Why Do My Gums Have White Spots? Causes & Treatment

woman with white gums

Have you ever taken a nice, close look at your gum tissue in the mirror? We call these tissues “gingiva”. Normally, at least in most people, gum tissue has a coral-pink color to it. Some individuals with darker skin pigments can occasionally have gums that are dark brown or a combination of brown and pink.

But one thing that isn’t very normal is having white gums, getting white spots on gums, or seeing other visible changes in tissues that look different from the gingiva around it. Knowing what’s “normal” and what isn’t can help you know when it’s time to see your dentist for treatment.

Common Symptoms

Are white spots on gums painful? Not usually. In most cases people notice the white spots on gums when they’re looking at something else inside of their mouth. Having white gums or speckled areas of discoloration are usually differentiated from one another based on other symptoms, such as:

For instance, if you have an abscessed tooth, you’ll usually see a white spot on gums (painful or not) that also has drainage or puts off a salty taste.[1] It may look like a pimple. But if you have a candida or “yeast” infection, the white spots on gums typically spread across a wider area and may wipe off, revealing a red or raw area underneath. Being familiar with the other symptoms will allow for a more accurate — and timely — diagnosis.

Common Causes

There are numerous factors that can contribute to white gums. Are white spots on gums painful? Not always. In fact, they rarely are. Being able to understand the underlying factors will help you minimize the risk of a dental emergency, life-threatening illness, or quickly treat the issue at hand.

If you tend to get red or white spots throughout your mouth, here are some of the most common causes and what you need to know about each one.

1) Canker Sores

Symptoms

Ulcers or “canker sores” are commonly linked to irritation, trauma (bumps to your mouth,) orthodontic appliances, acidic foods, or acid reflux disease. They tend to look like small, white, round circles inside of your lips, in the floor of the mouth, sides of the tongue, or directly on the gums. Most canker sores are extremely sensitive.

Treatment

Avoid acidic foods or accidentally bumping the ulcer. If you’re in braces, use orthodontic wax over your appliances in that area to minimize irritation. Usually the best thing to do is to just allow the ulcer to run its course.[2]

2) Oral Thrush

Symptoms

Oral thrush typically affects infants, elderly, and immunocompromised individuals (such as cancer patients.) Some people also get thrush infections after taking antibiotics, due to changes in their oral flora.[3] It’s a fungal infection that can create white patches or speckles on different parts of the mouth. You might also notice a foul odor.

Treatment

Good oral hygiene is key. Always clean your mouth immediately after meals. Consider adding yogurt to your diet, as it’s a natural probiotic. Severe cases of thrush may need to be treated with an anti-fungal medication. For babies, use a clean damp cloth to wipe their mouths out after each feeding.

3) Leukoplakia

Symptoms

White gums with streaks or patches on them. Sometimes the white will wipe off; other times it will not. Leukoplakia typically will not cause any pain or discomfort. The visible symptoms tend to be the most noticeable. In some cases, there will also be signs of chronic cheek biting/chewing or tobacco use.[4]

Treatment

Most types of leukoplakia do not need to be “treated” per se. Generally, dentists will tell you to watch it and make sure it doesn’t get worse and allow it to go away on its own. If the area is due to some type of tissue trauma or habit, behavior modification is typically the best treatment.

4) Oral Lichen Planus

Symptoms

Rather than seeing specific speckles or white spots on gums, oral lichen planus tends to create what dentists refer to as “lacy” types of patches. But unlike leukoplakia, oral lichen planus tends to also cause symptoms of pain or burning.[5] You might also see open sores, redness, or swelling.

Treatment

Most treatments are focused around minimizing the symptoms of pain or burning. In some cases, a biopsy or bloodwork may be needed for additional diagnostics. A topical corticosteroid may be prescribed.

