White Spots In Mouth

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Sometimes, seeing white spots in your mouth isn’t related to a health problem and is just related to something about your lifestyle.

Leukoplakia

Leukoplakia is a condition that causes painless white or gray patches to develop inside your mouth. You may develop leukoplakia because something is irritating the inside of your mouth. People with leukoplakia may have an increased risk of oral cancer. Healthcare providers treat the condition with surgery that removes the patches.

Overview

What is leukoplakia?

Leukoplakia is a condition that creates white patches in your mouth. The patches don’t hurt but they don’t go away, even if you rub them. You may develop leukoplakia because something is irritating the inside of your mouth. Leukoplakia may become oral cancer, so your dentist may recommend you see a specialist to diagnose and treat it.

What are the types of leukoplakia?

There are two types of leukoplakia:

• Homogeneous leukoplakia: Homogeneous leukoplakia may look like a flat white patch in your mouth. The patch surface may be smooth, wrinkled or have ridges. This leukoplakia is typically benign, meaning it usually doesn’t become oral cancer. It’s more common than non-homogeneous leukoplakia.
• Non-homogeneous leukoplakia: Non-homogeneous leukoplakia may cause irregular or odd-shaped white or red patches in your mouth. The patches may be flat or have raised surfaces. Studies show that non-homogenous leukoplakia is seven times more likely to become cancerous than the homogenous type.

What are leukoplakia subtypes?

The two leukoplakia subtypes are:

• Proliferative verrucous leukoplakia(PVL): Some studies suggest more than 60% of people with PVL develop oral cancer. PVL may look like small white patches in your mouth. The patches can grow on your tongue, gums, the soft tissue between your lips and gums, and tissue lining the inside of your cheeks. PVL patches can grow very quickly and may develop tiny lumps or bumps.
• Oral hairy leukoplakia: This condition looks like its name — white hairy patches, often with folds so it looks like hair is growing out of the folds. These spots mostly happen on your tongue but might appear in other parts of your mouth. This leukoplakia type doesn’t become cancer. People with HIV/AIDS or Epstein-Barr virus often develop oral hairy leukoplakia.

Does leukoplakia always become oral cancer?

No, it doesn’t. Studies show less than 15% of people with leukoplakia develop oral cancer. Medical researchers are studying why and when leukoplakia may become cancer. For example, leukoplakia on your gums is less likely to become cancer than leukoplakia on your tongue or the floor of your mouth.

Not every white patch in your mouth will become cancer. Your healthcare provider will tell you what to expect if you have leukoplakia.

Is leukoplakia common?

Leukoplakia is relatively rare. It affects less than 5% of people worldwide.

Symptoms and Causes

What are the symptoms?

Leukoplakia symptoms are patches inside your mouth that don’t go away. The patches may:

• Appear on your tongue, gums and the inside of your cheeks.
• Look flat or slightly raised.
• Be white, gray or white with tiny red dots.

What causes leukoplakia?

You can develop leukoplakia if something irritates tissue lining the inside of your mouth. For example, you may chew the inside of your cheeks or use dentures that don’t fit well.

Leukoplakia may also happen when certain genes mutate, or change. (Genes tell cells what to do, such as how fast they should grow or when they should die off to make room for new cells.) In leukoplakia, genetic mutations make mouth tissue cells multiply faster than normal, creating patches.

What are risk factors of leukoplakia?

The following activities increase your chances of developing leukoplakia:

• Smoking or using chewing tobacco and smokeless tobacco.
• Regularly drinking substantial amounts of beverages containing alcohol.
• Having certain health conditions that affect your immune system, like Epstein-Barr virus or HIV.

Diagnosis and Tests

How is leukoplakia diagnosed?

A healthcare provider will diagnose leukoplakia by examining your mouth and any unusual white patches. They’ll try to find what’s causing your symptoms. For example, if you use dentures, your provider may make sure your dentures aren’t rubbing against your gums or the inside of your cheeks. Your provider may do biopsies and send a sample of your tissue to medical pathologists to examine under a microscope.

Should all suspected leukoplakia be biopsied?

Yes, they should. A biopsy is the only way to determine if you have leukoplakia that may become oral cancer.

Management and Treatment

How is leukoplakia treated?

Healthcare providers treat leukoplakia by removing the patches in your mouth. They may remove the patches with a scalpel. Other potential procedures include:

• Using a laser to remove the patches.
• Using light-activated cancer drugs (photodynamic therapy).
• Using cryotherapy, which is extreme cold that freezes and kills abnormal cells and removes the patches.
• Using an electrically heated needle or other instrument to remove the patches (electrocauterization).

