White spots on the gums are a frequent observation that often prompts concern about what these changes might signify. The appearance of a white patch or bump along the gumline can have a wide range of causes, from benign developmental cysts to indicators of infection or chronic irritation. Understanding the context of the spot—such as the age of the person and the appearance of the lesion—is the first step in determining its nature. While many white spots resolve without intervention, others signal a need for professional dental evaluation. This guide explores the most common reasons for these spots and when a consultation with a dentist becomes necessary.
Harmless Spots Frequently Seen in Infants
The sight of white bumps in a newborn’s mouth can be alarming for new parents, but in many cases, these are temporary and entirely harmless developmental phenomena. Two common examples are Bohn’s nodules and Epstein pearls, both of which are types of inclusion cysts. These small, whitish-yellow bumps are filled with keratin, the same protein found in hair and nails, and are not a cause for concern.
Bohn’s nodules specifically form along the gum ridges, known as the alveolar ridges, and are remnants of small salivary gland tissue. They typically appear on the lip or tongue side of the gums, often on the upper jaw. Epstein pearls are similar in appearance but are usually found along the midline of the roof of the mouth, or palate. These pearls form when epithelial tissue gets trapped during the fusion of the palate during fetal development.
These nodules and pearls are painless, do not interfere with feeding, and are extremely common. They typically resolve on their own within the first few weeks or months of life as a result of the friction from nursing or bottle feeding. No medical treatment is necessary for these benign cysts, but any persistent or unusual bumps should still be mentioned to a pediatrician for confirmation.
Acquired Causes of White Spots in Children and Adults
White patches on the gums in older children and adults are typically acquired conditions resulting from infection, chronic irritation, or tissue changes. One common cause is oral thrush, or candidiasis, a fungal infection caused by an overgrowth of Candida yeast. This infection appears as creamy, slightly raised white or yellowish patches on the gums, tongue, or inner cheeks, sometimes resembling cottage cheese. These patches are often associated with soreness and may bleed slightly if rubbed.
Another acquired condition is leukoplakia, which presents as thick, white, or grayish patches that develop in the mouth, including on the gums. Unlike oral thrush, leukoplakia patches cannot be scraped away, and they may feel rough or hardened. The condition is often linked to chronic irritation from factors like tobacco use, heavy alcohol consumption, or ill-fitting dentures that rub against the tissue. While many cases of leukoplakia are benign, they are considered potentially precancerous lesions, making professional evaluation and biopsy necessary to rule out malignancy.
Trauma and Canker Sores
Minor physical trauma can also result in temporary white spots on the gums. This often occurs from accidentally scraping the gum tissue with a toothbrush, consuming very hot food, or irritation from sharp edges on dental appliances. These localized injuries can cause a white or yellow appearance due to inflammation and superficial tissue sloughing, but they usually heal quickly on their own within a few days.
When canker sores, also known as aphthous ulcers, develop near the gum line, they start as red bumps that quickly develop a pale white or yellow center surrounded by a distinct red border. These shallow ulcers are often painful, especially when exposed to acidic or spicy foods, but typically resolve within two weeks.
Identifying Warning Signs and When to Consult a Dentist
While many white spots on the gums are harmless or temporary, certain features require prompt professional attention from a dentist or healthcare provider. Any white spot or patch that does not begin to heal or disappear within 10 to 14 days should be evaluated. This two-week benchmark is used to identify conditions that require active surveillance or further testing.
The presence of accompanying symptoms also indicates the need for a consultation. Warning signs include:
- Persistent pain, swelling, or bleeding that is not easily explained by a minor injury.
- Difficulty with chewing, swallowing, or moving the mouth.
- A noticeable change in the size or color of the spot.
A simple distinction to note is whether the white patch can be easily wiped away; if it can, it suggests a fungal infection like thrush. If it remains firmly attached, it is more likely to be a different type of lesion, such as leukoplakia. Ultimately, a thorough dental evaluation, which may include a biopsy, is the only reliable way to diagnose the underlying cause.