Oral lesions are sores, patches, bumps, blisters, ulcers, or other changes that develop on the lips or inside the mouth. They may affect the tongue, gums, inner cheeks, roof or floor of the mouth. Many oral lesions are harmless and temporary, but a lesion that persists, changes, or repeatedly returns should be evaluated to determine the cause and rule out a more serious condition.
Types of Oral Lesions
Adult Oral Ulcer
Oral Textural Changes
Pediatric Oral Ulcer
What causes Oral Lesions?
Oral lesions can develop for many reasons. Common causes include:
- Minor trauma or irritation from accidentally biting the cheek or tongue, sharp teeth, dental work, braces, dentures, burns, or irritating foods
- Viral, bacterial, or fungal infections, including cold sores caused by herpes simplex virus and oral thrush caused by Candida
- Inflammatory or immune-related conditions, such as canker sores, lichen planus, or autoimmune disease
- Allergic reactions or sensitivity to foods, medications, toothpaste, or other oral-care products
- Nutritional deficiencies, including low levels of iron, folate, or vitamin B12
- Dry mouth, stress, hormonal changes, or certain medications
- Tobacco and heavy alcohol use, which can increase the risk of precancerous changes and oral cancer
- Benign growths, cysts, or blocked salivary glands
- Precancerous changes or oral cancer
Because different conditions can look similar, the appearance of a lesion alone may not reveal its cause.
What Are the Symptoms of Oral Lesions?
Symptoms vary depending on the type and cause of the lesion. An oral lesion may be painful, tender, or completely painless. Signs and symptoms can include:
- A sore or ulcer inside the mouth
- White, red, or mixed red-and-white patches
- A lump, bump, blister, or thickened area
- Swelling of the lips, gums, tongue, or other oral tissues
- Burning, tingling, itching, or tenderness
- Bleeding, crusting, or a lesion that does not heal
- Pain when eating, drinking, speaking, or swallowing
- Changes in taste or sensation
- Recurring sores or lesions that increase in size or change in appearance
A painless lesion can still require medical attention, especially if it lasts longer than two weeks or continues to change.
How Are Oral Lesions Diagnosed?
Diagnosing an oral lesion usually begins with a medical history and a careful examination of the lips, mouth, tongue, throat, and neck. Your provider may ask when the lesion appeared, whether it is painful, whether it has changed, and whether you have experienced recent illness, injury, medication changes, or repeated irritation. Tobacco and alcohol use, immune-system conditions, and other health factors may also be discussed.
Depending on the lesion’s appearance and your symptoms, diagnosis may include:
- A visual and physical examination to assess the lesion’s size, color, texture, location, and tenderness
- A swab, scraping, or culture when a viral, bacterial, or fungal infection is suspected
- Blood tests if a nutritional deficiency, autoimmune condition, or another systemic cause may be involved
- A biopsy, in which a small tissue sample is removed and examined under a microscope, when the diagnosis is uncertain or the lesion appears persistent or suspicious
- Referral to a dentist, oral surgeon, ear, nose and throat specialist, or another medical specialist when additional evaluation is appropriate
A biopsy does not automatically mean that a lesion is cancerous. It is an important diagnostic tool that can identify benign, inflammatory, precancerous, and cancerous changes.