White Spots in the Mouth: What Causes Them?

There are many causes for white spots in your mouth, ranging from mild issues to severe conditions.

White spots in the mouth can be caused by a range of things. Some causes of white spots in the mouth like dehydration are simple and easy to fix. Others like viral infections, sexually transmitted infections (STIs), thrush, and canker sores may need to be treated.

In some cases, white spots in the mouth are caused by more serious problems—for example, a condition called leukoplakia that causes white spots in the mouth that can become cancerous.

This article will go over the causes of white spots in your mouth, how to find out why you have them, and how to get rid of them and keep them from coming back.

Causes of White Patches in the Mouth

There are many reasons that white patches can develop in the mouth. Some of these causes are common and easy to treat on your own, but others are more serious.

Leukoplakia

Leukoplakia is a condition that is commonly caused by heavy tobacco or alcohol use. However, you can also get leukoplakia if you don’t smoke.

The term “leukoplakia” literally means “white patch” (leuko means white and plakia means patch).

Two main types of leukoplakia are:

• Homogenous: This refers to an even-colored, thin patch that is consistent in appearance and primarily white. The patch can look wrinkled or smooth or have a ridged surface.
• Non-homogenous: Patches are primarily white, red, and irregularly shaped. The patches can be flat or they may appear nodular or elevated. Non-homogenous patches can be nodular (speckled) or ulcerated (an open sore). These qualities indicate that leukoplakia is more likely to become cancerous than the homogenous type.

The white spots in the mouth caused by leukoplakia could become cancerous.

According to the Cleveland Clinic, once leukoplakia develops, 3% to 17.5% of people will go on to be diagnosed with a common type of skin cancer called squamous cell carcinoma within 15 years.

Lifestyle Factors

Sometimes, seeing white spots in your mouth isn’t related to a health problem and is just related to something about your lifestyle.

• Dehydration can cause your mouth to get dry and you may see white patches in your mouth.
• Not taking care of your oral health by regularly brushing your teeth and tongue can also lead to white spots in your mouth.
• Having stones in your tonsils or salivary ducts could also lead to white spots in your mouth.
• If you wear dentures, you could get white spots on your gums and in your mouth if they don’t fit well and are causing sores to develop.
• Smoking and using tobacco in other ways is another lifestyle factor that can cause white patches in your mouth. Using alcohol can also make white spots in your mouth more likely to happen.

Serious Viral Infection

A condition called oral hairy leukoplakia is when a person with a weak immune system gets “hairy-looking” white patches on the tongue or other areas of their mouth.

Oral hairy leukoplakia is associated with the Epstein-Barr virus and human immunodeficiency virus (HIV).

This type of leukoplakia is present throughout a person’s lifetime.

Sexually Transmitted Infections (STIs)

In addition to HIV, other sexually transmitted infections (STIs) can cause white spots in the mouth.

For example, human papillomavirus (HPV) is a common STI that can cause mouth sores. Herpes virus can also cause white spots in or around the mouth.

Oral Lichen Planus

Oral lichen planus is a chronic inflammatory condition of the mucous membranes inside the mouth.

These white spots in the mouth can look also look red. They often have a lacy appearance or can show up as red inflamed open sours.

Other symptoms of oral lichen plants are:

• A burning sensation
• Pain
• Discomfort at the site of the lesions

Oral Thrush

Oral thrush is caused by an overgrowth of fungus in the mouth. It is a type of fungal infection that needs to be treated with oral antifungal medication.

Thrush is caused by an organism called Candida albicans ‚ which also causes vaginal yeast infections and diaper rash.

The symptoms of oral thrush include white patches that can also look like a white coating of the mouth. Thrush can also cause redness and burning of the mouth.

Canker Sores

A canker sore is a single, large white patch in the mouth. It can look red around the white area of the patch.

There are several causes of canker sores, including irritation from food or drink, tobacco use, injuries from accidentally biting the cheek or lip, and other causes.

Canker sores are usually painful but tend to heal on their own without a problem.

Underlying Health Conditions

Some health conditions that don’t have to do with your mouth can actually have white spots or sores in your mouth as a symptom.

• Behcet’s syndrome
• Celiac disease
• Crohn’s disease
• Ulcerative colitis
• Immune system disorders (e.g., lupus)

Mouth Cancer

White spots in your mouth can be caused by many things that are not serious. However, a possible cause to be aware of is mouth cancer.

