White spots on the gums can have many different causes. These can range from mild issues to more severe health conditions.

The white spots may be accompanied by other symptoms such as pain or discomfort. The spots can occur individually or in a cluster.

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In this article, we address the causes and symptoms of white spots on the gums and list some treatment options.

What are the causes?

Some of the most common causes of white spots on the gums include:

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Canker sores

White spots on gums are often caused by mouth ulcers
The most common cause of white spots on gums are canker scores, more widely known as mouth ulcers.

Canker sores develop on the soft tissues of the mouth and around the gums. Also known as mouth ulcers, they tend to:

  • be oval or round
  • have red edges
  • have a white or slightly yellow center

The cause is unclear, but they may be triggered by:

  • injury or irritation of mouth tissue
  • dietary deficiencies
  • bacteria
  • stress

Canker sores can be minor or major. Minor sores are relatively widespread and usually heal within 2 weeks. Major sores tend to be deeper and more painful and can take up to 6 weeks to heal.

People with canker sores that persist for more than 14 days should consult a doctor or dentist.

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Leukoplakia

Leukoplakia is characterized by thick, white patches in the mouth that cannot be scraped off with a toothbrush.

Doctors do not know what causes leukoplakia. But, it is likely that smoking or chewing tobacco contributes to its development. Ill-fitting dentures or long-term alcohol use may also cause leukoplakia.

Most cases of leukoplakia are benign, but some can be precancerous. However, it is areas with red lesions (erythroplakia) that are more likely to be cancerous or precancerous, according to the American Cancer Society.

Oral lichen planus

Oral lichen planus is an autoimmune condition that involves inflammation of the mucous membranes in the mouth. It tends to cause white, lacy patches.

There is no cure for oral lichen planus, but symptoms can be managed. Oral lichen planus can increase the risk of secondary infections and oral cancer. It can also cause nutritional deficiencies, as some people may avoid a variety of healthful foods that aggravate their symptoms.

As a result, people with oral lichen planus should organize regular check-ups with their doctor.

Oral thrush

This oral infection is caused by an overgrowth of the Candida fungus. It presents as slightly raised sores that are creamy white in appearance. They often have the texture of cottage cheese.

Babies and older adults are most commonly affected due to reduced immunity, but oral thrush can occur in anyone. People with uncontrolled diabetes or who are taking certain antibiotics are also more likely to get the infection.

What are the symptoms?

Symptoms that accompany white spots on the gums vary depending on the underlying cause.

Canker sore symptoms include:

  • red edges to the sores
  • stinging pain, especially when eating or talking
  • tingling or burning before onset

Leukoplakia patches may:

  • appear with red lesions (erythroplakia)
  • be flat or irregularly-shaped
  • get thicker or harden over time
  • lead to discomfort or pain when swallowing in severe cases, although it is not typically painful

Oral lichen planus symptoms include:

  • bleeding when eating or brushing the teeth
  • burning pain
  • open sores
  • redness
  • sensitivity to hot or acidic food
  • swelling
  • white, lacy patches in the mouth

Oral thrush may cause:

  • a cotton-like sensation in the mouth
  • cracking or bleeding at the corner of the mouth
  • creamy, white sores
  • irritation or pain under dentures
  • loss of taste
  • minor bleeding
  • pain
  • redness

People should see a doctor or dentist if they experience any of the above symptoms alongside white spots on the gums.

Diagnosis

Diagnosing white spots on gums
Visit a doctor or dentist if you have white spots and redness, bleeding or swelling of the gums.

A doctor or dentist will diagnose the cause of white spots on the gums by:

  • visual examination
  • medical history
  • blood tests
  • biopsy

Sometimes a doctor may take a small sample of tissue from oral lesions to diagnose oral lichen planus or to check for cancerous or precancerous cells associated with leukoplakia.

Treatment options

Treatment depends on the underlying cause.

Canker sores

Minor canker sores typically resolve within 1 to 2 weeks. Major canker sores often require treatments such as:

  • oral rinses, ointments, and gels
  • pain-relieving medication
  • salt water rinses

A doctor can treat severe cases by sealing the sores or prescribing oral steroids. Lasers can also help to reduce pain and promote faster healing.

Leukoplakia

Doctors will advise people with leukoplakia to stop using tobacco products, as these contribute to the condition. The white patches may be removed with a scalpel, laser, or frozen off.

If a weak immune system causes the condition, a doctor may prescribe antiviral medications.

Oral lichen planus

There is no cure for this condition, so treatment aims to reduce symptoms and improve quality of life. Treatment can include corticosteroids for inflammation and numbing gels to reduce pain.

Oral thrush

Doctors usually prescribe an antifungal medication for oral thrush. It is available as a tablet, lozenge, or rinse. Persistent or widespread Candida infections may require a stronger antifungal medication.

Prevention

Preventing white spots on gums
Maintaining good oral hygeine by brushing your teeth, flossing and using mouthwash on a daily basis may be the best prevention method.

The best method of prevention is good oral hygiene.

Suggestions include:

  • brushing twice daily, flossing once a day, and using a mouth rinse
  • using oral hygiene products that are free of sodium lauryl sulfate, as this can contribute to canker sore development
  • avoiding using a very firm toothbrush as it may irritate the gums and soft tissues in the mouth
  • visiting a dentist for regular check-ups and cleanings
  • using a tongue scraper to remove plaque, food particles, and bacteria from the tongue
  • practicing stress-reducing techniques, such as exercise, meditation, and progressive muscle relaxation
  • eating a balanced diet and limiting the intake of sugar, salt, and alcohol
  • avoiding the use of tobacco and any products containing it
  • addressing underlying health conditions promptly

Takeaway

The outlook for people with white spots on the gums depends on the underlying cause, the overall health of the person, and how quickly a person received treatment.

Careful monitoring and regular dental screenings can ensure oral conditions get prompt treatment. Early detection can prevent the problem from progressing and may reduce the risk of complications.

If anyone notices white spots or any other mouth sores that do not disappear within 2 weeks, it is essential they schedule an appointment with a doctor or dentist.