Why Does the Roof of My Mouth Hurt? Causes, Relief and When to Worry

01Burns

Burns and injuries

Hot food and drinks are the most common cause of a sore palate, nicknamed “pizza burn”. The skin may blister, peel and feel rough or tender for a few days, and it usually heals within a week. Scratches from crisps, crusty bread, hard sweets or a toothbrush can cause small cuts that sting with salty or acidic food.

Avoid very hot, spicy, crunchy and acidic foods while it heals.

02Ulcers

Mouth ulcers and cold sores

• Mouth ulcers: round, white or yellow sores with a red border, more common on the soft palate, cheeks and tongue; they usually heal in 1 to 2 weeks.
• Cold sores: caused by herpes simplex virus; they usually appear on the lips but can affect the hard palate as small clusters of blisters.
• Viral infections in children: hand, foot and mouth disease and herpangina cause painful spots on the palate with fever.

03Infections

Thrush and other infections

Oral thrush is a fungal infection causing white patches or a red, sore palate, often under dentures, after antibiotics, with inhaled steroids or in people with diabetes or a weakened immune system. It needs antifungal treatment.

Throat infections, tonsillitis and strep throat can cause small red spots on the soft palate and pain when swallowing. See strep throat.

04Dry mouth

Dry mouth and irritants

• Dehydration and not drinking enough water.
• Breathing through the mouth at night; see mouth breathing.
• Smoking, vaping and alcohol.
• Medicines that reduce saliva, such as antidepressants and antihistamines.
• Toothpastes containing sodium lauryl sulfate, mouthwashes with alcohol, and strong mint or cinnamon flavours.

05Sinus and teeth

Sinus and dental causes

The roots of the upper back teeth sit close to the maxillary sinuses, and inflammation in either can cause aching felt in the palate and upper teeth. A dental abscess can cause a painful swelling on the palate behind a tooth. Ill-fitting dentures or new braces can rub and cause sore areas.

See sinus infection symptoms.

06Lumps

Lumps on the roof of the mouth

• Torus palatinus: a hard, painless bony bump in the middle of the hard palate, present for years; harmless.
• Incisive papilla: a small bump just behind the front teeth that can swell after injury.
• Mucoceles: small, soft, bluish swellings from blocked saliva glands.
• Growths: any new lump that grows, bleeds or does not go away needs assessment, as rarely it can be a salivary gland tumour or cancer.

07Other

Other causes

• Acid reflux reaching the mouth, especially at night.
• Vitamin deficiencies, such as B12, folate and iron, causing a sore mouth.
• Allergic reactions to foods or dental materials.
• Burning mouth syndrome, a burning pain without visible changes, more common in women after menopause.
• Dehydration from illness or exercise.

08Relief

What helps at home

• Eat cool, soft foods such as yoghurt, porridge, smoothies and soup that is not hot.
• Avoid spicy, salty, acidic and crunchy foods until healed.
• Rinse with warm salt water several times a day.
• Use an antiseptic mouthwash or pain-relieving gel from a pharmacy.
• Take paracetamol or ibuprofen if suitable.
• Drink water regularly and stop smoking.

09Prevention

Preventing a sore palate

• Let hot food and drinks cool before eating.
• Chew sharp foods carefully.
• Keep dentures clean, remove them at night and have them checked if they rub.
• Stay hydrated and treat nasal blockage that causes mouth breathing.
• Have regular dental check-ups.

11Summary

Key points to remember

• Burns and minor injuries are the most common causes and heal within a week.
• Ulcers, cold sores, thrush and dry mouth also cause pain.
• Cool soft foods, salt-water rinses and painkillers help.
• Sores or lumps lasting more than 3 weeks need checking.