Home MouthMouth Patches White Spots in Mouth and Small Painful White Patches in Mouth Causes, Treatment

White Spots in Mouth and Small Painful White Patches in Mouth Causes, Treatment

by Dr. Joe Morales

White patches in the mouth or small white spots in the mouth can be a sign of cancer, thrush, leukoplakia, an STD, strep throat etc. With the peeling white mouth patches, spots, and bumps, you can get bad breath, sore gums and even pain. Here are the causes, related symptoms, and treatment for small white patches in the mouth.

A white patch in the oral cavity is a “white or gray patch that develops on the tongue, the inside of the cheek, or on the floor of the mouth.” Sometimes, the coating forms on the roof of the mouth, on gums or sides of the tongue.

In most cases, the patches are a sign of irritation in the mouth. The source of the irritation can be broken dentures, wisdom tooth extraction or a rough tooth. Irritants such as tobacco, alcohol and some diseases such as thrush, HIV and diabetes cause overgrowth of cells in the mouth. These produce the white patches, spots, and bumps in the mouth.


White patches in mouth pictures

The size of the patches can differ. Some of them are small white spots. If the infection is spreading, you can easily get large patches or even sore bumps. Below are pictures to illustrate the symptom. You will also find pictures throughout the page to distinguish the various causes and what they mean.

White patches in mouth from oral thrush

Oral thrush affects babies because of weak immune systems.

Note that canker sores can be small white bumps or spots. Canker sores can also be tender white patches that peel off and recur or won’t go away. Other than using photos and pictures to identify the cause of the white substance, see a doctor for a biopsy and treatment.

Causes of white spots in mouth

Most cases of white spots and patches in the mouth and oral cavity point to a fungal infection. Oral thrush is one of the most common causes of a peeling white coating in the mouth. Patients of diabetes are the most likely to show white substances forming in their mouths.

There are over 25 different causes of white spots in the mouth. Some of them can be serious health conditions. Others are manageable problems that will go away on their own. In detail, the following are the possible causes of white patches in cheeks, tongue, lips, gums, the roof of mouth and floor of the mouth.

1. Oral thrush or fungal infection, candida

Fungal infections in the mouth are called thrush or candidiasis. It is when the fungus accumulates in your mouth lining. When infected, a patient can experience white bumps and patches on the mucous membranes of the oral cavity. The signs of yeast infection in the mouth and throat include the following:

white spots and blotches on in mouth from candida

Candida in the mouth

  • White patches (plaques) in the mouth that can often be wiped off, leaving behind red areas that may bleed slightly” [Source – NHS]
  • A burning sensation in your mouth, usually with cracks on corners of lips.
  • Bad taste in mouth or loss of taste.
  • Painful patches in the mouth that may become red due to irritation.

Oral thrush patches are common in babies. Infants are highly prone to fungal infections because of poor oral hygiene and weak immune systems. When infected with this overgrowth of Candida albicans, infants will have “creamy white lesions, usually on the tongue or inner cheeks. Sometimes oral thrush may spread to the roof of your mouth, your gums or tonsils, or the back of your throat.” [Source – Mayo Clinic]

2. Leukoplakia white patches that peel off

Leukoplakia is, in a general sense, a white patch that forms in the mouth. Leukoplakia white spots in the mouth form on the mucous membranes of the mouth. These patches often peel off. According to the National Health Service, leukoplakia patches do not cause pain.

Leukoplakia patches in mouth

Leukoplakia patches in the mouth.

  • Leukoplakia is one of the most common premalignant or malignant disorders of the mouth.
  • According to DermNet NZ, leukoplakia patches are defined as “white patch or plaque of the oral mucosa.” These patches cannot be categorized as any other disease.
  • Excessive drinking of alcohol, tobacco smoking and chewing and rough dentures are commonly identified as causes of leukoplakia.
  • Oral leukoplakia patches can form on the lips, mouth, side of the tongue, under the tongue, gums cheeks and roof of the mouth.

Usually, a biopsy is done to determine the cause of the white spots in the mouth. A biopsy is important because it can identify changes that may identify oral cancer.

