‘I’m an Orthodontist, and Here’s Why the Roof of Your Mouth Hurts So Bad’

If you’ve ever sucked on a sour candy for too long or taken a sip of coffee that was a little too hot, you know roof-of-mouth pain. The part of your body is called your palate, and it’s a pretty delicate area, so it doesn’t take much to irritate it. When the roof of your mouth hurts temporarily, it’s no biggie. But if it’s persistent pain? That could be your body’s way of telling you something more is happening.

To get to the root of your palate pain, we spoke to Marina Gonchar, DMD, an orthodontist and founder of Skin to Smile. We also discuss treatment options for roof-of-mouth irritation and when to see a dentist.

What causes the roof of your mouth to hurt?

There are many reasons why the roof of your mouth might hurt, but here are some of the most common causes.

1. You have a mouth ulcer

Mouth ulcers are sores or scrapes (usually red, yellow, or white) that can pop up anywhere inside your mouth—including the roof. Dr. Gonchar says they can be very painful and uncomfortable due to the delicate nature of the skin inside your mouth. While there are many kinds of mouth ulcers, canker sores are the most common, which can “result from trauma, burns, infections, and allergies,” Dr. Gonchar adds. Even stress can set them off.

Luckily, mouth ulcers don’t last very long—they usually resolve themselves in seven to 14 days and usually “become less painful within two to three days of the initial healing period,” Dr. Gonchar says.

How to treat it

Mouth ulcers will usually resolve on their own, but there are some things you can do to help relieve the pain. Dr. Gonchar recommends things like rinsing with warm salt water, avoiding spicy and acidic foods, using over-the-counter (OTC) topical anesthetics like Orajel ($7.32), and, if severe enough, prescription mouth rinses and corticosteroids.

2. You have cold sores

Cold sores are ulcers or blisters caused by the herpes simplex virus—a common infection that primarily spreads through skin-to-skin contact. Dr. Gonchar says they typically show up on your lips and the outside of your mouth, but they can also show up on the roof of your mouth. And they can be pretty painful.

“There are a lot of nerve endings on the roof of the mouth,” says Dr. Gonchar. “Meaning, you’ll feel more pain in this area.” Other symptoms you might experience include itching, burning, or tingling a day or so before the blisters form. And if it’s your first outbreak with the herpes virus, you may also have body-wide symptoms like:

• Fever
• Painful gums
• Sore throat
• Headache
• Muscle aches
• Swollen lymph nodes

How to treat it

“Treatment for cold sores is usually warm saltwater rinses, avoidance of irritating foods, and OTC numbing gels,” Dr. Gonchar says. If these don’t do the trick, see your healthcare provider, who can prescribe stronger antiviral creams and/or oral medication to reduce symptoms and prevent breakouts, she says.

During an active outbreak, also avoid close contact with others (think kissing, oral sex, or sharing utensils, razors, and towels) so you don’t inadvertently spread the infection.

3. You burned your mouth

Anyone who’s eaten a spoonful of piping hot soup or taken a bite of a cookie fresh out of the oven knows the pain of a mouthburn. When this happens, it “causes the sloughing of the delicate outer layer of tissue on the roof of the mouth,” Dr. Gonchar says. Ouch.

Not only can high temperatures cause burns on the roof of your mouth, but super spicy foods can as well, she says.

How to treat it

There’s not much you can do for mouth burns except wait it out. While it heals, you can try to relieve the pain by drinking cold water or sucking on ice. Additionally, avoid “acidic and spicy foods that can further irritate the injury,” Dr. Gonchar adds.

4. You have a cut (or other injury)

This may not be top-of-mind, but anything you put in your mouth that’s sharp can potentially cut or bruise the roof of your mouth. This may include pens (if you’re guilty of chewing on them), forks, oral appliances like retainers or dentures, or dental restorations like fillings and crowns with sharper edges, says Dr. Gonchar.

How to treat it

“The best treatment for this injury is to identify the cause of the problem,” Dr. Gonchar says. If the cause of the cut came from outside of your mouth (i.e., a pen or fork), try to avoid it in the future or be more mindful of it. If it came from inside your mouth (i.e., retainers or crowns), try to get in to see your dentist for an adjustment, she says.

5. It’s a fungal infection (aka thrush)

“Thrush or oral candidiasis is a fungal infection” that can produce pain on the roof of your mouth, Dr. Gonchar says. You can usually tell you’re dealing with oral thrush if you see red and creamy white mouth sores and patches. Or, you may have other symptoms like a loss of taste, a cottony feeling in your mouth, or bleeding from the lesions.

Thrush can develop after using antibiotics (which disturb the balance of good and bad bacteria in your mouth) or with certain medical conditions like diabetes, though ultimately, it’s an “indication of a weakened immune system,” says Dr. Gonchar.

In rare cases, the fungal infection that causes thrush can spread to your esophagus, causing symptoms like pain and difficulty swallowing, chest pain, and fever.

