Frequently asked questions about white patches in the mouth

What is a white patch in the mouth?

A white patch is an area of thickening in the lining of the mouth (mucosa) and has a white appearance (also called leukoplakia).

Why do people get white patches?

Your mouth (and tongue) are lined with a special type of skin (mucosa), which looks (mostly) pink because it is thinner than your other skin (eg on your arms and legs). Some changes to your mouth lining can change its colour to white:

  • 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).

  • If you burn your mouth (eg after hot drinks or food) you can get white blisters, which usually peel off soon afterwards.

  • If you have been ill for a while or haven't moved your tongue around much, you can get a furry white tongue. This is because the skin on the taste buds has not been rubbed off normally. You can usually gently rub/scrape this off with a toothbrush.

  • Mouth ulcers can be white because of thicker layers of skin cells forming that are trying to heal the injury.

  • If people have poorly fitting dentures they can get ulcers or sometimes white patches forming.

Dentists and doctors are most concerned about the white patches that can't be rubbed or scraped away. These show areas of thicker mouth lining, which can be signs of mouth conditions.

Where are white patches found?

A white patch can be situated anywhere in the mouth.

How big are white patches?

A white patch can be of any size.

What causes a white patch?

White patches are almost always due to some form of irritation including infection:

Other types are due to a generalised condition of the skin and mucosa (see below) and some might not have an easily identifiable cause.

How are white patches diagnosed?

Often an experienced dentist or doctor can tell what kind of white patch you have by its appearance, position and by asking you questions about how long you have had it etc.

Sometimes they will wish to take a biopsy of a white patch to make sure it is not something that requires more involved treatment.

What will a biopsy involve?

A biopsy is a sample of mouth tissue (eg lip, cheek, gum, tongue) that enables us to look at it under a microscope. We will use local anaesthetic to numb the area and sew it up afterwards using dissolvable stitches (sutures).

The biopsy area might be a little sore for a couple of days afterwards and you should rinse your mouth with warm salted water for a week to keep the area clean.

What can be done to help white patches heal?

As described above, there are many causes of white patches. Your dentist (or doctor) might offer you the following advice:

  • Stop (or greatly reduce) smoking (smoker's keratosis);

Or will offer you the following treatment to help it heal up (or prevent it forming):

  • Smoothing sharp edges on teeth (frictional keratosis);

  • Remaking or relining dentures;

  • Eradicating infection (such as fungal infections: candida);

I have a sore white patch, what can I do to make it more comfortable?

Occasionally, white patches can become sore. If this is the case, it is important to avoid anything that might make it worse, such as spicy or abrasive foods and alcohol.

If it remains a problem, your dentist or doctor can prescribe special mouthwashes or ointments.

Should I be worried about white patches?

Most white patches are a reaction to an irritation and are not a cause for concern. Very rarely, they can be an early sign of more serious mouth conditions (including mouth cancer). This is why it is important to seek advice from an experienced professional (your dentist or doctor) so they can help you remove possible reasons for them forming and follow up on any unusual ones.

I have a white patch that is being 'watched', how often will I need to return and what should I do between appointments?

Some people have white patches that we have some concerns about and are not sure if they will repair on their own (or after we have removed some of the possible causes of irritation).

We will explain that we are 'watching' the patch and would like you to return for a follow-up appointment (usually after 3-12 months).

It is important that you attend these appointments so we can check that the white patch has not changed.

Do heed any advice you are given about stopping smoking, and reducing a heavy alcohol intake, or cleaning the area.

Do keep an eye on the patch yourself and if you think that it has changed, or if it becomes painful or forms an ulcer or lump, please ring the dentist or doctor who is caring for you. Explain to them what you have noticed and they might decide to bring your appointment forwards. It is better that they take a look at it to stop you worrying about it.

What is leukoplakia?

Leukoplakia just means white patch in Greek. It is a term used for white patches that do not fit into any of the above categories, most of which have causes that can be avoided or treated.

If we are not sure of the cause and type of white patch we will often want to find out what is happening in the mouth or skin by taking a biopsy.

Depending on the biopsy result, we might recommend that the white patch is completely removed or carefully watched by an experienced professional to make sure that it doesn't develop into anything more serious. These options will be discussed with you carefully.