Is the Roof of Your Mouth Painful or Sore?

Environmental causes

Food and liquids often contact the mouth first. You may experience irritation or an allergic reaction that affects the roof of the mouth more severely.

• Irritants: Tobacco and alcohol are serious irritants to the body. They can cause significant irritation of the mouth and even cause some types of cancer. Tobacco and alcohol can cause excess cell growth in the mucosal lining of the mouth due to chronic irritation and dehydration and result in painful sores in the roof of the mouth.
• Trauma: The most common causes of mouth ulcers are due to trauma. Trauma includes a direct injury, such as a blow or a fall to the face or mouth, but trauma can also occur from ill-fitting dentures, loose fillings, and even braces.
• Diet: Different types of food can trigger the development of painful sores or lesions in the roof of the mouth. Foods that cause this include spicy or acidic foods like oranges, eggs, strawberries, and even chocolate. Diets that lack nutrients such as vitamin B12, vitamin C, folate, or iron can also result in pain localized to the roof of the mouth.

Acute necrotizing ulcerative gingivitis (anug)

Acute necrotizing ulcerative gingivitis (ANUG) is a relatively rare infection of the gums. It's also known as "trench mouth", as it was discovered in a large number of soldiers in WWI that were stuck in trenches. The pain caused by ANUG is what makes it different from chronic periodontitis, and it requires treatment by professionals.

Rarity: Rare

Top Symptoms: bleeding gums, gum pain, chronically bad breath, severe mouth pain, gum swelling

Urgency: In-person visit

Viral throat infection

A sore throat is most often caused by the same viruses that cause influenza and the common cold. The illness spreads when an infected person coughs or sneezes, and then someone else inhales the airborne virus or touches a surface where it has landed.

Those most at risk for viral sore throat are children, smokers, those who work indoors with others, and anyone with a weakened immune system.

Symptoms include throat irritation; pain when swallowing or talking; red, swollen tonsils; fever; body aches; and cold-like symptoms of cough, sneezing, and runny nose.

If symptoms do not clear up within 24 hours – especially in children – a medical provider should be seen. A persistent sore throat can be a symptom of serious illness such as mononucleosis, measles, chickenpox, or croup.

Diagnosis is made through physical examination and throat swab.

Treatment involves rest, fluids, and over-the-counter pain relievers. Do not give aspirin to children. Antibiotics only work against bacteria and cannot help against a viral illness.

The best prevention is frequent and thorough handwashing.

Oral herpes

Oral herpes infection or HSV-1 is caused by a virus called herpes simplex virus. It transmitted when a person with active sores has intimate or sexual contact, such as kissing or oral sex with another person. The first outbreak tends to be the most painful because people typically get a cluster of mouth sores and other symptoms such as fever, headache, sore throat, and swollen lymph nodes.

Rarity: Rare

Top Symptoms: fever, gum pain, painful mouth sore, gum swelling, gum redness

Symptoms that always occur with oral herpes: gum pain

Urgency: Self-treatment

Melanoma of the mouth

Mucosal melanoma of the head and neck (MMHN) is a rare cancer that is approximately 10% of melanomas arising in the head and neck and approximately 1% of all malignant melanomas. It is more common in an elderly population and has a poor prognosis.

You should see your doctor in the next 24 hours, where a biopsy of your lesion is diagnostic. Surgical removal is generally considered the primary treatment whenever the lesion is able to be removed. Radiation therapy has not yet been well proven, but it is often used after surgery to improve control of the disease.

Rarity: Ultra rare

Top Symptoms: gum pain, gum swelling, brown-colored skin changes, black-colored skin changes, mouth rash resembling an amalgam tattoo

Urgency: Primary care doctor

Gingivitis

Gingivitis is the infection of the gums surrounding the teeth. It is caused by plaque and/or tartar that has built up on your teeth. Plaque is a sticky layer of gunk made by food particles, mucus, and bacteria. After a while, plaque hardens to become tartar (or calculus). Plaque and tartar at the bottom of the teeth causes the gums to become irritated and infected.

You should go to the nearest dentist in the next few weeks. There, the dentist or dental hygenist will clean your teeth, getting rid of that nasty plaque/tartar. Once cleaned, you should rinse your mouth twice-a-day with chlorhexidine 0.12% oral rinse (PerioGard) or half-strength hydrogen peroxide. Flossing and brushing your teeth are also essential.