How to treat it

Treating thrush will often involve taking an anti-fungal prescribed by your healthcare provider, which can come in the form of rinses, lozenges, or even oral medications, notes Dr. Gonchar. Because it’s usually a secondary condition, treating it will also involve identifying and treating the primary cause, she adds.

6. You have dry mouth

Dry mouth (also known as xerostomia) is a condition where your salivary glands don’t produce enough spit. When your mouth lacks saliva, you can develop a “variety of dental problems including pain and discomfort” in the roof of your mouth, says Dr. Gonchar. More specifically, it can trigger inflammation and increased sensitivity to that area.

While there are myriad causes of dry mouth, the most common include aging, certain medications, or radiation therapy for cancer. Even if you don’t have the condition itself, you may wake up with a dry mouth after sleeping with it open all night. The Mayo Clinic notes other symptoms as the following:

• Dryness or a feeling of stickiness in your mouth
• Saliva that seems thick and stringy
• Bad breath
• Having a hard time chewing, speaking, and swallowing
• Dry or sore throat and hoarseness
• Dry or grooved tongue
• A changed sense of taste
• Problems wearing dentures
• Lipstick stuck to teeth

How to treat it

Most cases of dry mouth can be treated at home with over-the-counter (OTC) saliva substitutes like Biotène ($16.99) and by drinking enough water, says Dr. Gonchar. But “if the cause of your dry mouth is a medical condition or certain medications,” work with your healthcare provider or dentist to identify and treat the underlying cause.

If that doesn’t help, Dr. Gonchar says some healthcare providers may offer a prescription medication that helps stimulate salivary flow, like pilocarpine (Salagen) or cevimeline (Evoxac).

7. It’s a bony growth (aka torus palatinus)

If you have palate pain and a bump on the roof of your mouth, you might be dealing with a torus palatinus (also known as a palatal tori). These are bony growths—which can be present at birth or develop later in life—form in the center of your hard palate. Though they’re harmless, they “can be very uncomfortable due to their bulky sizes,” Dr. Gonchar says. When they’re large, “they can exert pressure on soft tissues, blood vessels, and nerves, resulting in pain,” she says.

How to treat it

“If the tori formed as a result of pressure due to a denture or other appliance, adjusting the dental appliance can prevent further growth of the tori,” Dr. Gonchar says. “However, most tori do not have a known cause (but include factors such as genetics, hormones, age, gender, and environmental factors).”

Additionally, if your tori is causing pain or discomfort without an external cause (like a retainer, for example), surgery may be recommended by your healthcare provider.

Other symptoms with roof of mouth pain

It’s not uncommon to feel additional symptoms when the roof of your mouth hurts. This is because any inflammation of the palate tissue can “directly affect the nerves and blood vessels of the head and neck,” causing radiating symptoms, Dr. Gonchar says. She says additional symptoms may include things like:

• Diffuse tooth pain
• Sinus pressure
• Sinus headaches
• Pain in your ears
• Possible soreness of your throat
• Non-descriptive head and neck discomfort

Could it ever mean oral cancer?

In some cases, yes, roof-of-mouth pain can mean oral cancer, per Dr. Gonchar. This may happen when cancer cells invade nearby tissue, causing inflammation of blood vessels and nerves, she adds. But “not all oral cancers present with pain,” Dr. Gonchar says. Some people may instead just experience swelling or a change in the color of their palate tissue.

Oral cancer is rare, but if you’re worried about it, other signs to look for include the following:

• A lip or mouth sore that doesn’t heal
• A white or reddish patch on the inside of your mouth
• Loose teeth
• A growth or lump on the inside of your mouth
• Mouth pain
• Ear pain
• Difficult or painful swallowing

If you notice any suspicious changes in your mouth, be sure to report them to your healthcare provider or dentist, says Dr. Gonchar. They can request a biopsy to help detect serious illnesses like cancer early, which is key to proper and effective treatment.

How to get rid of roof-of-mouth pain

Usually, palate pain is temporary. If you’ve accidentally poked yourself with a fork or sipped on a hot beverage, for example, your tissues should heal on their own within a few days. In the meantime, you can alleviate your discomfort with these simple strategies:

• Avoid irritating foods. Spicy or acidic foods may exacerbate your symptoms.
• Use OTC medications. Over-the-counter drugs such as topical anesthetics, numbing gels, and NSAIDS can provide pain relief.
• Identify the root cause of the pain. “If the pain is a result of overuse of medications or secondary to another medical condition, that condition must be addressed to resolve the discomfort,” Dr. Gonchar says. For instance, once you treat oral issues like thrush or xerostomia, your mouth pain should improve.

When to see a dentist

“If pain or swelling persists for more than seven days, it is important to see your dentist for an evaluation to diagnose and treat the problem,” Dr. Gonchar says.

In fact, “you should see a dentist for any changes on the roof of your mouth,” she says. “Even if it’s painless, including swelling and tissue irritation.” While there are several benign reasons for roof-of-mouth pain, in some rare cases, persistent pain can be a sign of something serious. So, it’s better to get checked out.