3. Cancer patches and bumps in mouth

White patches, bumps and spots in the lining of the mouth should not be ignored. They could be a sign of oral cancer, also called mouth cancer. This type of cancer can affect any part of the oral cavity. These include the roof of the mouth, under the tongue, the lips, tongue, and gums.

The most common causes of mouth cancer include smoking, drinking too much alcohol, chewing tobacco, poor dental hygiene and HPV and erythroplakia. Cancer may also develop for no apparent reason. Its symptoms include the following:

  • White patches, spots or bumps mouth. These can form anywhere in the mouth.
  • Red erythroplakia patches in the mouth.
  • Pain when chewing and swallowing.
  • Numbness in the mouth.
  • Unusual bleeding in your mouth and loose teeth.
  • A lump may form on the lip, mouth, throat or even roof of the mouth (palate).

NOTE: Cancer is a terminal disease. Early treatment and management can prevent it from spreading. If you have any mouth sores or ulcers that don’t heal or go away after three weeks, see a dentist or doctor for a check-up.

4. STDs – HIV, Herpes

Are white patches in the mouth a sign of HIV? As seen above, we noted that WebMD lists HIV and AIDS as part of the possible causes of white patches in the mouth. Normally, mouth sores may show as symptoms of the many diseases that come with HIV. STDs such as AIDS cause a weakened immune system, leaving the patient prone to candida attacks.

  • At a later stage of HIV infection and development, patients get a yeast infection, also called candida or oral thrush.
  • It causes white spots on the tongue and parts of the mouth.
  • Walls of the mouth are likely to be infected and form a white coat, some of which occur on the sores.

5. Mono or glandular fever

Mononucleosis or mono is a viral disease that is commonly spread through kissing. If you get white patches in mouth after kissing, it is likely to be caused by mono. This disease is also called ‘the kissing disease’ or glandular fever.

White patches on lips from leukoplakia

Glandular fever, fungal infections etc. may have such symptoms

This infection comes with flu-like symptoms. You are likely to feel sick, fever, headaches and even have a sore throat. According to NHS, mono or glandular fever causes swollen glands in neck and back of ears. You can also get small red or purple spots on the roof of your mouth.

There is no cure for mono or glandular fever. Its symptoms should go away on their own after a few weeks. However, remedies may include the use of over-the-counter painkillers, rest and taking enough fluids.

6. Mouth aids, dentures or braces

For white patches on gums, cheeks, and roof of the mouth, things to do with teeth may be to blame. Gums may experience white patches more often because they are irritated every now and then. However, your gums should be able to withstand most of the roughing from toothbrushes, food and other oral movements.

  • Poorly fitting dentures, braces, and mouth aids may cause white patches on the tongue and other parts of the mouth.
  • A rough crown and cheek biting can also cause painful white spots in cheeks.

According to Cambridge University Hospitals, “It is common for people to have a line of white along the inside of their cheeks, this is where their teeth rub against the cheek (and is quite normal).”

7. Tobacco smoking and chewing

You may be getting white patches in the mouth from chewing tobacco. Smoking causes white patches in the mouth or oral thrush. Leukoplakia is a common problem among smokers. According to Mayo Clinic’s statistics, two out of three tobacco users will develop leukoplakia in their lives.

White coating under tongue

Side effects of tobacco chewing and smoking may include white cancer lesions in the mouth

  • Dipping drugs or tobacco is known to cause white patches inside lower lips.
  • Other than a white coating on tongue and mouth, chewing tobacco can cause a sore throat that does not go away easily.
  • Smokers are highly likely to be found with a white or red patch on the gums, lips, tongue, or lining of the mouth.

In order to prevent and stop the white or greyish patches and spots inside the mouth, tongue, and cheeks, quit smoking cigarette.

8. Diabetes and white spots in mouth

Diabetes is highly linked to white spots on the mouth. In fact, oral thrush or candida is common in diabetics. High blood sugar creates a conducive environment for fungus to grow and thrive. Diabetics who take antibiotics often are even more prone to white bumps in the mouth due to yeast infections.

Other common oral and dental problems associated with diabetes include burning mouth syndrome, gingivitis, dental caries, dry mouth, lichen planus and taste dysfunction. Management of diabetes can help reduce the infections that come with it.

