If you’ve ever looked in the mirror and noticed a strange white spot on your gums, tongue, or inner cheek—you’re not alone. While some causes of white spots in the mouth are harmless, others may require immediate treatment or even indicate a more serious condition. In this article, Dr. Joseph Nemeth, a periodontist in Southfield, MI, breaks down the six most common causes of white spots and how they’re treated.

1. Canker Sores

Canker sores are small, painful ulcers that can appear on the gums, tongue, or inner cheeks. They often start as white or yellowish spots with a red border and can make eating or speaking uncomfortable.

Home Treatment for Canker Sores:

• Saltwater rinses or hydrogen peroxide rinses
• Topical numbing agents (like benzocaine)
• Prescription steroid rinses
• Advanced option: Dr. Nemeth uses silver nitrate or laser cauterization to speed healing and relieve pain by sealing nerve endings

2. Oral Thrush (Candidiasis)

Oral thrush appears as a white, creamy coating—usually on the tongue, inner cheeks, or roof of the mouth. It’s caused by an overgrowth of a natural fungus called Candida, and often happens after antibiotic use or in people with weakened immune systems.

Symptoms of Thrush:

• Cottony feeling in the mouth
• Loss of taste
• White patches that may wipe off, leaving red or bleeding areas underneath

Treatment:

Antifungal medications like Nystatin (rinses or tablets) are commonly prescribed for 14 days to clear up the infection.

3. Lichen Planus

Lichen planus is a chronic inflammatory condition that often appears as white, lace-like patterns on the gums or inner cheeks. In some cases, it can cause redness, soreness, or even a burning sensation.

What Causes It?

It’s believed to be an autoimmune condition, though the exact cause is unknown. It can flare up and subside over time.

Treatment Options:

• Topical corticosteroid rinses
• Immune-modulating therapy (in some cases)
• Regular monitoring by a periodontist or oral medicine specialist

Note: Lichen planus can also appear on the skin, nails, and other mucous membranes.

4. Pregnancy-Related Gum Changes

Pregnancy can cause hormonal changes that affect your gums, leading to swelling or even white patches or coatings. While typically harmless, these symptoms should still be evaluated to rule out infection or gum disease.

Treatment:

• Improved oral hygiene during pregnancy
• Professional cleanings or deep scaling if necessary
• Most gum symptoms resolve post-pregnancy

5. Leukoplakia

This is one of the more serious potential causes of white spots. Leukoplakia appears as thick, white, leathery patches that cannot be wiped away. It is most often caused by nicotine or tobacco use—especially when held in the same spot in the mouth repeatedly.

Why It Matters:

While leukoplakia is not cancer, it can become cancerous over time. Any suspicious white patch that doesn’t rub off should be checked by a periodontist, dentist, or oral surgeon.

Treatment:

• Biopsy or monitoring
• Surgical removal if the lesion appears precancerous or worsens

6. Periodontal Abscess

In cases of advanced gum disease, a white spot may appear due to an abscess—a pocket of pus caused by infection. These areas may appear swollen, red, or produce discharge.

Symptoms of an Abscess:

• Pain when biting or chewing
• Swelling of the gums or jaw
• Foul taste or pus drainage

Treatment:

• Antibiotics to reduce infection
• Periodontal therapy to clean out infected tissue
• Ongoing maintenance to prevent recurrence

When to See a Periodontist

While some white spots are harmless and resolve on their own, others may require urgent care. Here’s when to make an appointment:

• White spots that don’t go away after two weeks
• Spots that bleed, thicken, or become painful
• Recurring or worsening sores
• Unexplained changes in the appearance of your gums or tongue

Watch: Dr. Nemeth Explains the 6 Causes of White Spots

?? Want to hear it straight from the expert? Watch Dr. Nemeth explain each cause and treatment option in this informative video:

Final Thoughts: Don’t Ignore White Spots in the Mouth

Some white patches are mild and manageable, while others could be early signs of serious conditions. When in doubt—get it checked. Dr. Nemeth and his team are here to help you uncover the cause and get the treatment you need to restore your oral health.

?? Schedule your consultation at DrNemeth.com