How Did They Get There and What Can You Do About Them?
We may enjoy polka dots on our umbrella. A cheetah spotted sweater may be the favorite piece of clothing to build an outfit. A pocket square could be the well-spotted accessory that pulls together everything you’re wearing (or maybe it’s the spotted socks). There are certainly ways that spots or polka dots can improve our day and our appearance. However, if we find spots inside our mouths, we’re not happy to see those. They are not the perfect cap to our appearance; instead, they’re a matter of medical concern. White or yellow spots or bumps sometimes do appear on the roof of the mouth, and it’s totally normal to want to know what they are and what to do about them.
Most Likely Culprit: Oral Thrush
If your mouth has developed a case of cream-colored or white spots that may move or bleed if you wipe at them with gauze or a toothbrush, you may very well be suffering from oral thrush. Oral thrush tends to occur most often in babies, but it absolutely can pop up in older children and adults. When it occurs in adults, it occurs most often in adults who use dentures or certain medications, particularly inhaled corticosteroids, that change how your immune system and oral microbiome function. Thrush also tends to occur in people who have weakened immune systems. Thrush is an infection caused by a common type of fungus (or yeast) that can overgrow in certain people.
What Can Be Done: At Home or In-office Medical Treatment
For many people, an at-home treatment may be enough to deal with oral thrush. At-home options include rinsing with saltwater or using baking soda water on the thrush spots. It’s also important to properly clean your retainers, dentures, or anything else you would leave in your mouth to keep the fungus from re-infecting your mouth. If you prefer medical office treatment or if at-home options are not working, your doctor or dentist can help you with an antifungal medication.
When the Spots Won’t Budge: Leukoplakia
If you have tough white spots that won’t budge at all when wiped, it’s probably not oral thrush. It’s possible that you have changed to the skin of your mouth called leukoplakia. Most of the time, those whitish, different looking patches in the mouth are benign. However, there is a small chance that these changes are pre-cancerous or can become pre-cancerous, particularly if you have a history of tobacco use. So, it’s a good idea to have any changes to the inside of your mouth checked out by your dentist.
What Can Be Done: See Your Dentist
Your dentist has the training to evaluate spots inside your mouth and determine if they are safe and can be left alone, if they need additional monitoring, or if they need prompt care. Most of the time, leukoplakia just needs monitoring and can be left alone. If you have a history that puts you at a higher risk for cancer, your dentist may recommend a biopsy, where a small piece of the spot is removed and examined under a microscope to make sure there are no dangerous changes. Either way, your dentist is the right person to consult for next steps to maintain optimal oral health.
When Your Spot is a Lump: Torus Palatinus
So, what if it’s less of a spot on the roof of your mouth and more of a hard lump? It might be a common type of bone overgrowth called a torus palatinus. If it’s painless, started growing at some point around puberty, and is in the middle of the roof of your mouth (your hard palate), it’s likely to be this type of growth. Although it’s not perfectly understood why some people develop torus palatinus, it’s believed to be at least partially genetic since it runs in families. It also is associated with clenching and grinding, and high bone density. It’s most common in women and people of Asian descent.
What Can Be Done: Patience!
There’s usually no reason to mess with a torus palatinus. It’s not likely to turn cancerous, and it doesn’t usually hurt anything. If the lump becomes too large for safe eating and drinking or interferes with oral appliances (dentures, retainers), your dentist may refer you to a specialized surgeon to discuss if surgical removal of the overgrown bone is right for you. However, most of the time, it requires absolutely no attention or treatment.
The Bottom Line
Any time you have a spot or bump in your mouth, your dental care team is happy to help you correctly identify the causes and recommend a proper treatment plan. Most spots and lumps are readily dealt with, so there’s no reason to worry and avoid getting answers.