Mouth Problems, Noninjury

Overview

It is not unusual to have a problem with your mouth from time to time. A mouth problem can involve your gums, lips, tongue, or inner cheeks, the roof of your mouth (soft and hard palates), under your tongue, your neck, or your teeth. Your mouth may be dry, or food may not taste right. You may have bad breath or a sore on your lip, gums, or tongue that makes it hard to eat or talk. Many of these problems can get better with home treatment.

Common mouth problems include:

  • Sores, such as cold sores (also called fever blisters) and canker sores. Canker sores form inside the mouth, while cold sores and impetigo usually affect the area around the outside of the mouth.
  • Infections. These can be caused by a virus (such as herpes simplex) or by bacteria (such as epiglottitis, or impetigo, or a sexually transmitted infection). An infection is more serious when it causes rapid swelling of the tongue or throat and blockage of the airway.
  • Tender, red splits or cracks at the corner of your mouth (angular cheilitis). These can be caused by infection, a diet too low in vitamins, and over-closure of the mouth in someone who has been without teeth or dentures for some time.
  • Chapped lips. They can be caused by dry, windy, cold, or very hot weather.
  • Dry mouth (xerostomia). A common cause of dry mouth is dehydration. Over time, having a dry mouth increases your risk of mouth infections, gum disease, and dental cavities.
  • Thick, hard, white patches inside the mouth that can't be wiped off (leukoplakia). This is commonly caused by irritation of the mouth, such as from a rough tooth or poorly fitting dentures rubbing against tissue or from smoking or using smokeless (spit) tobacco.
  • Thrush. This is a common infection of the mouth and tongue. It's caused by the yeast Candida albicans. Thrush appears on the mouth and tongue as white patches that look like cottage cheese or milk curds. When the patches are wiped away, the area underneath looks red and raw and may bleed. In babies, thrush may cause a rash in the diaper area.
  • Taste changes. Your sense of taste may be decreased, lost, or changed, such as a metallic taste in your mouth.

Your tongue may become sore or swollen, or it may change color or texture. A buildup of food and bacteria on the tongue may make the tongue look thick or furry ("hairy tongue"). Often the problems will go away if the surface of the tongue is regularly brushed with a soft-bristled toothbrush. If your tongue problem is from some local irritation, such as tobacco use, the tongue problem may clear up when you remove the source of the irritation. Rapid swelling of the tongue can be caused by an allergic reaction, which can interfere with breathing.

Bad breath (halitosis) or changed breath can make you feel embarrassed. Make sure that you brush your teeth twice each day and floss once a day to decrease the bacteria that can cause bad breath. Brushing your tongue can also help.

The use of alcohol and tobacco can cause many mouth problems. Your chances of having oral cancer are higher if you smoke, use smokeless (chew) tobacco, or use too much alcohol.

Mouth problems may occur more often with other conditions and diseases, such as diabetes, Down syndrome, and HIV (human immunodeficiency virus). Many medicines also can cause mouth problems.

Check Your Symptoms

Do you have a mouth problem?
A mouth problem can involve the lips, tongue, gums, teeth, or any of the tissue inside the mouth.
Yes
Mouth problem
No
Mouth problem
How old are you?
Less than 3 months
Less than 3 months
3 to 11 months
3 to 11 months
1 to 11 years
1 to 11 years
12 years or older
12 years or older
Are you male or female?
Male
Male
Female
Female

The medical assessment of symptoms is based on the body parts you have.

