When you notice a patch of white on your gums near a tooth, it is understandable to feel alarmed. Healthy gum tissue, known as the gingiva, typically maintains a uniform pink or coral color, which comes from the dense supply of underlying blood vessels. A localized change in color signifies an alteration in the tissue itself or a covering on the surface, which always warrants professional dental evaluation. This discoloration can stem from a variety of causes, ranging from simple, temporary irritation to deeper biological processes.
White Patches Caused by Infection or Inflammation
One common source of white patches is an infection or a localized inflammatory reaction. An overgrowth of the fungus Candida albicans causes oral thrush, which presents as creamy white or yellowish spots that often resemble cottage cheese. These patches can usually be wiped away with gentle friction, revealing a red, often tender or slightly bleeding area underneath. This fungal infection typically occurs when the balance of microorganisms in the mouth is disrupted.
A dental fistula is a concerning, localized white spot. This small, pimple-like bump on the gum line is the draining point for a deep-seated bacterial infection, or abscess, near the tooth root. The white or yellowish appearance comes from accumulated pus draining through this channel to relieve pressure. While drainage might temporarily reduce pain, the underlying infection is serious and requires immediate endodontic treatment or extraction.
Localized inflammation from conditions like gingivitis can sometimes lead to pale or whitish tissue. Similarly, small, painful canker sores, or aphthous ulcers, are common. They appear as round or oval lesions with a pale white or yellow center surrounded by a bright red border. These ulcers are a form of localized inflammation that usually resolves on its own within one to two weeks.
Persistent White Lesions Requiring Biopsy
Some white patches represent a fundamental change in the gum tissue itself rather than surface coatings or pockets of pus. These lesions are often chronic, meaning they do not resolve on their own, and cannot be scraped away from the mucosal surface. The most recognized of these is leukoplakia, a thick, non-removable white plaque. Leukoplakia is a potentially malignant disorder, carrying a risk of transforming into oral cancer.
Risk factors for leukoplakia include chronic irritation, most commonly from tobacco use and excessive alcohol consumption. Because a biopsy is the only way to determine if the tissue change is benign or contains dysplastic (precancerous) cells, any persistent white patch must be professionally examined. The location of the lesion, such as the floor of the mouth or the side of the tongue, can influence the level of concern.
Another chronic condition is Oral Lichen Planus (OLP). The white form of OLP typically presents as a characteristic web-like or lacy pattern on the gums, known as Wickham’s striae. OLP is considered a chronic condition that requires long-term monitoring by a specialist. While the risk is small, OLP carries a potential for malignant transformation over time.
Temporary Whitening After Dental Procedures or Trauma
Not all instances of white gums are signs of disease; some are transient responses to injury or dental treatment. Following a tooth extraction or deep cleaning procedures like scaling and root planing, it is common to see a temporary white layer over the healing site. This white material is granulation tissue that forms a protective layer over the socket or wound. It typically resolves as the gum tissue fully regenerates, usually within one to two weeks.
Temporary paleness can also occur following the application of strong chemicals or thermal injury. During in-office teeth whitening procedures, bleaching agents may cause a transient whitening of the adjacent gum tissue. This is a chemical reaction, and the gums usually return to their normal color within a few hours. Similarly, minor trauma from accidentally scraping the gums with sharp food can cause a localized, temporary whitening due to reduced blood flow in the area.
Next Steps and Seeking Professional Care
If a white patch on the gums appears, the most important step is to schedule an appointment with a dental professional. Diagnosis often begins with a visual inspection and a test to see if the patch can be wiped away. If an infection like oral thrush is suspected, a swab test can confirm the presence of the Candida fungus.
For any white lesion that is persistent, non-removable, or associated with other concerning symptoms, a specialist may be needed. An oral surgeon or periodontist may perform a small biopsy to collect a tissue sample for microscopic analysis. An urgent dental visit is warranted if the white spot is accompanied by severe pain, rapidly increasing swelling, a fever, or difficulty swallowing, as these can indicate a spreading infection or abscess.