Peeling gums, a symptom that can be alarming to experience, is clinically referred to as oral mucosal sloughing. This condition occurs when the delicate lining of the mouth, known as the oral mucosa, separates and sheds from the underlying tissue. Understanding the cause is the first step toward relief, as the triggers for this symptom can range from simple product irritation to complex underlying health issues.
Understanding Gum Sloughing
Gum sloughing is the physical shedding of the outermost epithelial layer of the gingiva. The symptom often presents as small, ragged pieces of white or gray tissue that detach, leaving the underlying gum tissue exposed. The exposed areas are typically raw, bright red, and can be tender or painful to the touch. Sloughing is a direct separation of a tissue layer, distinct from simple gum bleeding or recession. While it may look severe, the cause can frequently be traced back to a temporary irritant.
Irritants: Common Culprits in Oral Care Products
The most common cause of peeling gums is a chemical reaction to ingredients found in daily oral hygiene products. These irritants can disrupt the protective barrier of the oral mucosa, leading to a toxic or allergic response. The most frequent offender is Sodium Lauryl Sulfate (SLS), a detergent added to many toothpastes and mouthwashes to create a foamy lather.
SLS is a surfactant that can denature the protective proteins and strip away the mucin layer that naturally coats the gums. This chemical action reduces the tissue’s resistance to irritation, causing the superficial epithelial cells to detach and peel away. This reaction is often dose-dependent, meaning the higher the concentration of SLS, the more likely sloughing may occur.
Other ingredients that can cause irritation include harsh flavorings, particularly the aldehyde cinnamal, which provides a strong cinnamon taste. Strong alcohol content in mouthwashes can also dry out and irritate mucosal tissues, reducing their protective integrity. Furthermore, over-the-counter whitening products that contain high concentrations of peroxide can chemically burn the gums if they come into prolonged contact with the tissue.
When Peeling Gums Signal a Deeper Issue
When simple product changes do not resolve gum sloughing, the symptom may signal a systemic or autoimmune condition requiring professional diagnosis. One possibility is an allergic or adverse reaction to a medication, known as a drug-induced mucositis. Certain drug classes, including nonsteroidal anti-inflammatory drugs (NSAIDs) or specific antibiotics, can trigger a reaction that manifests as oral mucosal peeling.
Peeling gums can be the presenting sign of an autoimmune disease, where the body’s immune system mistakenly attacks its own oral tissues. Mucous Membrane Pemphigoid (MMP) is a blistering condition where autoantibodies target the proteins that anchor the outer gum layer to the tissue beneath it. This immune attack causes the outer layer to lift and shed, often leaving the gums bright red, raw, and ulcerated.
Oral Lichen Planus (OLP), a chronic inflammatory condition, can also cause sloughing, especially in its erosive form. OLP often appears as white, lacy patterns on the cheeks, but the erosive variant can lead to painful, red, and peeling gums that are highly sensitive to hot or spicy foods. Since these conditions can have serious complications, a professional diagnosis is necessary to manage the immune response and prevent chronic damage.
What to Do Next and When to See a Dentist
Immediately stop using any oral care products that contain known irritants. Switch to a bland, mild toothpaste that is specifically labeled as SLS-free, and avoid all mouthwashes containing alcohol or strong flavorings. This change often resolves the issue within a few days to a week.
While waiting for the gums to heal, maintain gentle oral hygiene using a soft-bristled toothbrush. Rinsing with a warm saline solution can soothe the raw tissues. Staying hydrated is also beneficial, as a dry mouth makes the oral mucosa more susceptible to irritation.
If the peeling persists beyond ten days after eliminating irritants, or if symptoms are severe, schedule an appointment with a dentist or periodontist. Immediate consultation is necessary if the peeling is accompanied by a fever, widespread sores outside the gum area, or other systemic symptoms. During the dental appointment, the professional will take a detailed patient history and may perform a biopsy to definitively diagnose the underlying condition.