  • If you are transgender or nonbinary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
  • If your symptoms aren’t related to those organs, you can choose the gender you identify with.
  • If you have some organs of both sexes, you may need to go through this triage tool twice (once as "male" and once as "female"). This will make sure that the tool asks the right questions for you.
Do you have an injury to your mouth or teeth?
Yes
Injury to mouth or teeth
No
Injury to mouth or teeth
Do you have a toothache or a problem with your gums?
Yes
Toothache or gum problem
No
Toothache or gum problem
Is pain or soreness in the back of your mouth and throat your main concern?
Yes
Pain or soreness in back of mouth and throat is main concern
No
Pain or soreness in back of mouth and throat is main concern
Do you think your baby may be dehydrated?
Yes
May be dehydrated
No
May be dehydrated
Are the symptoms severe, moderate, or mild?
Severe
Severe dehydration
Moderate
Moderate dehydration
Mild
Mild dehydration
Do you think you may be dehydrated?
Yes
May be dehydrated
No
May be dehydrated
Are the symptoms severe, moderate, or mild?
Severe
Severe dehydration
Moderate
Moderate dehydration
Mild
Mild dehydration
Are you having trouble drinking enough to replace the fluids you've lost?
Little sips of fluid usually are not enough. You need to be able to take in and keep down plenty of fluids.
Yes
Unable to maintain fluid intake
No
Able to maintain fluid intake
Are you having trouble breathing (more than a stuffy nose)?
Yes
Difficulty breathing more than a stuffy nose
No
Difficulty breathing more than a stuffy nose
Would you describe the breathing problem as severe, moderate, or mild?
Severe
Severe difficulty breathing
Moderate
Moderate difficulty breathing
Mild
Mild difficulty breathing
Is your tongue swollen?
Yes
Swollen tongue
No
Swollen tongue
Yes
Suddenly drooling and unable to swallow
No
Suddenly drooling and unable to swallow
Could you be having a severe allergic reaction?
This is more likely if you have had a bad reaction to something in the past.
Yes
Possible severe allergic reaction (anaphylaxis)
No
Possible severe allergic reaction (anaphylaxis)
Could you be having symptoms of a heart attack?
In some cases, a heart attack may cause a strange feeling in part of the face, such as the jaw.
Yes
Symptoms of heart attack
No
Symptoms of heart attack
Are you having trouble eating or swallowing?
Yes
Difficulty eating or swallowing
No
Difficulty eating or swallowing
Are you having trouble moving your tongue, chewing, or swallowing?
Yes
Difficulty moving tongue, chewing, or swallowing
No
Difficulty moving tongue, chewing, or swallowing
Could you be having symptoms of a stroke?
Yes
Symptoms of stroke
No
Symptoms of stroke
Did the problems with chewing and swallowing start suddenly?
Yes
Difficulty moving tongue, chewing, or swallowing started suddenly
No
Difficulty moving tongue, chewing, or swallowing started suddenly
Can you swallow food or fluids at all?
Yes
Able to swallow food or fluids
No
Unable to swallow food or fluids
Is there any pain?
Yes
Pain
No
Pain
How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine?
8 to 10: Severe pain
Severe pain
5 to 7: Moderate pain
Moderate pain
1 to 4: Mild pain
Mild pain
Has the pain lasted for more than 2 days?
Yes
Pain for more than 2 days
No
Pain for more than 2 days
Are there any symptoms of infection?
Yes
Symptoms of infection
No
Symptoms of infection
Do you think you may have a fever?
Yes
Possible fever
No
Possible fever
Are there red streaks leading away from the area or pus draining from it?
Yes
Red streaks or pus
No
Red streaks or pus
Do you have diabetes or a weakened immune system?
What weakens the immune system in an adult or older child may be different than in a young child or baby.
Yes
Diabetes or immune problem
No
Diabetes or immune problem
Do you have any sores in or around your mouth?
Yes
Sores in or around mouth
No
Sores in or around mouth
Does your child have any mouth sores that look like blisters?
Yes
Child has mouth sores that look like blisters
No
Child has mouth sores that look like blisters
Are you concerned that a new sore may have been caused by sexual contact?
Yes
New sore may be related to sexual contact
No
New sore may be related to sexual contact
Do you think you may have a fever?
Yes
Possible fever
No
Possible fever
Do you feel sick?
Yes
Feels sick
No
Feels sick
Do you often get mouth sores?
Yes
Often gets mouth sores
No
Often gets mouth sores
Is there a crusty, honey-colored drainage coming from the sore?
Yes
Crusty, honey-colored drainage from sores around mouth
No
Crusty, honey-colored drainage from sores around mouth
Is there a black or brown coating on your tongue?
Yes
Black or brown coating on tongue
No
Black or brown coating on tongue
Have you tried home treatment for the black coating on your tongue?
Yes
Tried home treatment for black coating on tongue
No
Tried home treatment for black coating on tongue
Are there white patches in the mouth?
Yes
White patches in mouth
No
White patches in mouth
Are you being treated for thrush?
Thrush is a yeast infection of the mouth and tongue.
Yes
Being treated for thrush
No
Being treated for thrush
Have the thrush symptoms:
Gotten worse?
Thrush symptoms have gotten worse
Stayed the same (not better or worse)?
Thrush symptoms have not changed
Started to get better?
Thrush symptoms are improving
Did you start treatment for thrush more than 4 days ago?
Yes
Thrush treatment for more than 4 days
No
Thrush treatment for more than 4 days
Do you think that a medicine could be causing the mouth problem?
Think about whether the problem started soon after you began using a new medicine or a higher dose of a medicine.
Yes
Medicine may be causing mouth problem
No
Medicine may be causing mouth problem
Are your lips or the inside of your mouth burning, tingling, or numb?
Yes
Burning, tingling, or numbness of mouth or lips
No
Burning, tingling, or numbness of mouth or lips
Do you have burning, tingling, or numbness all the time?
Yes
Burning, tingling, or numbness of mouth or lips is constant
No
Burning, tingling, or numbness of mouth or lips is constant
Has the burning, tingling, or numbness lasted for more than 3 days?
Yes
Burning, tingling, or numbness for more than 3 days
No
Burning, tingling, or numbness for more than 3 days
Does your breath have a fruity odor?
Yes
Fruity odor to breath
No
Fruity odor to breath
Have you had a metallic taste in your mouth for more than 3 days?
Yes
Metallic taste for more than 3 days
No
Metallic taste for more than 3 days
Are dentures or any other type of dental device (like a crown or filling, for instance) causing pain or discomfort?
Yes
Discomfort from dentures or other dental appliance
No
Discomfort from dentures or other dental appliance
Are the dentures or other dental appliance broken?
Yes
Broken dentures or dental appliance
No
Broken dentures or dental appliance
Do you think your mouth problem may be caused by grinding your teeth?
Yes
Problem caused by grinding teeth
No
Problem caused by grinding teeth
Have you had mouth problems for more than 2 weeks?
Yes
Mouth problems for more than 2 weeks
No
Mouth problems for more than 2 weeks

