What is this white line that suddenly appeared on my gums?

white line on gums?
To know why a white line suddenly appeared on your gum, you first need to know the circumstances in which it occurred. It may result from oral surgery (extraction or gum graft), an injury, medication, or gum disease.
While most of them are harmless or even temporary, others have the potential to develop into more serious conditions.
In this article, you will learn about 8 potential reasons for white lines on your gums and their solution.

1. Receding gums

Gum recession—a condition where gums move away from teeth, leaving roots exposed—can have two main triggers: Plaque Buildup and Trauma.

When you don't keep up with regular oral care, a sticky white bacterial film called plaque starts to develop on your teeth and gums. If not cleaned away, it leads to inflammation, causing gums to gradually recede.

Alternatively, trauma stems from repeated gum tissue irritation. This irritation could be due to factors like piercings, aggressive brushing, or using a harsh toothbrush.

These ongoing irritations can harm the outer gum layer, initially creating Red or White fissures known as Stillman's Cleft. These fissures act as early indicators of gum recession. If overlooked, they can worsen, eventually revealing larger root areas.

Stillman's cleft, the first sign of gum recession

How is gum recession managed?

When you notice that your gums are receding, the first thing to do is to remove any local irritants. Start by brushing your teeth gently with a soft bristle toothbrush.
Also, visit your dentist for a professional tooth cleaning to remove tartar or any buildup from your teeth.
These measures will stop or even reverse the early stage of gum recession. However, if your gums have receded too far from your teeth, you may need a gum graft to cover the exposed roots.

2. Tartar accumulation

Plaque is a whitish, soft, bacteria-filled film that builds up on the surface of your teeth over time. When you don't brush your teeth for a long time, minerals from your saliva and food become incorporated and harden the plaque, turning it into tartar. Tartar can spread below and above your gum line, appearing as a white deposit that is hard to remove.

Because it sticks firmly to your teeth and gums, it can only be removed by professional dental cleaning (scaling and root planing).

3. After extraction or oral surgery

After surgery, especially if your dentist has incised and sutured your gums (following a gum graft or impacted wisdom tooth extraction), you need to give your tissues time to heal properly.

At the beginning of the healing process, your gums may look abnormal (white, swollen, and bleeding).

Don't worry about these symptoms, as they are temporary. They should gradually subside as healing progresses.

Most of the time, your gums will return to their normal appearance within 2 to 4 weeks, depending on the complexity of the procedure.

In rare cases, a whitish or pale pink line of scar tissue may remain at the surgical site. The risk of this happening is higher in older people and smokers. Persistent inflammation during the healing period or a systemic disease such as diabetes can also lead to scarring.

It is important to follow the post-operative care instructions provided by your surgeon to minimize the risk of scarring and ensure optimal healing.

4. Oral thrush

Oral candidiasis or thrush is an infection caused by a fungus called candida albicans.

Under normal conditions, candida albicans live in harmony with the oral flora. However, certain factors can disrupt this balance and increase its virulence. Among them:
  • Wearing a denture for a long time with poor oral hygiene.
  • Dry mouth.
  • Excessive use of antibiotics or mouthwash.
  • Long-term treatment with corticoids.
  • Chemotherapy and radiotherapy.
  • Certain diseases and viral infections such as diabetes and HIV.

Oral thrush can lead to soft, flaky, thick, creamy white or yellow patches that may look like curdled milk or cottage cheese on the oral mucosa (the pink skin inside your mouth). It may be accompanied by other symptoms such as redness, pain, and difficulty swallowing.

They usually appear first on the tongue and inside the cheeks and may spread to the gums and roof of the mouth.

How is oral thrush managed?

Oral thrush treatment depends on its severity. For mild forms in people with good general health, treatment consists of topical applications of antifungals. In moderate or severe cases, treatment may be both local and general.

5. Leukoplakia

white patches due to leukoplakia

Leukoplakia is an oral condition that appears as white patches inside the mouth that cannot be stripped off. These lesions result from an overproduction of keratin, a protein secreted by the cells of the oral mucosa. The role of keratin is to protect our tissues from the external environment.

