Skin peeling in the mouth can be alarming if you haven’t experienced it before. It can occur on the cheeks, gums and palate. As a dental hygienist, I encounter many patients who experience skin peeling (tissue sloughing). I often discuss with them possible causes and how to stop the skin from peeling.
To prevent skin peeling (tissue sloughing) in the mouth, diagnose the root cause. Allergies, oral infections, burns, dry mouth, oral habits (smoking or mouth breathing) and oral trauma can cause peeling. Avoid triggers, complete appropriate treatment, and modify habits to decrease skin peeling.
In this post, I explain in detail the different allergic reactions, oral infections that can cause peeling, and all the information I give to my patients in my dental chair about tissue sloughing. Not everyone’s symptoms will be the same, and different mouth areas can have other causes of peeling.
Signs and symptoms of tissue sloughing; causes and appearance
*In the remainder of this post, I will use the term tissue sloughing instead of skin peeling.
Tissue sloughing is usually first noticed when the tongue explores the mouth, and we get stringy pieces attached to the tongue. The sloughing tissue is in very thin layers and can even appear as a thin whitish film over the soft tissue.
Tissue sloughing can also have other symptoms, such as;
- inflammation (redness and mild swelling)
- dry mouth or excessive salivation
- burning feeling in the mouth
- difficulty eating, drinking or speaking
If you find your tissue sloughing or experiencing any of these symptoms, it is essential to speak to your dental professional.
Having an in-person exam is ideal because your mouth is unique, and they can give you 100% tailored advice and a treatment plan for your specific concern and rule out other more serious issues.
Rule of thumb; if there is a lesion in your mouth or a lump or bump, please see your dental professional or medical doctor if it has not gone away within two weeks. I suggest taking pictures so you can monitor the size, shape, colour and location and compare them with future images.
For example, oral thrush can be easily confused with tissue sloughing, as a white film of an overgrowth of yeast can cause white patches that can be rubbed off.
Oral thrush (candidiasis) is a fungal infection, and medication will need to be prescribed to get rid of it.
Tissue sloughing can also be caused by dry mouth.
Dry mouth can occur from medications, medical conditions or the result of cancer treatment. Understanding the cause of tissue sloughing is essential to develop an appropriate treatment plan.
Tissue sloughing starts because there is an over-proliferation of soft tissue cells, and the body cannot keep up with the regular shedding of cells. When this happens, the cells are in abundance, and they will be lost in a more significant amount that you can see or peel off.
Typically, the mouth’s soft tissue cells change every 14-21 days. But when this is expedited, or the cells cannot shed properly due to dry mouth, the dead cells accumulate and can slough off, allowing the person to peel off the layer. Source
Below I talk about how to get tissue sloughing to stop or reduce, and what I discuss with my patients for different areas of the mouth experiencing tissue sloughing.
How to stop skin peeling in the mouth (tissue sloughing)
To stop tissue sloughing, change your toothpaste to one that does not contain SLS (sodium lauryl sulphate), a whitening or anti-tartar agent and stop using mouthwash. Do not consume burning hot liquids or food items to prevent burning the tissue in the mouth. Be mindful of oral habits such as cheek biting, clenching or grinding, smoking, and mouth breathing.
To learn more about SLS in toothpaste and how it affects the tissue in the mouth, I wrote a whole post on it which is linked below. The post goes into much more detail concerning SLS in toothpaste than I talk about in this post.
Below I go into more detail about the locations where you may be experiencing tissue sloughing. Different areas of the mouth can be affected differently for various reasons. I want to give you a more detailed answer according to the location in the mouth.
Allergies, trauma, or parafunctional habits such as clenching and grinding can cause tissue sloughing on any soft tissue surface in the mouth. Still, the specific location can hint at what is causing the tissue to slough off.
Tissue sloughing inside lips
Tissue sloughing on the inside of the lips can be from an allergic reaction and lip biting. I know I tend to bite on my lips when I am nervous and have anxiety. After a few days, the tissue starts to peel off, and the dead tissue cells are replaced by new cells.
Tissue sloughing inside cheeks
If the tissue sloughing is only occurring on the inside of the cheeks, it could be due to frictional keratosis.
Frictional keratosis is when repeated friction and trauma cause more keratin formation in that area. For example, It is similar to forming a callus on our hands when repeatedly using a shovel. The tissue on our hands will create a thicker area of keratin for protection.
The friction caused by clenching, grinding, or cheek biting can cause an increased formation of keratin on the inside of the cheeks, forming a linea alba.
The tissue on the linea alba can peel and slough off.
If the tissue is peeling from a larger area, it is more likely from using a substance that comes into contact with the inside of the cheek, such as mouthwash or toothpaste.
Tissue sloughing on the roof of the mouth (palate)
If tissue is sloughing only on the roof of the mouth, it is most likely caused by trauma. Hot food or drinks can burn the tissue, scratches or injury from biting into food such as hard bread can cause injury, and the injured tissue sloughs off during the healing phase.
When I was in dental hygiene school, one of my teachers was a dentist, and he made a joke about the tissue sloughing on the palate of our patients and how it often occurs when biting into hot pizza and the cheese burns the roof of the mouth. He called it “pizza palatini,” which we dental people thought was pretty funny.
Tissue sloughing on the gums
Tissue sloughing only on the gums is usually caused by trauma or an allergy to SLS or whitening agents.
While whitening teeth with hydrogen or carbamide peroxide, if it comes into contact with the gum tissue, it can burn the gums and eventually cause tissue sloughing as healing occurs.
For tips and tricks, I give my patients, I put together a post linked below about protecting the gums during teeth whitening!
I hope this information has helped you!