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

  • Your age. Babies and older adults tend to get sicker quicker.
  • Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
  • Medicines you take. Certain medicines, such as blood thinners (anticoagulants), medicines that suppress the immune system like steroids or chemotherapy, herbal remedies, or supplements can cause symptoms or make them worse.
  • Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
  • Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

  • Try home treatment to relieve the symptoms.
  • Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.

You can get dehydrated when you lose a lot of fluids because of problems like vomiting or fever.

Symptoms of dehydration can range from mild to severe. For example:

  • You may feel tired and edgy (mild dehydration), or you may feel weak, not alert, and not able to think clearly (severe dehydration).
  • You may pass less urine than usual (mild dehydration), or you may not be passing urine at all (severe dehydration).

Severe dehydration means:

  • Your mouth and eyes may be extremely dry.
  • You may pass little or no urine for 12 or more hours.
  • You may not feel alert or be able to think clearly.
  • You may be too weak or dizzy to stand.
  • You may pass out.

Moderate dehydration means:

  • You may be a lot more thirsty than usual.
  • Your mouth and eyes may be drier than usual.
  • You may pass little or no urine for 8 or more hours.
  • You may feel dizzy when you stand or sit up.

Mild dehydration means:

  • You may be more thirsty than usual.
  • You may pass less urine than usual.

Severe dehydration means:

  • The baby may be very sleepy and hard to wake up.
  • The baby may have a very dry mouth and very dry eyes (no tears).
  • The baby may have no wet diapers in 12 or more hours.

Moderate dehydration means:

  • The baby may have no wet diapers in 6 hours.
  • The baby may have a dry mouth and dry eyes (fewer tears than usual).

Mild dehydration means:

  • The baby may pass a little less urine than usual.

Many prescription and nonprescription medicines can cause mouth problems. A few examples are:

  • Antibiotics.
  • Some seizure medicines.
  • Medicines used to treat cancer (chemotherapy).
  • Steroid medicines.
  • Medicines used after organ transplant.

Symptoms of difficulty breathing can range from mild to severe. For example:

  • You may feel a little out of breath but still be able to talk (mild difficulty breathing), or you may be so out of breath that you cannot talk at all (severe difficulty breathing).
  • It may be getting hard to breathe with activity (mild difficulty breathing), or you may have to work very hard to breathe even when you’re at rest (severe difficulty breathing).

Severe trouble breathing means:

  • You cannot talk at all.
  • You have to work very hard to breathe.
  • You feel like you can't get enough air.
  • You do not feel alert or cannot think clearly.

Moderate trouble breathing means:

  • It's hard to talk in full sentences.
  • It's hard to breathe with activity.

