A number of patients suffer from white spots on the normally completely pink-looking gums. In other patients, the gums are even completely white. These gum abnormalities have several mild but also some serious causes. In addition, the gum disease may be accompanied by other symptoms, such as pain or discomfort. Furthermore, sometimes one spot or several spots appear in groups on the gums. These vary in size, shape and texture. Patients with gum discolouration should visit the doctor or dentist for a thorough check-up. If necessary, the doctor will treat the underlying problem of the gum stains or other gum discoloration after making the diagnosis. Finally, adhering to a healthy lifestyle and practicing good oral hygiene are some key points for reducing the risk of gum problems, such as white-looking spots on the gums and white gums.

• Causes of white (looking spots on) gums

• Canker sores
• Anemia
• Gingivitis
• Leukoplakia
• Oral cancer
• Oral lichen planus
• Thrush
• Dental treatment

• Diagnosis and examinations
• Prognosis of white gum spots and white gum discoloration
• Prevention of white spots on the gums

• Lifestyle
• Oral hygiene

Causes of white (looking spots on) gums

Canker sores

Canker sores develop on the soft tissues of the mouth and around the gums. The cause is unclear, but some risk factors do play a role, such as a bacterial infection, injury or irritation of the oral tissue, stress and nutritional deficiencies. Before the mouth ulcers appear, the patient may already have a tingling or burning sensation in the mouth. Canker sores are oval or round in shape and have red edges. Typically they have a white to pale yellow center. They cause stabbing pain, especially when eating or talking. When the patient has mild ulcers, they are relatively widespread and usually heal within one to two weeks. Larger ulcers are usually deeper and more painful. The recovery time is longer for these large ulcers, up to six weeks. If mouth ulcers persist for more than fourteen days, consult a doctor or dentist for professional medical advice. The doctor will then prescribe a mouthwash, ointment, gel and/or painkillers. The patient is also advised to rinse the mouth with salt water. If the patient suffers from severe canker sores, the doctor will use oral (taken by mouth) steroids. Laser therapy also reduces pain and promotes the healing process.Fatigue is one of the symptoms of anemia / Source: Concord90, Pixabay

Anemia

Anemia is a condition in which the patient has a shortage of red blood cells. As a result, tissues and organs do not receive enough oxygen. The condition has various causes, such as an iron deficiency or a vitamin B deficiency. Crohn’s disease (condition with diarrhea and abdominal pain) and other inflammatory diseases may also result in anemia. The blood disease is characterized by the following symptoms, among others:

• breathlessness
• paleness of the skin (pallor: lack of oxygen due to anemia)
• dizziness
• an irregular heartbeat
• extreme fatigue
• headache
• cold hands and feet
• chestpain
• weakness

Dietary changes, supplements, and treatment of underlying diseases are possible treatments for anemia.

Gingivitis

Gingivitis is the medical term for inflammation of the gums. The bacterial infection is accompanied by loose teeth, inflamed or red gums and bleeding gums when brushing or flossing the teeth. Most often, the condition results from poor oral hygiene leading to white-looking gums. Good brushing and flossing hygiene is necessary in combination with a six-monthly dental visit. The dentist is able to treat gingivitis with a few procedures.Leukoplakia may be the result of poorly fitting dentures / Source: Jim Sneddon, Flickr (CC BY-2.0)

Leukoplakia

Leukoplakia is characterized by thick, white spots in the mouth that cannot be removed with a toothbrush. The condition, which has an unknown cause, is more likely to develop due to smoking or the use of chewing tobacco, the abuse of alcohol and the wearing of ill-fitting dentures. The pale-looking spots may appear in combination with red lesions (erythroplakia). They are flat or irregular in shape. Furthermore, they thicken or harden over time. They cause pain and discomfort when swallowing (swallowing pain, difficulty swallowing) in severe cases, although most patients experience some soreness. Leukoplakia is normally a benign condition, but in some patients the spots in the mouth are a precursor to oral cancer. However, the presence of erythroplakia is often a greater risk factor for oral cancer. Stopping the use of tobacco products is recommended. Furthermore, if necessary, the doctor removes the white gum spots with a scalpel, laser or cryotherapy (treatment via freezing). Finally, antiviral drugs can be used for patients with leukoplakia who have a weak immune system.

