The roof of a healthy mouth is normally pink in color, but some people notice white spots or patches on the roof of their mouth. This typically harmless condition is known as geographic tongue or benign migratory glossitis.
What causes white spots on the roof of the mouth?
There are a few potential causes for white spots on the palate:
- Geographic tongue – This common, benign condition causes irregular white patches on the top and sides of the tongue. The white spots are caused by missing layers of cells on the surface of the tongue. The spots come and go over time, giving a map-like appearance.
- Oral thrush – A yeast infection in the mouth caused by an overgrowth of Candida fungi can lead to white patches on the roof of the mouth. Oral thrush is more common in infants and people with weakened immune systems.
- Leukoplakia – White plaques in the mouth that can’t be easily scraped off may be a precancerous condition called leukoplakia. It is often caused by irritants like tobacco.
- Oral lichen planus – An inflammatory condition affecting the mucous membranes in the mouth can result in white patches, including on the palate. The cause is unknown.
- Chemical burns – Accidentally ingesting something acidic or alkaline can burn the sensitive tissues of the mouth and cause white patches to form as the area heals.
Are white spots on the palate normal?
For most people, having small white spots or patches on the roof of the mouth is harmless and quite common. Here is an overview:
- Up to 2% of the general population has geographic tongue at any given time. It is so common that it can be considered a normal variant.
- 30-50% of infants develop oral thrush, but it goes away with antifungal treatment and usually doesn’t recur.
- Leukoplakia only affects about 1 in 100 people over the age of 30. The risk increases with age and tobacco use.
- Oral lichen planus affects less than 2% of the population. Middle-aged women are most commonly affected.
- Chemical burns can happen to anyone but are relatively uncommon in healthy adults.
While harmless in most cases, white spots or patches on your palate deserve attention if they:
- Are painful or irritated
- Bleed easily when scraped
- Contain thick white patches that can’t be rubbed off
- Don’t go away after a couple weeks
When to see a doctor
See your dentist or doctor if you have:
- Persistent white spots on the roof of your mouth
- Red, irritated, or painful patches
- Difficulty swallowing or talking
- Oral thrush that keeps recurring
- Spots combined with other mouth symptoms like bad breath or gum disease
- White spots along with a fever or fatigue
Professional evaluation can determine if treatment is needed for conditions like oral thrush, leukoplakia, or other medical issues.
What does the doctor do?
During an exam for white spots on the palate, the doctor may:
- Ask about your medical history and symptoms
- Look closely at the roof of your mouth and tongue
- Feel for any lumps, bumps, or changes in texture
- Test the spots by rubbing with gauze to see if they can be scraped off
- Take a small sample (biopsy) if needed
- Order blood tests or imaging if concerned about cancer
- Prescribe antifungal medicine if thrush is present
These steps can help diagnose the cause and determine appropriate treatment if needed.
If you have small white spots that don’t seem irritated or painful, you can try these home remedies while monitoring your symptoms:
- Brush your teeth and tongue gently after each meal
- Avoid irritants like smoking, spicy foods, acidic foods, alcohol
- Rinse your mouth with baking soda and salt water
- Apply over-the-counter antifungal mouth gel
- Take supplements like vitamin B12, zinc, and folate
Your spots may come and go on their own. But be sure to see your doctor if symptoms persist or get worse.
If home remedies aren’t helping and a doctor confirms oral thrush or another condition, they may prescribe:
- Antifungal medication – Common prescriptions are Nystatin liquid, Clotrimazole lozenges, Fluconazole pills
- Medicated mouthwash – Chlorhexidine rinse helps treat infections
- Steroid medication – Topical steroids reduce inflammation from conditions like lichen planus
- Surgery – Rarely needed, but may remove abnormal looking patches (leukoplakia) to prevent cancer
Follow your doctor’s treatment instructions carefully and call if your symptoms don’t start to improve within 1-2 weeks.
What causes white gums?
Some of the same conditions that cause white spots on the roof of the mouth can also affect the gums, leading to white gums. Typical causes include:
- Gingivitis – Mild gum inflammation causes gums to turn red or bleed easily
- Oral lichen planus – Chronic inflammatory condition that affects mucous membranes
- Leukoplakia – Precancerous white patches on gums, sometimes related to tobacco use
- Oral thrush – A yeast infection that spreads to the gums
White gums can also result from irritation, vitamin deficiencies, genetics, and more. Proper oral hygiene and regular dental cleanings help prevent white gums.
When to worry about white gums?
See a dentist if you have:
- Sudden unexplained white gums
- Pain, soreness, or irritated gums
- White patches that won’t rub off
- Bleeding while brushing and flossing
- Bad breath or other signs of infection
- Oral thrush that keeps coming back
- Spots combined with gum recession
A dental exam and possible biopsy can diagnose the cause. Treatments like antifungal medication, medicated mouthwash, and empiric antibiotics may be prescribed.
To help prevent white spots or patches on your palate and gums:
- Brush and floss your teeth at least twice daily
- See your dentist every 6 months for cleanings and checkups
- Avoid tobacco and limit alcohol
- Rinse your mouth after using inhaled corticosteroids
- Practice good oral hygiene if you wear dentures
Promptly treating any mouth infections, trauma, or irritation can also reduce your risk of white spots developing.
When to see a doctor
Schedule an appointment with your primary care doctor or dentist if you have:
- Unexplained white spots on your palate or gums
- Spots that are painful, irritated, or bleeding
- Difficulty eating, swallowing, or talking
- Oral thrush that keeps recurring
- White patches combined with other symptoms
- Spots that don’t go away after 2-3 weeks
It’s important to get an evaluation to determine the cause and check for any underlying medical conditions requiring treatment.
White spots on the roof of the mouth or gums are commonly caused by harmless conditions like geographic tongue. However, sometimes they indicate more serious issues like infection, irritation, or precancerous changes.
See a doctor promptly if you notice white patches combined with pain, bleeding, or difficulty eating or swallowing. With an accurate diagnosis, conditions like oral thrush and leukoplakia can be treated early and complications can be avoided.
Practicing good oral hygiene and getting regular dental cleanings can help reduce your risk of white spots developing. But even with great care, some causes like geographic tongue may occur at times. Pay attention to any changes in your mouth and talk to your dentist if you have concerns.