There are several factors that link white spots in the mouth to cancer, such as:

• The type
• The size and shape
• Abnormal cells
• Location (there is conflicting evidence as to whether having white patches on the floor of the mouth or the underside of the tongue could pose a higher risk of cancer)
• White or red masses (that can look like pebbles)
• Ulcerations, bleeding, or nodules

Symptoms

White spots in the mouth that are leukoplakia are defined as:

• One or more white patches that cannot be wiped off on or under the tongue, or inside the cheeks
• No pain or other symptoms

Symptoms that are linked with other causes of white spots in the mouth include:

• Redness around the white spot
• Pain
• Burning sensation
• Discomfort

When to See a Provider

White spots in the mouth are most often temporary, harmless, and easily treated. However, they can also have more serious causes.

If you see a white patch in your mouth that cannot be wiped off and does not go away after a few days, or you have white spots in your mouth along with other symptoms that are worrying you, make an appointment to see a dentist or your provider.

Diagnosis

Often the first time white spots in the mouth are noticed is when a person goes to the dentist or has a routine visit with their primary care provider.

With leukoplakia, the white spots in the mouth are the only sign or symptom so it’s easy to overlook.

A provider will want to rule out specific causes of white spots in the mouth like:

• Rubbing/friction inside the mouth (e.g., caused by dentures)
• Repeatedly biting the inside of the cheek
• A fungal infection (e.g., thrush in the mouth)

Lichen planusIf your provider is not able to determine the cause just by looking at the white patches in your mouth, they might take a small sample to be looked at in a lab (biopsy).

If the biopsy does not lead to a diagnosis, your provider might conclude that the white spots are leukoplakia and recommend treatment to help lower the chances of them becoming cancerous.

If your dentist is the first to notice the white spots in your mouth, they might want you to see your provider for a diagnosis.

Treatment

White spots in your mouth will often go away once you remove the cause—for example, when you stop using tobacco.

That said, it can still take weeks or months for white spots to clear up depending on what’s causing them.

Possible treatments for white spots in your mouth include:

• Quitting smoking and/or using alcohol
• Changing your diet to make sure you’re properly hydrated and getting adequate nutrition
• Using topical vitamin A (retinoids)
• Taking supplements of vitamin A and beta-carotene by mouth (however, the spots will usually come back if you stop taking the supplements)
• Steroids and other medications to reduce inflammation
• Medications to help with pain and discomfort
• Using alcohol-free mouth rinses or lozenges to help with mouth dryness or conditions like thrush
• Antibiotics to treat infections caused by bacteria and antifungals to treat fungal infections
• Isotretinoin supplements (a synthetic derivative of vitamin A)
• Surgery to remove lesions (however, the lesions can still come back and the area may still become cancerous)
• Laser or light ( photodynamic ) removal of lesions
• Freezing ( cryotherapy ) to remove sessions
• Electric heat ( electrocauterization ) to remove lesions

Prevention

You can’t always prevent white spots in your mouth but there are some steps you can take to make them less likely to pop up and stick around:

• Avoid tobacco and alcohol
• Stay hydrated and eat a nutritious diet
• Take care of your oral health (e.g., get the right toothbrush, avoid irritating toothpaste or mouthwash, floss regularly, and see a dentist for cleanings)
• Promoting your overall health and well-being by managing stress, spending time with loved ones, and getting enough sleep
• Managing any health conditions you have
• See your provider, especially if you have other symptoms, and follow their recommendations

Know that even with treatment and prevention, the white spots may come back, depending on what caused them.

You may need to have your mouth checked by your dentist or provider to make sure that the area is healing well and catch the spots early if they start to return.

Summary

Most causes of white spots in your mouth are probably not serious and can be managed on your own by making some changes like drinking more water and taking care of your oral health.

However, if you have white spots in your mouth along with other symptoms, it’s important to talk to your provider. Causes like STIs, underlying health conditions, and cancer need to be diagnosed and treated.

Taking care of your overall health—but especially your oral health—can help prevent white spots in your mouth and keep them from coming back once you clear them up.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

1. Cleveland Clinic. Leukoplakia.
2. Carrard V, van der Waal I. A clinical diagnosis of oral leukoplakia; A guide for dentists. Med Oral. :0-0. doi:10.4317/medoral.22292
3. University of Florida. Leukoplakia.
4. Kuribayashi Y, Tsushima F, Morita K, et al. Long-term outcome of non-surgical treatment in patients with oral leukoplakia. Oral Oncology. 2015;51(11):1020-1025. doi:10.1016/j.oraloncology.2015.09.004

By Sherry Christiansen
Sherry Christiansen is a medical writer with a healthcare background. She has worked in the hospital setting and collaborated on Alzheimer’s research.

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