9. Strep throat or a sore throat

Strep throat is a bacterial infection in the throat. It usually causes the throat to feel sore and painful. It is caused by streptococcal bacteria. The most prominent sign of strep throat is the throat feeling scratchy or itchy.

White mouth patches, spots, and bumps spread to the tonsils and throat. You may suffer difficulty swallowing food, or pain when swallowing, with white substances in the throat. These may be caused by strep throat.

According to eMedicineHealth, “A sore throat associated with strep throat is usually described as starting rather suddenly, and the tonsils and the back of the throat may appear red and swollen. Swallowing is usually painful…” Tonsillar exudate or white patches on tonsils or back of throat and mouth are also listed as signs of strep throat.

10. Antibiotics e.g. amoxicillin

You can also get white bumps, spots and patches in mouth after taking antibiotics. Candida albicans is a yeast that is naturally found in the mouth. Antibiotic medications may cause signs of oral thrush, including white spots and patches in the mouth.

Strong antibiotics such as amoxicillin can disturb the balance of these yeast cells in the mouth. The result is an overgrowth of the yeast cells, causing white spots in the mouth. Without a remedy, the spots can grow and spread into large white mouth patches. Other medications that can also lead to white patches include:

  • Corticosteroids
  • Birth control pills and
  • Most strong antibiotics such as penicillin

11. Mouth ulcer patches that won’t go away

Mouth ulcers can also cause white patches in the mouth. This is because there will be a thick layer of cells that will form trying to heal the area with an injury. Biting cheeks, the lip or any physical trauma on the mouth can cause mouth ulcers. This type of ulcers is called traumatic ulcers and can produce white bumps, spots, and patches.

White patches inside cheeks due to mouth sores

Mouth ulcers and sores

Mouth ulcers that won’t go away or won’t heal are called aphthous mouth ulcers. These recur from time to time and may be painful. However, gray patches in the mouth from such ulcers usually go away on their own and may not require treatment. They may then come and go periodically.

However, remain observant especially if the white patch on cheeks in mouth remains persistent, becomes painful and bumpy or ulcerous. This could indicate a serious health problem such as oral cancer that might need immediate medical attention.

12. Painful white patches in the mouth from oral lichen planus

Mouth lichen is a chronic inflammation of the mucous membranes of the mouth. It can affect gums, tongue, cheeks, and inside of lips. It may result in “white, lacy patches; red, swollen tissues; or open sores.

  • Oral lichen planus is an autoimmune disorder. It occurs when the immune system attacks the mucous lining of the mouth cavity.
  • Painful white spots in mouth, bumps or patches result from this autoimmune attack.
  • Patients of mouth lichen planus are at a higher risk of developing oral cancer.

The lesions and sores in the mouth that develop as a result of this problem can be large and painful. They can spread up to the lips, back of the throat and even tonsils. The British Oral Health Foundation notes that “Large ulcers may appear near the tonsils and can be very painful, especially when you swallow. You usually only get one at a time.”

13. Canker sores and cold sores on tongue and mouth

Tongue sores and canker sores can appear as white spots in mouth

Tongue sores and canker sores can appear as white spots in mouth

The mouth can get all kinds of sores. These may include tooth abscess sores, canker sores, and cold sores. Cold sores are caused by the HSV virus. They form lesions and blisters around the mouth, nose, and lips. Sores on nose, mouth, and lips can spread onto the inner lip. The resultant scab of the cold sore healing process can leave a whitish spot on the mouth.

Canker sores, on the other hand, are ulcers that usually occur in the mouth. According to Colgate, canker sores in the mouth often run in families. They are also linked to some diseases, such as Behcet’s syndrome.

  • “Canker sores are white or yellow and surrounded by a bright red area.” [U.S. NLM]
  • These sores and white spots in the mouth are not cancerous.
  • While canker sores often co-occur with viral infections, the cause is sometimes not known.

Hormonal changes during pregnancy, biting the cheek, rough brushing of teeth and some food allergies may all cause canker sores that appear as white spots in the mouth. In addition, vitamin and mineral deficiency, especially iron, folic acid, or vitamin B-12 may cause canker sores.

