Sore Palate – Causes of Roof of Mouth Pain

The roof of the mouth is technically referred to as the palate. The structure of the palate is composed of both bone and cartilage. The bony region of the palate is a part of the skull, and covers the anterior two-thirds of the roof of the mouth. The posterior one-third region of the palate is composed of cartilage.

The anterior (front) bony part of the palate is referred to as the hard palate, whereas the posterior (rear) cartilaginous part of the palate is referred to as the soft palate. The hard palate is rigid, and cannot move. The posterior cartilaginous part of the palate is flexible, and can vibrate. However, the cartilage also provides a firmness to this structure.

Both the hard and the soft palate are covered by a soft mucosal tissue lining. This mucosal tissue lining is continuous with the mucosal lining in other parts of the mouth. The palate serves to anatomically separate the cavities in the mouth and the nose. The oral and nasal cavities eventually meet each other at the back of the mouth, and continue into the throat.

Why is the palate painful?

Pain can arise in any region of the mouth, such as the cheeks, tongue, teeth, gums and palate. In some cases, the pain may be felt in the entire mouth. Such a condition is technically referred to as stomatitis. A cause of pain in the mouth may either be specific to a certain structure in the mouth or may affect multiple regions in the mouth.

Also read swallowing pain.

Causes of Sore Palate

Pain or soreness in the palate can be caused by a variety of factors. Some may be linked to dietary and lifestyle factors while others are due to disease (pathologic). A sore palate is only a symptom of some underlying condition and may be accompanied by other symptoms. It is therefore important to have persistent palate soreness, with or without other symptoms, investigated by a medical professional.

Dry mouth

A dry mouth can cause soreness in many structures of the mouth. The soreness may affect the palate in some cases. A dry mouth can be caused by a number of different factors, including reduction in saliva secretion, and excessive air intake through mouth breathing. Reduced saliva secretion can be caused by dehydration or diseases such as Sjogren syndrome. Mouth breathing typically occurs when there is nasal congestion.

Injury

Injury to the palate is the most common cause of a sore palate. An injury to the palate is mostly caused by mechanical or chemical agents. For example, accidental consumption of very hot food or drink can scald the palate. Sharp bones in meat or fish and hard toothbrush bristles can also cause mechanical injury to the palate. Strong alcohol, tobacco, illicit drugs and repeated vomiting can cause chemical injury to the palate. .

Acid reflux

Acid reflux refers to a backward flow of stomach acid into the esophagus, throat and mouth. A common cause of repeated acid reflux is the gastroesophageal reflux disease (commonly abbreviated as GERD). The stomach acid causes irritation and inflammation of the tissues in the esophagus, throat and mouth. The stomach acid can often cause a sore palate. Acid reflux is more common during the night when one lies down to sleep. The affected individuals frequently wake up in the morning with a sore throat and a sore palate.

Infections

A variety of bacterial, fungal and viral infections can cause soreness in the mouth. The tongue and the palate are most commonly affected. Streptococcal infections are the most common bacterial infections that can result in sore throat and sore palate.

Some bacterial infections causing sore palate may also be due to sexually transmitted diseases such as syphilis and gonorrhea. Bacterial infections in the mouth are facilitated by the presence of a pre-existing injury or disease in the mouth. Fungal infections are less common than bacterial infections of the mouth.

Individuals with a weakened immune system (such as HIV-infected patients and poorly managed diabetics), and those who have dry mouth or a chronic mouth injury are relatively more likely to contract fungal infections.

Candida albicans is the most common type of fungi to infect the oral palate. Candida infection of the mouth causes oral thrush. Viral infections of the mouth can be caused by a variety of viruses, including herpes simplex virus type 1 (abbreviated as HSV-1), varicella zoster virus (that causes chicken pox), Epstein-Barr virus, and cytomegalovirus (abbreviated as CMV).

Allergies

Allergies occur when the immune system reacts abnormally to harmless substances in the environment and causes inflammation. Allergies occur only in certain individuals who are hypersensitive to some commonly encountered substances. A sore palate can be caused by allergies that are triggered by food (such a gluten) or other ingested substances. Toothpastes and mouthwashes can also trigger an allergic reaction in certain individuals.

Autoimmune

Autoimmune disorders refer to conditions in which the immune system starts attacking body’s own tissues. In many cases, the exact cause of the autoimmune reaction is not known. Autoimmune conditions that can cause a sore palate include lichen planus and Sjogren syndrome. These conditions are often characterized by a dry mouth or presence of lesions within the mouth. Kawasaki disease and Behcet’s syndrome can also cause a sore palate.

Snoring

Snoring causes vibration of soft tissues in the mouth. The soft palate also vibrates due to the air movements caused by snoring. Due to this constant movement of tissues, snoring can cause soreness of the palate and the throat. A variety of conditions such as deviation of nasal septum, nasal congestion, alcohol consumption, obesity and obstructive sleep apnea have been linked to snoring.

Burning mouth syndrome

The burning mouth syndrome is characterized by a burning sensation in the mouth. In many cases, the exact cause of the burning sensation is not known. Such cases are referred to as idiopathic or primary burning mouth syndrome. Secondary burning mouth syndrome has been linked to a variety of factors such as food allergies, nutritional deficiencies, hormonal disturbances, dry mouth, acid reflux, medications and mental health conditions.

Nasal infections

A sore palate may also occur in case of nasal cavity infections that extend down into the throat and the mouth. Upper respiratory tract infections (such as common cold) can also cause soreness of the palate.

Apart from direct infection, the palate can also become sore due to frequent sneezing and mouth breathing that these illnesses cause. Such cases are also accompanied by nasal soreness, which usually resolves within a few days or weeks.

Other causes

A sore palate may also be seen in conditions such as nutritional deficiency, ulcerative colitis, oral cancer, pharyngotonsillitis, nerve disorders, excessive screaming or talking, and eating disorders.

Read more on blood in the mouth.

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