Red Spots in the Mouth: Causes and Concerns

Small red spots in the oral cavity?

Today, I noticed a small red spot on the mucosa near the inner side of my lower second molar (also quite close to my tongue), and it's located deep inside, requiring me to stick my tongue out completely to see it.
I accidentally ruptured it earlier, and it bled a little.
I would like to know if this is concerning.
I have previously mentioned oral-related issues and I have gastroesophageal reflux disease.
Thank you.
Dear esteemed inquirer: Based on your description, it could be a localized mucosal inflammation causing the small red spot.
Since you accidentally ruptured it, if the wound heals without a trace within a day, there is no need to worry too much.

I previously had it heal, but the small red spot is still there, and I accidentally ruptured it again, causing it to bleed.
I went to the dentist yesterday, and the doctor said that the area often rubs against the molars and has many microcapillaries.
He advised me not to touch it anymore and mentioned that it seems to be a bit of an ulcer.
Now, when I look in the mirror, it appears to have a white center surrounded by redness and swelling, and sometimes it even hurts when I talk.
Should I just leave it alone? Although I have been prescribed an oral ointment, it is really difficult to apply it because it is so deep inside.

Danxin, 20~29 year old female. Ask Date: 2010/07/16

Dr. Chen Jianzhi reply Otolaryngology

Dear Inquirer,
I recommend that you use the oral ointment properly.
The method of application should be as follows: before going to bed, after brushing your teeth, apply the ointment to the affected area, and then go to sleep.
Keep the ointment in your mouth until morning.
This method should be used once a day.
Please remember that the key moment for using the oral ointment is right before bedtime.
It is okay if you swallow a little of the ointment.
I believe that the oral wound will heal within two days, so please do not worry.
Sincerely,
Chen Chien-Chih, Lecturer, Fu Jen Catholic University

Reply Date: 2010/07/16

More Info

Understanding red spots in the mouth can be concerning, especially when they are accompanied by pain or bleeding. Based on your description, it seems you are experiencing a localized inflammation or ulceration near the mucosa close to your second lower molar. This area is particularly sensitive due to the proximity to numerous blood vessels and the constant friction caused by chewing, which can lead to irritation and the formation of red spots or ulcers.

The presence of a red spot that has bled after being accidentally injured suggests that it could be a minor oral ulcer, often referred to as an aphthous ulcer or canker sore. These types of ulcers can be triggered by various factors, including mechanical irritation (like friction from teeth), stress, certain foods, or underlying health conditions. Given your history of gastroesophageal reflux disease (GERD), it is also possible that acid exposure could contribute to mucosal irritation in the mouth, although this is less common.

The white center you mentioned could indicate that the ulcer is in the healing process or could be a sign of a secondary infection. It's important to monitor the ulcer for any signs of worsening, such as increased pain, swelling, or the development of additional lesions. If the ulcer does not heal within a week or two, or if it continues to cause significant discomfort, it would be advisable to seek further evaluation from a healthcare professional, such as an oral surgeon or an ear, nose, and throat (ENT) specialist.

In terms of management, here are some recommendations:
1. Avoid Irritants: Try to avoid spicy, acidic, or abrasive foods that could further irritate the ulcer. Soft foods may be easier to consume without causing additional pain.

2. Maintain Oral Hygiene: Continue to practice good oral hygiene by brushing your teeth gently and using a mild mouthwash. This can help prevent secondary infections.

3. Topical Treatments: If you have been prescribed a topical ointment, such as a corticosteroid or a protective barrier gel, try to apply it as directed. While it may be challenging to reach the area, even partial application can help reduce inflammation and promote healing.

4. Hydration: Staying well-hydrated can help maintain oral moisture and promote healing.

5. Pain Management: Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can help manage discomfort. However, be sure to follow the recommended dosages.

6. Follow-Up: If the ulcer persists, consider scheduling a follow-up appointment with your dentist or a specialist. They may recommend further diagnostic tests or treatments, such as a biopsy if there is concern about a more serious condition.

In conclusion, while localized red spots and ulcers in the mouth can often be benign and self-limiting, it is essential to monitor your symptoms closely. Given your ongoing discomfort and the history of GERD, it is prudent to consult with a healthcare professional for a thorough evaluation and tailored management plan. Your oral health is crucial, and addressing these concerns promptly can help prevent complications and improve your quality of life.

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