The United States library of medicine describes these mouth sores as follows:

  • One or more painful, red spots or bumps that develop into an open ulcer
  • White or yellow center
  • Small size (most often under one-third inch across)
  • Gray color as healing starts

See home remedies for white mouth patches below for treatment and ways to get rid of canker sores in your mouth, cheeks, lips, and tongue.

Burning after eating or rinsing with hydrogen peroxide

Hot foods, acidic foods, and substances such as hydrogen peroxide can also lead to white spots and patches in the mouth. According to the Cambridge University Hospitals, burning your mouth when eating, you are likely to end up with white blisters. The blisters will start to peel off afterward.

Rinsing or gargling with hydrogen peroxide can also cause similar symptoms. If you do not dilute hydrogen peroxide, you are likely to burn your lips, cheeks, gums, and roof of the mouth. Similar chemical irritation can occur from aspirin and smoking (smoker’s keratosis).

Other causes of white bumps in mouth or white blotches in the mouth include the use of inhalers that irritate the mucosa lining. Measles and leukemia have also been identified as possible causes of mouth sores and ulcers.

You may also get white blotches behind teeth or on the roof of mouth after tooth extraction or after tonsillectomy surgery. This is due to the thickening of the lining of the mouth as the trauma spots begin to heal.

Symptoms white patches on the roof of the mouth

If caused by a mouth infection or a disease, some symptoms may accompany these bumps, spots, blotches, and patches. The accompanying symptoms may be severe or mild, depending on the reason behind them.

Leukoplakia white patches and bumps on tongue and mouth

Leukoplakia patches on the tongue

  • Bad breath and bad taste in your mouth
  • Fever Chills
  • Sore gums that may bleed or form an abscess
  • Painful sores on gums, inside lips and cheeks or roof of the mouth
  • White patches in the mouth that rub off or peel off
  • Spreading blotches – these usually start as small areas and grow into large blotches and patches
  • Headaches in case of severe infections.

It is important not to ignore these symptoms. See your doctor for proper diagnosis and treatment.

White patches in mouth treatment

Treatment may not be needed to get rid of white patches in baby’s mouth. If need be, especially when the thrush is not clearing by itself within a few days, a pediatrician will prescribe an anti-thrush gel medication, usually miconazole or drops of nystatin.

You can also prevent white patches in the mouth by practicing good oral hygiene and avoiding sugary foods. For babies, sterilize their feeding equipment especially the teats of feed bottles.

a) Antifungal treatment for oral thrush

People with a weakened immune system may find it difficult to get rid of oral thrush and white patches. Your doctor is likely to prescribe anti-fungal medications to manage and treat candida overgrowth in the roof of the mouth, gums, cheeks, and floor of the mouth.

Anti-fungal medications are taken over 10 to 14 days. You can get these prescription treatments for white mouth patches and spots in the form of lozenges, tablets, and liquids.

b) Chemotherapy and radiation treatment for oral cancer

Cancer treatment options include surgery, radiation treatment, and chemotherapy. The most preferred method of treating early cancer in the mouth is surgery. The ulcer that is forming a white patch in the mouth is surgically removed and with it cancerous cells.

Laser surgery may sometimes be used to remove smallmouth cancers. This may be combined with a light-sensitive medicine in the treatment known as photodynamic therapy (PDT).” [Patient.info]

Radiotherapy and chemotherapy are also popular methods of treating cancer. Your doctor will advise you which of these is the best for your situation.

c) Antibiotic treatment for strep throat

When mouth white spots are caused by strep throat or bacterial infections, antibacterial treatments are given. These may be in the form of mouth sprays or tablets. These medications are meant to inhibit the spread of the bacteria in the oral cavity.

  • Examples of medications commonly prescribed to get rid of strep throat include penicillin and amoxicillin.
  • Ibuprofen or acetaminophen are pain relievers that may also be given to reduce the pain that comes with strep throat.

d) Painkillers to manage mouth ulcers that hurt

Mouth ulcers caused by the autoimmune disease have no treatment. However, your doctor is likely to apply symptomatic treatment to help relieve the pain and discomfort in the mouth.

  • Corticosteroid prescriptions will help reduce inflammation that may be caused by lichen planus.
  • These pain relievers may be given as oral, injections or topical medications.