5) Oral Cancer

Symptoms

Oral cancer can take on many forms. Typically, dental professionals will tell you to look for red or white spots on gums (painful or not does not matter, as oral cancer rarely “hurts” early on) that look different from the tissues around them.[6] Watch for other signs like sores that won’t heal, lumps, or difficulty swallowing.

Treatment

The best treatment for oral cancer is early diagnosis. If you have a sore that’s not healing, let your dentist know so that they can order a biopsy. Surgery or radiation therapy may be needed, depending on the extent of the disease. Unfortunately, most people do not self-diagnose oral cancer until it is quite aggressive. Seeing your dentist regularly (every six months) for an exam and oral cancer screening could save your life.

6) Cyst

Symptoms

There are numerous types of dental cysts that can develop inside of a person’s mouth. They are not all painful and do not always cause white gums. However, if you notice an unnaturally raised area where the tissues are stretched out, puffy, or appear to be depressible, it could be that there is some type of cyst developing just underneath your gums.

Treatment

Your dentist will probably refer you to an oral surgeon to have the cyst biopsied and/or removed. Since cysts can be caused by various factors, it’s important to rule out any pathology.

7) Periapical Abscess

Symptoms

Abscessed teeth tend to cause a singular white spot on gums, at the area where the infection is draining. You may notice a “fistula” (small pimple) where the salty discharge builds up. The tooth may or may not hurt.

Treatment

Root canal therapy or extraction is a typical treatment that can restore an abscessed or dying tooth.  If swelling is present and the face looks asymmetrical, going to the ER immediately is recommended.

8) Periodontal Abscess

Symptoms

Chronic gum disease (periodontal disease or periodontitis) may lead to visible areas of swelling or abscesses along the gumlines if the infection is severe.

Treatment

A deep cleaning with your hygienist to remove the disease-causing bacteria from underneath your gum tissue. Your dentist may prescribe a special mouth rinse or antibiotic if the infection is severe, but physical removal of the buildup is the most important step in treatment.[7]

Preventing White Spots On Gums

Ultimately the best way to prevent common white spots on gums or other areas of your mouth is to practice great oral hygiene. Since white spots on gums are frequently linked to dental infections, taking good care of your mouth can lower your chances of such complications.

White gums can also be a sign of medical issues — like anemia or iron deficiency — so if it’s more generalized, you might want to have some bloodwork done.

Unfortunately, white spots on gums aren’t always preventable. If you have something like oral cancer (and you’ve already taken preventive steps like minimizing sun exposure or avoiding tobacco) the best treatment is early diagnosis.

People with weak immune systems or who are immunocompromised will be more prone to things like oral thrush or lichen planus. Again, oral hygiene comes into play to keep a clean environment that’s less likely to lead to white gums.

If you have orthodontic appliances or a removable prosthetic (such as a full denture or partial,) keeping your mouth clean is crucial. Poor oral hygiene can quickly lead to infections, swollen gums, raw tissues, thrush, etc.

If there’s only one takeaway that you remember when it comes to white gums, it’s to keep your mouth clean!

Pain Relief At Home

Are white spots on gums painful? Usually not unless they’re associated with a canker sore or periodontal abscess. If you’re already in communication with your dentist about getting the proper treatment, here are a few easy things you can do to minimize discomfort while you’re still at home:

If the discomfort is severe, ask your dentist about getting a prescription for what’s called “miracle mouthwash.” This special rinse contains lidocaine, which can numb any sores inside of your mouth for a few hours at a time, making it easier for you to get through the day.

Overcoming White Spots On Gums

White spots on gums, painful or not, aren’t what you consider “healthy” or “normal.” Depending on their cause and severity, it could be something as minor as an everyday ulcer or severe as oral cancer. Keeping an eye on the area and letting your dentist know if it doesn’t heal within a week or so is the most important thing to keep in mind. Oral hygiene habits have a significant role to play when it comes to preventing white spots on gums. For more information, it’s best to see your dentist in person!

Dr. Joseph Powers