Oral cancer

White gums are sometimes an indication of oral cancer (oral cavity cancer). This serious condition may spread quickly (metastasis) and affect the gums, tongue and palate. The patient then experiences small, flat and thin lumps around or on these areas. These are colored white, red or pink. However, some patients have no symptoms of oral cancer, so the doctor only makes the diagnosis at a late stage, when it has already spread to other areas of the mouth and also to the lymph nodes (lymph node metastases). Treatment usually consists of chemotherapy and surgery, although this also depends on the cancer stage.

Oral lichen planus

Oral lichen planus is an autoimmune disease that causes inflammation of the mucous membranes in the mouth. This causes the patient to develop white spots on the gums. Symptoms of oral lichen planus include:

• bleeding when eating or brushing your teeth
• burning pain
• open wounds
• redness
• sensitivity to hot or acidic foods
• swelling
• white, lacy spots in the mouth

The condition increases the risk of secondary infections and oral cancer. In addition, this causes nutritional deficiencies to develop more quickly, because some patients avoid healthy foods because they worsen the symptoms. There is no treatment for the disease, but to improve quality of life, the doctor prescribes corticosteroids to reduce inflammation. He may also use gels to relieve the pain. The patient must have regular check-ups with the doctor to check whether he or she is not suffering from nutritional and vitamin deficiencies. If necessary, the doctor prescribes additional supplements.

Thrush

Oral thrush (oral candidiasis) is a fungal infection caused by an overgrowth of the Candida albicans fungus. The condition presents as slightly raised sores with a creamy white appearance (resembling cottage cheese) on the gums. Babies and the elderly are most often affected by thrush in the mouth area, because they often have a weak immune system. Patients with only controlled diabetes mellitus or patients who use certain antibiotics are also at increased risk of thrush, although the fungal infection can occur in anyone. The condition may cause numerous symptoms such as:

• cracks or bleeding in the corner of the mouth
• a cottony feeling in the mouth
• a small bleeding
• a loss of taste
• irritation or pain under dentures
• pain
• creamy, white sores
• redness

The doctor prescribes an antifungal medication to treat thrush. Persistent or widespread Candida infections require a stronger antifungal drug (antimycotic).

Dental treatment

Having a tooth extracted causes trauma to the mouth, resulting in white gums. Teeth whitening is also a risk factor for temporarily white-looking gums. This is the result of the chemicals used. After a few hours, the gum discoloration disappears again.

Diagnosis and examinations

A doctor or dentist will inspect the white spot or spots on the gums and note any additional symptoms. To detect the cause of the white-looking spots on the gums, he may perform an extensive blood test and/or a biopsy (remove a piece of tissue and have it examined microscopically).

Prognosis of white gum spots and white gum discoloration

The outlook for patients with pale spots on the gums depends on the underlying cause, the patient’s overall health, and the speed of treatment. A regular dental examination is useful because it detects oral diseases more quickly and the patient can then receive prompt treatment. In this way it is possible to reduce the risk of complications. If the gum stains do not disappear within two weeks, it is recommended to make an appointment with the doctor or dentist.

Prevention of white spots on the gums

Sufficient exercise is important / Source: Skeeze, Pixabay

Lifestyle

The patient reduces the existing stress by using meditation, muscle relaxing exercises and by performing sufficient exercise. In addition, he eats a balanced diet and limits the intake of sugar, salt and alcohol. The patient should also avoid sugary drinks such as soft drinks, as the acid and sugar damage the gums.

Oral hygiene

Good oral hygiene prevents most gum problems, including white spots on the gums. The patient therefore visits the dentist twice a year for a check-up and to have the teeth cleaned. He also brushes his teeth twice a day with fluoride toothpaste and flosses his teeth once a day. The patient uses a soft or semi-soft toothbrush because hard toothbrushes irritate the gums and soft tissues in the mouth. Using a tongue scraper is useful to remove plaque, food particles and bacteria from the tongue. When using an oral care product, the patient uses a product without sodium lauryl sulfate, because this substance contributes to the development of cancer.

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• Teeth: Abnormal colors (tooth color) and shapes (tooth shape)
• Leukoplakia: Thickened white patches in the mouth and cheeks
• Oral cancer: Cancer in the mouth with swallowing problems and tumors
• Gingivitis: Inflammation of gums due to plaque on teeth
• Aphthous Mouth Ulcers: Painful aphthous ulcers (ulcers) in the mouth