Mild trouble breathing means:

  • You feel a little out of breath but can still talk.
  • It's becoming hard to breathe with activity.

Severe trouble breathing means:

  • The child cannot eat or talk because he or she is breathing so hard.
  • The child's nostrils are flaring and the belly is moving in and out with every breath.
  • The child seems to be tiring out.
  • The child seems very sleepy or confused.

Moderate trouble breathing means:

  • The child is breathing a lot faster than usual.
  • The child has to take breaks from eating or talking to breathe.
  • The nostrils flare or the belly moves in and out at times when the child breathes.

Mild trouble breathing means:

  • The child is breathing a little faster than usual.
  • The child seems a little out of breath but can still eat or talk.

Symptoms of a stroke may include:

  • Sudden numbness, tingling, weakness, or paralysis in your face, arm, or leg, especially on only one side of your body.
  • Sudden vision changes.
  • Sudden trouble speaking.
  • Sudden confusion or trouble understanding simple statements.
  • Sudden problems with walking or balance.
  • A sudden, severe headache that is different from past headaches.

Babies can quickly get dehydrated when they lose fluids because of problems like vomiting or fever.

Symptoms of dehydration can range from mild to severe. For example:

  • The baby may be fussy or cranky (mild dehydration), or the baby may be very sleepy and hard to wake up (severe dehydration).
  • The baby may have a little less urine than usual (mild dehydration), or the baby may not be urinating at all (severe dehydration).

Pain in adults and older children

  • Severe pain (8 to 10): The pain is so bad that you can't stand it for more than a few hours, can't sleep, and can't do anything else except focus on the pain.
  • Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it's severe when it's there.
  • Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.

Pain in children under 3 years

It can be hard to tell how much pain a baby or toddler is in.

  • Severe pain (8 to 10): The pain is so bad that the baby cannot sleep, cannot get comfortable, and cries constantly no matter what you do. The baby may kick, make fists, or grimace.
  • Moderate pain (5 to 7): The baby is very fussy, clings to you a lot, and may have trouble sleeping but responds when you try to comfort him or her.
  • Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds when you try to comfort him or her.

Symptoms of infection may include:

  • Increased pain, swelling, warmth, or redness in or around the area.
  • Red streaks leading from the area.
  • Pus draining from the area.
  • A fever.

To do home treatment for a black or coated tongue:

  • Brush your tongue daily with a soft-bristled toothbrush and toothpaste or a solution of 1 part hydrogen peroxide to 2 parts water.
  • Scrape the tongue with the edge of a spoon to remove the furry coating.
  • Do not use tobacco.

Bismuth products, such as Pepto-Bismol, can turn your tongue black. The black color will go away after you stop taking the medicine.

Sudden drooling and trouble swallowing can be signs of a serious problem called epiglottitis. This problem can happen at any age.

The epiglottis is a flap of tissue at the back of the throat that you can't see when you look in the mouth. When you swallow, it closes to keep food and fluids out of the tube (trachea) that leads to the lungs. If the epiglottis becomes inflamed or infected, it can swell and quickly block the airway. This makes it very hard to breathe.

The symptoms start suddenly. A person with epiglottitis is likely to seem very sick, have a fever, drool, and have trouble breathing, swallowing, and making sounds. In the case of a child, you may notice the child trying to sit up and lean forward with his or her jaw forward, because it's easier to breathe in this position.

Symptoms of a severe allergic reaction (anaphylaxis) may include:

  • The sudden appearance of raised, red areas (hives) all over the body.
  • Rapid swelling of the throat, mouth, or tongue.
  • Trouble breathing.
  • Passing out (losing consciousness). Or you may feel very lightheaded or suddenly feel weak, confused, or restless.

A severe reaction can be life-threatening. If you have had a bad allergic reaction to a substance before and are exposed to it again, treat any symptoms as an emergency. Even if the symptoms are mild at first, they may quickly become very severe.

Symptoms of a heart attack may include:

  • Chest pain or pressure, or a strange feeling in the chest.
  • Sweating.
  • Shortness of breath.
  • Nausea or vomiting.
  • Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly, or in one or both shoulders or arms.
  • Lightheadedness or sudden weakness.
  • A fast or irregular heartbeat.

For men and women, the most common symptom is chest pain or pressure. But women are somewhat more likely than men to have other symptoms, like shortness of breath, nausea, and back or jaw pain.

Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in adults are:

  • Diseases such as diabetes, cancer, heart disease, and HIV/AIDS.
  • Long-term alcohol and drug problems.
  • Steroid medicines, which may be used to treat a variety of conditions.
  • Chemotherapy and radiation therapy for cancer.
  • Other medicines used to treat autoimmune disease.
  • Medicines taken after organ transplant.
  • Not having a spleen.

Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in children are:

  • Diseases such as diabetes, cystic fibrosis, sickle cell disease, and congenital heart disease.
  • Steroid medicines, which are used to treat a variety of conditions.
  • Medicines taken after organ transplant.
  • Chemotherapy and radiation therapy for cancer.
  • Not having a spleen.

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

  • Call your doctor today to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care today.
  • If it is evening, watch the symptoms and seek care in the morning.
  • If the symptoms get worse, seek care sooner.

Make an Appointment

Based on your answers, the problem may not improve without medical care.

  • Make an appointment to see your doctor in the next 1 to 2 weeks.
  • If appropriate, try home treatment while you are waiting for the appointment.
  • If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

  • Call your doctor now to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care in the next hour.
  • You do not need to call an ambulance unless:
    • You cannot travel safely either by driving yourself or by having someone else drive you.
    • You are in an area where heavy traffic or other problems may slow you down.

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

Sometimes people don't want to call 911. They may think that their symptoms aren't serious or that they can just get someone else to drive them. Or they might be concerned about the cost. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

  • Call your dentist today to discuss the symptoms and arrange for care.
  • If you cannot reach your dentist or you don't have one, seek care today.
  • If it is evening, watch the symptoms and seek care in the morning.
  • If the symptoms get worse, seek care sooner.

Make an Appointment

Based on your answers, the problem may not improve without medical care.

  • Make an appointment to see your dentist in the next 1 to 2 weeks.
  • If appropriate, try home treatment while you are waiting for the appointment.
  • If symptoms get worse or you have any concerns, call your dentist. You may need care sooner.

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

After you call 911, the operator may tell you to chew 1 adult-strength (325 mg) or 2 to 4 low-dose (81 mg) aspirin. Wait for an ambulance. Do not try to drive yourself.

Sometimes people don't want to call 911. They may think that their symptoms aren't serious or that they can just get someone else to drive them. Or they might be concerned about the cost. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.

Sore Throat and Other Throat Problems
Mouth and Dental Injuries
Toothache and Gum Problems

Self-care

Caring for a sore or ulcer inside your mouth

Try these tips to help care for a sore or ulcer inside your mouth.

  • Make changes in your diet to relieve pain when you eat or drink.
    • Drink cold drinks, such as water or iced tea, or eat flavored ice pops or frozen juices. Use a straw to keep the liquid from touching your mouth sore.
    • Eat soft, bland foods that are easy to swallow. These include ice cream, custard, applesauce, cottage cheese, macaroni and cheese, soft-cooked eggs, yogurt, and cream soups.
    • Cut foods into small pieces. Or you can grind, mash, blend, or puree foods.
    • Avoid coffee, chocolate, spicy and salty foods, citrus fruits, nuts, seeds, and tomatoes.
    • Avoid very hot, cold, or sweet foods and drinks if they make your pain worse.

Lip care

Try these tips to help treat chapped lips.

  • Avoid licking or biting your lips.
  • Avoid sun or wind exposure, and use a lip balm with sunscreen.
  • For severely chapped lips, build a barrier by applying petroleum jelly, such as Vaseline.
  • Use a humidifier in your home.

Treating a bad taste

Everyone gets a bad taste in the mouth from time to time. Try the following simple home treatment measures to improve the taste in your mouth.

  • Gargle with water.
  • Using toothpaste, brush your teeth, tongue, roof of your mouth, and gums at least two times a day.
  • Rinse your mouth with mouthwash.
  • Drink liquids, chew sugar-free gum or mints, or suck on sour candies.
  • Use plastic utensils if you have a bitter or metallic taste when eating.

When to call for help during self-care

Call a doctor if any of the following occur during self-care at home:

  • New or worse signs of infection, such as redness, warmth, swelling, pus, or a fever.
  • New or worse dehydration.
  • Symptoms occur more often or are more severe.

Learn more

Preparing For Your Appointment

Credits

Current as of: March 9, 2022

Author: Healthwise Staff
Medical Review:
William H. Blahd Jr. MD, FACEP - Emergency Medicine
Kathleen Romito MD - Family Medicine
Adam Husney MD - Family Medicine