You can see the development of small red spots on roof of mouth without any forewarning symptoms, injuries or disorders. These red spots could be canker sores, candidiasis, petechiae or any viral infections.

Usually, these red spots might create minor inconvenience but sometimes they could be signs of serious medical conditions. That’s why it is important to know the exact cause for early treatment.

Moving further in this article, you will see more about red spots on roof of mouth with types, cause and treatment options.

Canker sores

Canker sores are small circular elevations that appear in the mouth in different areas. They occur in many pathological conditions. They are usually reddish and appear as a soft spot with a white center and a bright red boundary.

These sores are recurrent and are different from cold sores which are usually seen outside the mouth such on the lips. Canker sores are seen most commonly on the roof of the mouth, the floor, or the inner lining of the cheeks.

Causes

Canker sores look like small ulcers and may have many possible causes. Often, they develop because of stress and anxiety and may heal on their own in a few days. These are recurring and the condition is termed as Recurrent Aphthous Stomatitis. (1)

They may also arise due to bad habits such as smoking and chewing of tobacco.

Canker sores can also occur if there is an irritation to our oral tissues because of dentures or some other ill-fitting prosthesis. Similarly, a sharp tooth edge may also irritate our mucosa and cause an ulcer.

Canker sores are also called aphthous ulcers. These sores are also linked to vitamin and iron deficiencies, particularly in females.

Sometimes, canker sores may be a manifestation of some systemic diseases like the Coeliac disease, or Crohn’s disease.

Treatment

Canker sores should be identified along with their cause. If the cause is linked to stress, then the sores are mostly self-healing and may resolve in about two weeks.

If they burn or cause irritation, topical anesthetics can be applied. One should avoid eating excessively spicy or hot food. If the sore is due to ill-fitting dentures, they should be corrected by a dentist.

Red spots on roof of mouth infographic

Petechiae

Petechiae are tiny red spots on roof of mouth. They are usually seen on the palate, overlying the blood vessels. They indicate increased pressure in the capillaries and may look red, purple or brownish.

Cause

Petechiae may be associated with different causes such as throat infections, side effects of medications like penicillin, quinine, etc., systemic conditions like endocarditis, vasculitis, scarlet fever, anemia, etc.

Treatment

You can manage petechiae through local antibiotics and painkillers. Even topical gels can be given for temporary relief.

Candidiasis

Candidiasis is a fungal condition, also called oral thrush. The organism which is the most common cause is Candida albicans. It manifests in the mouth as red and white spots or patches.

Thrush is more common in denture wearers, or patients having any debilitating illness like Diabetes or HIV. You can usually find these red spots on roof of mouth and corners of the lips.

Causes

Candidiasis has multiple aetiologies. Usually, fungi are present naturally in the mouth. But when the balance is disrupted, and the quantity of fungi increases, there is a fungal infection.

Thrush can also be present as a side effect of radiation therapy and chemotherapy for cancer treatment. These therapies weaken the immune system and make us more susceptible to such infections.

Similarly, any disease that weakens the immune system puts us at an increased risk of candidiasis. HIV, Diabetes, Leukaemia, etc. are some such diseases. (2)

Candidiasis is also seen in pregnant females as a vaginal infection and can be transported to the newborn. (3)

Clinical Appearance

Oral thrush manifests in forms that vary according to their location.

They can be seen inside mouth as white scrapable patches on the tongue, roof, and cheek lining. You can see white or red bumps which may bleed if scraped off. Occasionally, these turn out to be painful.

Treatment

Antifungal medications like Nystatin, Fluconazole are effective against thrush. Secondarily, identifying the cause and its management will provide relief to the patient.

Additionally, it is imperative to maintain good oral hygiene. Dentures should be kept clean, and one must use soft toothbrushes and periodically change them.

Viral Infections

There are a few viral infections that present as red dots on roof of mouth.

Coxsackie Virus

Coxsackievirus is the causative virus for hand foot and mouth disease. As the name suggests, it affects the hands, feet, and mouth. Blisters, sores or small ulcers are seen on the palate.

Though it is more common in children, it is also seen in adults.

Herpes Virus

Herpes simplex virus causes herpes, which may also be present in the recurrent form. Orally, it may present as small ulcers, elevations or bumps on the palate, floor, corner of the lip.

Recurrent herpes labialis is a contagious form of the infection that recurs frequently, and presents most commonly on the lips, but may secondarily spread inside the mouth as red spots.

Treatment

Antiviral treatment therapy, over the counter painkillers, and mouthwashes to provide relief from the sores- these are the primary methods to treat oral manifestations of viral diseases.

Acyclovir is the principle antiviral medicine used in the treatment of herpes infections. (4)

Over to you

White or red spots on roof of mouth might mean multiple things and have different treatments. But it is essential to maintain good oral hygiene and prevent these from spreading or aggravating in the mouth.

Red spots on roof of mouth can develop without any forewarning symptoms. These red spots could be canker sores, candidiasis, petechiae