Dear doctor;

I have small white spots on the inside of each side of my upper lip. They don’t hurt, and if I squeeze them nothing happens. There’s also another spot with them that looks swollen like an ulcer. Can you get ulcers on your lip rather than inside your mouth?

Isabimana, 37.

Dear Isabimana,

The diagnosis of the cause of white spots depends on how long the spots have been there, whether size is same or increased, is there associated pain, swelling, painful swallowing  and or itching.

Infections bacterial, viral or fungal can cause white spots inside the mouth. Bacterial infections are usually associated with swelling and pain. Viral infections tend to subside spontaneously after a week or so, but bacterial and fungal infections would persist and increase unless treated. Immune depressed conditions like diabetes, HIV/Aids increase susceptibility to infections, including those in oral cavity.

Infections or inflammation of the teeth, gums and or tongue can cause chronic inflammation and also white spots inside the mouth. Trauma whether external or internal like due to lose teeth or hot food can cause ulcers and white spots in any part of oral cavity or around lips. Chronic inflammation and sores inside mouth can also be due to infections like syphilis, aerobic bacteria,

Use of tobacco particularly chewing of tobacco, use of alcohol and other abusive substances chronically also increase the risk of developing ulcers or sores which may manifest as white spots.

Most of these conditions are benign. But sometimes these chronic spots can be precancerous. Even cancer can manifest as white spots on lips, tongue or palate.

If along with the white spots there is swelling, pain, fever or they are increasing in size, one should definitely consult a doctor and get investigated for the cause.