If the patient is suffering from severe pain, immune response medicines may be given to help get rid of the white patches in the mouth. These may include calcineurin inhibitors such as pimecrolimus (Elidel) and tacrolimus (Protopic). Medications that suppress the immune system may also be given.

e) Remove the irritant

What is the treatment for leukoplakia and oral thrush? White patches inside mouth treatment may involve mainly removing the cause of the irritation. The following treatments and cures may be applied for leukoplakia white oral patches.

  1. Smoothening out of a rough tooth causing it.
  2. Stop smoking or reduce smoking if tobacco smoke is the main cause of the problem.
  3. After a biopsy, the doctor might decide to treat the lesion by removing it surgically.
  4. Antiviral medication may be prescribed to treat oral thrush – caused by a yeast infection or candida.
  5. Your doctor may change the antibiotic medications causing the white spots in the mouth.

For diabetic patients, and those having white patches in the mouth due to cancer, it is important to see a doctor as soon as possible. Avoid trying home remedies and treatments such as rubbing off the lesion.

Home Remedies to Get Rid of White Spots in Mouth

Home care tips can also help you improve the situation. Proper dental hygiene is one of the best ways to get rid of white mouth patches and spots. Hydrate your body enough to prevent a dry mouth and an itchy throat.

Eating a well-balanced diet will also help prevent infections that may cause sores, lesions, and patches in the mouth. If you are a smoker, quit smoking and chewing tobacco. Reduce alcohol intake too to prevent and get rid of oral leukoplakia lesions. These are some of the major irritants that cause white mouth blotches. Here are more home remedies for white mouth sores and lesions.

1. Salt water rinse

Saltwater discourages the growth of bacteria and other microorganisms in the mouth. If these are the ones causing white patches in the mouth, you will be able to get rid of them with salt water gargles and swishes.

  1. Make a warm water solution with some salt.
  2. Swish this water in your mouth for about 2 minutes.
  3. Spit the solution out.
  4. Repeat this twice a day to get rid of the white blotches in the mouth.

2. Hydrogen peroxide remedy for mouth sores

Improper use of hydrogen peroxide can burn your mouth and cause further irritation. Ensure you are careful with it. Hydrogen peroxide has antiseptic, antibacterial and antifungal properties. It can help heal oral thrush and strep throat. Here’s how to get rid of white spots in the mouth with hydrogen peroxide.

  1. Dilute hydrogen peroxide with water in a ratio of 1:1.
  2. Apply the solution directly to the area of your mouth with white lesions. Use a cotton swab for this.
  3. Leave for about 3 minutes and rinse your mouth well with plenty of water.
  4. You can also swish this mixture in your mouth daily for better results.

3. Milk of Magnesia and half Benadryl liquid

These two are anti-allergens and will help remove white mouth patches and spots caused by allergies. Here’s how to use them as home treatments for your sores and lesions.

  1. Mix a quarter a glass of milk of magnesia with a quarter a glass of Benadryl liquid.
  2. Stir well to mix.
  3. Rinse your mouth with this remedy for about one minute.
  4. Spit it out after swishing well.
  5. Repeat daily for faster healing.

4. Chamomile tea bags

Chamomile has both antiseptic and anti-inflammation properties. Due to this, it can be used as a home remedy for painful patches and sores in the roof of the mouth. Here’s how to use chamomile tea bags to get rid of the white coating in the mouth, tongue, roof of the mouth, gums, cheeks and even floor of the mouth.

  1. Soak a chamomile tea bag in water for about 2 minutes.
  2. Place the tea bag in your mouth, especially on parts with the white patches and coating.
  3. Leave it for about 7 minutes.
  4. Repeat twice a day to get rid of the lesions fast.

You can also use sage tea bags instead of the chamomile tea.

Sources and references

  1. WebMD: Leukoplakia Patches: Causes, Symptoms, and Treatments
  2. Mayo Clinic: Oral Thrush Causes, Symptoms and Treatment
  3. The U.S National Library of Medicine: Leukoplakia Causes, Biopsy, Prevention and Treatment
  4. eMedicineHealth: Strep Throat Causes, Symptoms and Treatment
  5. The British Oral Foundation: Mouth Ulcers
  6. Patient.info: Aphthous Mouth Ulcers,

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