White spots on gums can be a cause for concern. While some are benign and resolve without intervention, others may signal an underlying health issue.
Understanding these differences helps determine when professional evaluation is necessary. This article explores various causes of white spots on gums.
Appearances That Are Harmless
Some white spots on the gums are common and do not indicate a serious problem. In infants, white spots can sometimes be milk remnants after feeding, which are easily wiped away. White or pale areas can also be observed when teeth are about to emerge, particularly in babies or young children, as the erupting tooth causes the gum tissue to appear lighter.
Fordyce granules are another benign presentation, appearing as small, yellowish-white spots. These are visible sebaceous glands that can occur on oral mucosa, including the gums, and are considered a normal anatomical variation. Newborns may also exhibit small, harmless cysts on their gums or the roof of their mouth, known as gingival cysts of the newborn (Epstein pearls or Bohn’s nodules). These typically resolve on their own within a few weeks or months after birth.
Conditions That Warrant Concern
White spots on gums can sometimes be a symptom of conditions requiring professional attention. Oral thrush, or candidiasis, is a fungal infection that often appears as creamy white, slightly raised patches on the gums or other areas of the mouth. These patches may resemble cottage cheese and can sometimes bleed if scraped.
Oral lichen planus is a chronic inflammatory condition that can manifest as white, lace-like patterns on the gum tissue. It may also present with red, swollen areas or open sores. Leukoplakia involves thickened, white patches that cannot be easily scraped off the gums, tongue, or inner cheeks. These patches can be flat, rough, or slightly raised and may indicate precancerous changes. Herpes simplex virus (HSV) infection can lead to cold sores or canker sores, which may appear as white or yellowish spots or ulcers on the gums. Aphthous ulcers, or canker sores, are small, painful lesions with a white or yellowish center surrounded by a red border. Additionally, white spots can result from trauma or irritation, such as from biting the gum or ill-fitting dental appliances.
Accompanying Signs and When to Seek Advice
Observing white spots on the gums, especially alongside other changes, can indicate a need for professional evaluation. Pain, burning sensations, or bleeding from the affected area are important signs. Swelling, difficulty eating or swallowing, or a persistent cottony feeling in the mouth also warrant attention. White spots that spread, change in size or color, or do not disappear within one to two weeks should prompt a visit to a dentist or doctor.
Any white spots accompanied by systemic symptoms, such as fever, should also be assessed by a healthcare professional. Persistent soreness, unusual dryness, or a bad taste that does not resolve are additional indicators.
Professional Diagnosis and Care
When white spots on the gums are concerning, a dental professional will conduct a thorough oral examination and review the individual’s medical history. Further diagnostic steps might include taking a small tissue sample for a biopsy, especially if conditions like leukoplakia or oral lichen planus are suspected.
Care for white spots on gums depends entirely on the underlying cause. Benign conditions may only require observation or improved oral hygiene practices.
Fungal infections like oral thrush are typically treated with antifungal medications, which can be in the form of rinses, gels, or tablets. Inflammatory conditions such as oral lichen planus might be managed with topical corticosteroids to reduce discomfort.
For white spots caused by trauma, removing the source of irritation is often the first step, allowing the tissue to heal. Precancerous lesions, like some forms of leukoplakia, may require monitoring or surgical removal to prevent progression.