When the mouth undergoes continuous irritation or aggression, it will release a thick layer of keratin to defend itself. The most known trigger is tobacco. Other aggravating factors include:
  • Alcohol.
  • Oral thrush.
  • Viral infection.
  • Hormonal imbalance.
  • Dietary deficiency.

The most affected sites are inside the cheeks and the lips sides, followed by the tongue, lips, roof of the mouth, and gums.
Most of the lesions are noncancerous. However, in some cases, leukoplakia can show early signs of cancer.

How is leukoplakia managed?

A lab test is needed to confirm leukoplakia, as many conditions resemble it, including oral cancer. If no signs of early cancer are detected, no treatment is required. However, monitoring every 6 months is necessary to assess any clinical changes.
If a precancerous lesion is suspected, the measures are to remove smoking and alcohol habits and treat the underlying infections. In extreme cases, surgical removal of the lesions may be necessary to prevent a malignant transformation.

6. Lichen planus

Lichen planus is an inflammatory condition that occurs due to immune system dysregulation, with unknown causes.

Immune cells attack the keratin-producing cells of the oral mucosa. As a response, our body will overproduce keratin, leading to intersecting white-line lesions. The exact cause triggering this is unknown. However, psychological stress often aggravates the condition.

Any site in the mouth can be affected, including the gums. As with leukoplakia, lichen planus lesions should also be evaluated, as they have precancerous potential.

How is lichen planus managed?

Treatment consists of stopping the suspected trigger for these reactions, including stress, medications, or amalgam fillings.
In the short term, topical anti-inflammatory agents or steroids can help relieve symptoms.

7. Gum disease

Gum disease is an inflammatory condition that affects the tissues surrounding our teeth, including the gums, bones, and ligaments. It gradually progresses deeper, destroying the tissues that hold the tooth in place. In fact, gum disease is the leading cause of tooth loss in adults.

One of the most severe forms is called necrotizing ulcerative gingivitis (NUG). It is a painful and rapidly progressing condition.

It starts by affecting the triangle-shaped gum between the teeth. In its early stage, red and painful lesions may appear, covered by a greyish-white substance. They can rapidly develop into ulcerations.

At an advanced stage, the entire gum between the teeth is destroyed. The defect can then spread to the rest of the gum.

NUG can also be associated with other symptoms, including bad breath, fever, and swollen lymph nodes. People with weakened immune systems are the most affected. Among the risk factors:
  • HIV seropositivity.
  • Stress.
  • Smoking.
  • Poor oral hygiene.

How is gum disease managed?

The gum disease treatment consists of deep dental cleaning to remove plaque and tartar. Also, your dentist may prescribe painkillers, antibiotics, and mouthwash to clear the infection.

8. White lesions due to tobacco use

Smoking affects our mouths in many ways. The heat generated and the toxins of tobacco smoke irritate the oral mucosa and can lead to ulcerations, white lesions, or even cancer.
Current smokers are 10 times more likely to get oral cancer than people who have never smoked.

In addition, smoking is a well-known risk factor for gum disease. It is reported that more than half of advanced gum disease can be linked to tobacco use. In fact, smokers are:
  • 6 times more likely to develop gum disease.
  • More periodontal pockets.
  • More gum recession.
  • More bone loss.
  • More tooth loss.
  • Less gum bleeding (which can hide the early signs of gum disease).
In conclusion, white lines or spots on the gums can have various causes, from harmless and temporary to more serious conditions. It is important to take note of the circumstances in which they appear, such as after an extraction, injury, gum disease, or smoking. By understanding the potential reasons for these white lines, you can take the necessary steps to address the issue and maintain good oral health.

  1. The gingival Stillman's clefts: histopathology and cellular characteristics. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4755679/
  2. Cho, Y.-D.; Kim, K.-H.; Lee, Y.-M.; Ku, Y.; Seol, Y.-J. Periodontal Wound Healing and Tissue Regeneration: A Narrative Review. Pharmaceuticals 2021, 14, 456. https://doi.org/10.3390/ph14050456
  3. Oral Changes Associated with Tobacco Use. https://maaom.memberclicks.net/
  4. A Color Handbook of Oral Medicine De Richard C. K. Jordan, Michael A. O. Lewis