The gums are the soft tissue that forms a protective barrier around the teeth and underlying bone structure. When this tissue develops white patches and becomes sore, it signals a reaction to an irritant, an infection, or an underlying systemic change. This visible change and discomfort warrant attention, as they indicate a disruption in the normal protective function of the oral mucosa. Understanding the characteristics of these lesions helps determine if the cause is transient or requires specialized treatment.
Acute Causes: Infections and Ulcers
White and sore lesions that appear suddenly often stem from a temporary infection or localized injury. One common cause is Oral Candidiasis, known as thrush, which results from an overgrowth of the Candida albicans fungus. This condition presents as creamy white, slightly raised patches that often resemble cottage cheese. These lesions can typically be wiped away, revealing a red, tender, or inflamed surface underneath. Thrush frequently causes a burning sensation or soreness and is often triggered by factors such as antibiotic use, which disrupts the mouth’s natural microbial balance, or a weakened immune system.
Another frequent source of acute oral pain is the Aphthous Ulcer, commonly called a canker sore. These are shallow, round, or oval lesions featuring a white or yellow-gray center surrounded by a bright red, inflamed border. While canker sores can form on many soft tissues, they often appear on non-keratinized areas, including the base of the gums, and cause intense pain. Most minor aphthous ulcers resolve on their own within one to two weeks and are not contagious, distinguishing them from viral lesions.
Physical damage to the gums can also produce transient white and sore areas due to localized tissue destruction. Aggressive tooth brushing, friction from sharp food, or irritation from a dental appliance can cause a temporary white patch. This white appearance is essentially necrotic tissue, or a protective layer of dead cells, that forms over the injury as healing begins. Although these traumatic injuries cause immediate soreness, they tend to be isolated to the site of damage and fade as the surface tissue regenerates.
Chronic and Inflammatory Conditions
Conditions that cause white patches to persist for several weeks or months often involve a chronic inflammatory or immune system response. Oral Lichen Planus (OLP) is a non-contagious, inflammatory disorder that affects the mucous membranes. The most recognizable form is the reticular pattern, characterized by delicate, lacy, white lines, known as Wickham’s striae, which are commonly seen on the cheeks but can extend to the gums.
When OLP affects the gums more severely, it can appear as the erosive or atrophic form, resulting in bright red, raw, and ulcerated areas. These erosive lesions cause soreness and discomfort, especially when eating or drinking acidic or spicy foods. OLP is an immune-mediated condition where T-cells mistakenly attack cells of the oral lining, leading to chronic inflammation and tissue changes. The condition requires ongoing management to control symptoms and prevent flare-ups.
A significant finding is Leukoplakia, defined as a persistent white patch or plaque that cannot be rubbed off and cannot be clinically diagnosed as any other condition. Unlike acute causes, these patches are often painless early on, but they become sore if continually irritated or ulcerated. Leukoplakia is primarily associated with chronic irritation, such as tobacco use, and is considered a potentially malignant disorder. The white appearance is due to a thickening of the keratin layer of the oral lining. While many leukoplakia lesions are benign, a small percentage contain cellular changes that may progress toward oral cancer.
When to Seek Professional Dental Care
The appearance of white, sore gums requires a professional assessment because only a dentist or oral pathologist can accurately distinguish between a common infection and a more serious condition. For self-care, simple measures like rinsing the mouth with warm salt water offer temporary relief and help maintain oral hygiene around the affected area. It is also helpful to avoid highly acidic, spicy, or abrasive foods that can irritate the raw tissue and worsen the soreness.
The nature and duration of the symptoms establish a timeline for seeking professional help. Any lesion that persists without noticeable improvement for 7 to 10 days should be examined by a dental professional. Several red flags indicate a need for immediate attention, including the presence of a fever alongside the oral pain, or any noticeable facial or gum swelling, which may signal a spreading infection.
Other concerning signs include white patches mixed with red, raised areas, known as speckled leukoplakia, as this appearance is associated with a higher risk of malignant change. For chronic or suspicious patches, a definitive diagnosis often requires a biopsy, where a small sample of tissue is removed for microscopic examination. This step is necessary to confirm the underlying cellular nature of the lesion, particularly for conditions like Leukoplakia or Oral Lichen Planus.