Common cold

The common cold is a contagious viral infection that can cause cough, congestion, runny nose, and sore throat. Most adults catch two to three colds per year, and kids can get more than eight colds each year.

Rest and drink plenty of fluids. Colds are contagious and can easily spread to other people, so if possible, avoid close contact with others, such as hugging, kissing, or shaking hands. Colds typically resolve within 7 to 10 days.

Cold sore

A cold sore, also called a fever blister or herpes, is actually a collection of tiny, fluid-filled, crusted blisters.

Cold sores are caused by herpes simplex viruses HSV-1 and HSV-2. The sores are highly contagious through direct contact, such as kissing or oral sex, even when no sore is visible.

Most susceptible are young adults who are sexually active, though anyone can be infected. The virus can also survive on shared towels, eating utensils, etc.

Symptoms include a tingling or burning sensation around the lips, nose, or cheeks a day or so before the blisters appear. There may also be fever, sore throat, and other flu-like symptoms.

The herpes simplex virus cannot be cured, but cold sores can be managed under medical supervision to ease discomfort and help prevent transmission or complications.

Diagnosis is made through physical examination.

The blisters usually heal within two to four weeks, but the virus remains dormant within the body and can recur at any time. Antiviral creams or pills are sometimes used to help the healing process.

Canker sore

Canker sores are small, grayish-white sores in the mouth, often on the inside of the cheeks, lips, and on the tongue. No one really knows why canker sores happen, but it seems to be inherited and susceptible to vitamin deficiencies and allergies.

You can safely treat this condition on your own using Chlorhexidine mouth washes (Peridex or Periogard) or steroid medications (Orabase, Betnesol, or Ovar).

Burning mouth syndrome

Burning mouth syndrome (BMS) is a chronic pain syndrome defined as having a burning pain or sensation in your mouth without a cause that can be found. It happens way more often in women (7 times more likely), typically during times of hormonal changes (just before or during menopause). While no one has identified the cause, it could have to do with the makeup of saliva, damage from dentures, tics or teeth grinding, infections, and even autoimmune diseases.

You should go to your primary care doctor in the next few weeks. There, the doctor will rule out other causes of your pain. If it is indeed burning mouth syndrome, there are a few medications you can take. However, treatment is often not successful.

Rarity: Common

Top Symptoms: dry mouth, changed sense of taste, tongue pain, burning sensation in the mouth, moderate mouth pain

Symptoms that always occur with burning mouth syndrome: burning sensation in the mouth, tongue pain

Urgency: Primary care doctor

Are canker sores contagious?

No, canker sores are not contagious. However, there is a similar mouth sore that presents similarly, called a cold sore, that is contagious. Make sure to make an appointment with your doctor to get the correct diagnosis.

What is the difference between a canker sore and a cold sore?

A cold sore is a painful mouth lesion that is caused by the herpes simplex virus. This virus is spread through bodily fluids and can transfer via kissing, sexual relations, and even sharing drinks. These sores usually look like small fluid-filled blisters clumped together that often occur right on the lips or at the border where the lips meet the skin on the face. Canker sores (also known as aphthous ulcers), on the other hand, are non-contagious lesions usually of inflammatory etiology. They can result from a variety of causes, including food and systemic conditions.

Is a pain in the roof of my mouth dangerous or life-threatening?

Pain in the roof of the mouth can be the first sign of a painful sore or lesion. This sore can be the first sign of serious skin reactions that can be life-threatening or cancer that is developing. It is always important to follow-up on your symptoms since many of the underlying conditions often require follow-up and treatment.

Is a pain in the roof of my mouth an acute or chronic condition?

There are some cases in which this symptom can be chronic, especially those associated with autoimmune conditions like inflammatory bowel disease. Red spots related to habits such as tobacco and alcohol may also persist and become chronic, whereas bacterial infections are more acute.

Can painful sores in my mouth spread to other parts of my body?

Painful sores in the mouth can spread or appear on other parts of the body depending on the cause. For example, infectious causes ranging from bacteria to fungi can cause spots to appear not only in the mouth but also in areas such as the genitalia and under the armpits.

What can I do at home to heal the roof of my mouth?

At-home remedies such as saltwater rinses can have multiple benefits at once by helping soothe some of the pain and by disinfecting the area. To avoid exacerbating the issue, do not eat spicy or acidic foods, and take over-the-counter medications such as ibuprofen to help with the pain.