Thickened, hardened white patches that are usually painless. They can appear on the gums, tongue, or inner cheeks. Causes & Risk Factors: Tobacco use (smoking or chewing) is the most significant risk factor. Heavy alcohol consumption, especially with tobacco, also increases risk. Chronic irritation from rough teeth or ill-fitting dentures can be a cause. Treatment: The first step is to remove the source of irritation (e.g., quit tobacco). A dentist will monitor the patch and may perform a biopsy to check for abnormal cells. If precancerous changes are found, the patch must be surgically removed.

• Learn More: Search for leukoplakia information on Cleveland Clinic

4. Oral Lichen Planus

What It Is: A chronic inflammatory condition, thought to be autoimmune, that affects the mucous membranes of the mouth. It is not contagious. Appearance & Symptoms: The most common form appears as lacy, web-like white streaks on the gums and inner cheeks. This form is often painless. Other forms can cause red, swollen, or painful sores. Causes & Risk Factors: The exact cause is unknown, but it's linked to an immune response. Stress and genetics may play a role. Treatment: If there are no symptoms, treatment may not be needed beyond regular monitoring. For painful sores, a dentist may prescribe topical corticosteroids (rinses or gels) to reduce inflammation.

• More Information: Search for resources on Oral Lichen Planus from the American Academy of Oral Medicine

5. Local Irritation or Injury

What It Is: A temporary white patch caused by physical or chemical irritation. Appearance & Symptoms: A localized white spot or ulcer at the site of an injury, such as a burn from hot food, a bite, or irritation from dental appliances or harsh mouthwash. The area is often sore. Causes & Risk Factors: Common causes include pizza burns, biting your gum, or chemical irritation from tooth-whitening gels or placing aspirin directly on the gum. Treatment: These injuries typically heal on their own within one to two weeks. Gentle salt water rinses can help keep the area clean. Avoid further irritation by eating soft foods.

6. Gum Abscess (Gum Boil)

What It Is: A pimple-like bump on the gum that signals an underlying bacterial infection from an abscessed tooth or gum disease. Appearance & Symptoms: A raised bump on the gum, often with a white or yellow center containing pus. It may be accompanied by a toothache, swelling, and a bad taste in the mouth. Sometimes, a chronic abscess can drain with little to no pain. Causes & Risk Factors: An untreated cavity, cracked tooth, or severe gum disease can lead to an abscess. Treatment: This requires immediate dental care. A dentist will treat the source of the infection, which may involve a root canal, tooth extraction, or deep cleaning of the gums. Do not try to pop a gum abscess yourself.

• Learn More: Search for information about dental abscesses on WebMD

7. Oral Cancer

What It Is: While rare, a persistent white or red-and-white patch on the gums can be a sign of oral cancer or a precancerous lesion. Appearance & Symptoms: A white or red patch that is thick, hard, or ulcerated and does not heal. Early lesions are often painless. In advanced stages, it can cause pain, loose teeth, or bleeding. Causes & Risk Factors: Major risk factors include tobacco use and heavy alcohol consumption, especially in individuals over 45. Certain strains of HPV are also a risk factor for some oral cancers. Treatment: If cancer is suspected, a biopsy is necessary for diagnosis. Treatment typically involves surgical removal of the cancerous tissue, possibly followed by radiation or chemotherapy. Early detection is critical for a better prognosis.

When to See a Dentist or Doctor

You should seek professional evaluation if you experience any of the following:

• A white spot or patch that lasts for more than two weeks.
• Significant pain, swelling, or signs of infection like pus.
• Difficulty eating, swallowing, or opening your mouth.
• White spots that are spreading to other areas of your mouth.
• A white patch accompanied by fever, weight loss, or swollen lymph nodes.
• You have risk factors for oral cancer (e.g., you are a smoker) and notice a new patch.

Prevention Tips for Healthy Gums

While not all causes are preventable, you can reduce your risk with these habits:

• Practice Excellent Oral Hygiene: Brush twice a day, floss daily, and use a fluoride toothpaste.
• Get Regular Dental Check-ups: Visit your dentist for cleanings and oral cancer screenings.
• Avoid Tobacco: Do not smoke or use chewing tobacco.
• Limit Alcohol: Moderate your alcohol consumption.
• Eat a Balanced Diet: A diet rich in vitamins and minerals supports a healthy immune system and oral tissues.
• Manage Stress: Stress can trigger canker sores and lichen planus flare-ups.
• Stay Hydrated: Drinking water helps maintain saliva production, which protects your mouth from infections.

---

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified dentist or healthcare provider for any health concerns or before making any decisions related to your health or treatment.