A painful white spot on the gum line or soft tissue inside the mouth is a common concern. While uncomfortable, this symptom is typically a localized, non-contagious issue that resolves naturally. Understanding the lesion’s characteristics helps determine the likely cause, which ranges from minor irritation to fungal infection. Most instances are benign, but monitoring the spot’s appearance and duration is important for oral health.
The Most Common Culprit: Aphthous Ulcers
The most frequent source of a painful, solitary white spot on the gums is an aphthous ulcer, commonly known as a canker sore. These lesions are small, round, or oval sores with a white or yellowish center surrounded by a distinct, inflamed red border. The pain can be severe, often starting as a burning or tingling sensation one to two days before the sore appears.
Minor aphthous ulcers are the most prevalent type, typically measuring less than five millimeters. They usually resolve within seven to fourteen days without leaving scar tissue. While the exact cause is not fully understood, they are believed to involve a localized immune response triggered by various factors.
Common triggers include minor injuries to the mouth lining, such as accidental biting, vigorous brushing, or irritation from dental appliances. Emotional stress is a well-documented factor that can precipitate an outbreak. Consuming highly acidic or spicy foods, along with nutritional deficiencies in iron, folate, or vitamin B12, may also contribute to their formation.
Other Causes: Fungal and Traumatic Lesions
If the white spot is not a singular, clearly defined ulcer, the cause may be a fungal infection or a localized physical injury. Oral thrush (candidiasis) is a fungal infection caused by an overgrowth of Candida albicans, a yeast naturally present in the mouth.
Oral thrush typically appears as multiple, creamy white, slightly raised patches resembling cottage cheese. Unlike canker sores, these lesions can sometimes be wiped away, exposing a red, inflamed area underneath that may bleed. Thrush is more likely in individuals with weakened immune systems, those who use inhaled corticosteroids, wear dentures, or have recently taken antibiotics.
A traumatic lesion is the result of direct physical damage to the gum tissue. This occurs from eating sharp foods, accidentally biting the gum, or burning the mouth with hot liquids. The resulting irritation or mild burn can cause the tissue to blanch and appear white. These spots are localized to the site of injury and heal quickly once the irritating factor is removed.
Managing Pain and Promoting Healing
While waiting for a benign white spot to heal, several home strategies can provide immediate relief from pain and discomfort. Rinsing the mouth several times a day with a warm saltwater solution helps soothe irritation and promotes a clean oral environment. A mixture of a teaspoon of salt in a cup of warm water is a simple, effective remedy.
Applying an over-the-counter topical anesthetic gel, such as those containing benzocaine, can temporarily numb the sore’s surface, making eating and speaking more comfortable. Modify your diet by avoiding spicy, highly acidic, or very salty foods, as these irritate the open lesion and increase pain. Focusing on soft, bland foods minimizes friction and allows the tissue to repair faster.
When Professional Medical Attention is Necessary
Although most painful white spots are harmless and temporary, certain characteristics warrant immediate consultation with a dentist or physician. Any lesion that persists for longer than two weeks without showing signs of healing should be evaluated. Prolonged existence, especially if the spot is painless or appears thick and difficult to scrape off, could indicate a more serious condition like leukoplakia.
Signs of a possible severe infection, such as a dental abscess, require prompt attention. Symptoms include rapid swelling of the gum or face, throbbing pain, high fever, or difficulty swallowing. In these cases, the white spot may be a pus-filled pocket needing drainage or antibiotic treatment to prevent the infection from spreading.