Oral Papilloma (Squamous Papilloma)
An oral papilloma is a small, bumpy growth in the mouth that looks a bit like a tiny cauliflower or a cluster of soft white fingers. People usually find one with their tongue, or a hygienist spots it on the palate or the side of the tongue. It's harmless in nearly every case, and once it's removed it rarely comes back.
An oral papilloma (squamous papilloma) is a benign, wart-like growth caused by low-risk HPV types 6 or 11, not the types linked to throat cancer. It's usually painless, under 1 cm, and white or pink with finger-like projections. It's only weakly contagious and isn't considered precancerous. Don't treat it at home. See a dentist, who can remove it and send it to a lab to confirm what it is.
Not sure this is what you have? Answer five quick questions in our mouth spot checker. It compares what you see with more than 40 common conditions and tells you how soon to have it looked at.
- What is an oral papilloma?
- What HPV in the mouth looks like
- Where papillomas grow
- Oral warts and other HPV bumps
- Papilloma vs. look-alikes
- What causes a papilloma in the mouth?
- Does HPV in the mouth cause cancer?
- HPV mouth symptoms
- Does an oral papilloma go away?
- What to do if you find one
- Over-the-counter products
- Papilloma removal and treatment
- Prevention and the HPV vaccine
- Kids, pregnancy and immune problems
- When to see a dentist
- FAQ
What is an oral papilloma?
A squamous papilloma is a small overgrowth of the surface lining of the mouth. It's the most common bumpy (papillary) growth dentists find inside the mouth. Under a microscope it looks like a bundle of fingers, each with a thin core of blood vessels and tissue covered by extra layers of surface cells.
Most papillomas are linked to human papillomavirus (HPV), usually types 6 and 11. Those are the same low-risk types that cause genital warts. They are not the high-risk types, like HPV 16, that are tied to cancer. That difference is the single most useful thing to know about this growth, and we'll come back to it below.
Papillomas show up at any age. Most are found in adults, men and women about equally.
What does HPV in the mouth look like?
Most of the time, HPV in the mouth doesn't look like anything. The virus lives quietly in the lining and clears on its own without a single bump. When low-risk types do cause a growth, an oral papilloma usually has these features:
- A rough, bumpy surface made of many tiny finger-like or pointed projections. People describe it as a little cauliflower, a sea anemone, or a wart in the mouth.
- White, off-white, or pink color. The more keratin on the surface, the whiter it looks.
- Often a narrow stalk, so it can wiggle when you push it with your tongue. Some sit flat on a wider base.
- Small size. Most are well under 1 cm, about the size of a pencil eraser or smaller, and they don't keep growing.
- Usually just one, and usually painless unless your teeth catch it.
If you're searching for HPV in mouth pictures, keep in mind that a photo can't tell you which HPV type is involved, or whether it's HPV at all. Several harmless bumps look a lot like a papilloma, and very rarely a cancer does too. You can't tell the HPV type by looking. A dentist can usually make a confident guess, and removing it for a lab check gives the real answer.
Where papillomas grow: tongue, palate, lips, gums and cheek
A papilloma can grow anywhere in the mouth, but some spots are much more common than others. Papilloma on the tongue and on the soft palate (including the uvula, the little tag that hangs at the back) make up a large share. The lips and gums come next. A wart in the mouth on the cheek lining is less common but happens.
Oral warts, papillomas and other HPV bumps
"Oral HPV" can show up in a few different ways. Squamous papilloma is by far the most common. The others are less common, and the differences matter mainly to the pathologist reading the lab report.
| Squamous papilloma | Common wart (verruca vulgaris) | Condyloma | Focal epithelial hyperplasia | |
|---|---|---|---|---|
| Usual HPV types | 6 and 11 | 2 and 4 | 6 and 11 | 13 and 32 |
| Who gets it | Adults mostly, any age | Often children | Teens and adults | Mostly children, in some families and communities |
| Look | Single white or pink "cauliflower" on a stalk | White, rough, firm wart, usually on the lips or front of the mouth | Pink, often larger, sometimes several | Many soft, flat, pale bumps on the lips, cheeks and tongue |
| How it spreads | Unclear. Only weakly contagious. | Often from finger warts (nail biting, thumb sucking) | Usually close or sexual contact | Thought to pass within households |
| Course | Usually stays the same until removed | May fade over time | Can spread or come back | Often fades on its own over months to years |
Oral papilloma vs. fibroma and other look-alikes
Lots of things in the mouth are bumpy. Here's how a papilloma compares with the bumps people most often confuse it with.
| Surface | Color | Usual cause | What to do | |
|---|---|---|---|---|
| Oral papilloma | Rough, finger-like, "cauliflower" | White or pink | Low-risk HPV | Have it removed and checked |
| Oral fibroma | Smooth, firm dome | Same pink as the cheek, maybe a white cap from rubbing | Repeated biting or rubbing | Removal if it bothers you or keeps getting bitten |
| Fordyce spots | Flat or barely raised dots | Yellow-white, in groups | Normal oil glands | Nothing, they're normal |
| Normal papillae at the back of the tongue | Round or leaf-shaped bumps | Pink to red | Normal anatomy, matched on both sides | Nothing, unless one side looks different |
| Pyogenic granuloma | Smooth or lumpy, soft | Bright red, bleeds easily | Irritation, plaque, pregnancy hormones | See a dentist, usually removed |
| Verrucous leukoplakia | Rough, warty, spread out as a patch | White | Often tobacco, sometimes unknown | Biopsy. Needs close follow-up. |
| Verrucous carcinoma (rare) | Broad, warty, slowly spreading | White or gray | Usually older adults, often tobacco users | Biopsy and specialist care |
A few practical clues: a papilloma is usually small and single, it's attached by a stalk or a narrow base, and it isn't spreading out sideways like a patch. A broad, flat, or spreading white rough area isn't a typical papilloma and deserves a prompt look. Denture wearers sometimes get a pebbly, red, bumpy palate under the denture called inflammatory papillary hyperplasia. It's from the denture, not HPV, and usually settles once the fit and hygiene improve. Our dentures page has more on fit and care.
What causes a papilloma in the mouth?
HPV is a very large family of viruses. More than 100 types exist, and about 40 of them can infect the mouth, throat and genital area. Papillomas come mainly from types 6 and 11.
Oral HPV is common. In a national U.S. survey, about 7 in 100 people ages 14 to 69 had some type of HPV in their mouth at a single point in time. Most people with oral HPV never get a papilloma, and most infections clear without anyone knowing they were there.
How the virus got there is usually impossible to say. It can pass through kissing and oral sex, and in children it can move from a wart on a finger to the mouth. HPV can also stay dormant for a long time, so a papilloma that shows up this year doesn't point to anything recent. Nobody should feel judged for having one.
Can a wart in the mouth not be HPV?
Yes. Lab studies find HPV in only about half of papillomas, depending on the testing method. And many bumps that people call a "wart" turn out to be something else entirely: a fibroma from cheek biting, an irritated papilla, or a swollen gland. That's one more reason the lab report is more useful than a guess.
Does HPV in the mouth cause cancer?
Some types can, but not the types that cause papillomas. This is where the confusion comes from, so here's the plain version.
- Low-risk HPV (6 and 11) causes papillomas and warts. A typical oral papilloma isn't considered precancerous and has no known link to mouth or throat cancer.
- High-risk HPV, mainly type 16, can cause cancer of the oropharynx: the tonsils, the base of the tongue and the back of the throat. The CDC estimates HPV causes about 60% to 70% of oropharyngeal cancers in the U.S., and these cancers have become more common over the past few decades.
- High-risk HPV doesn't cause warts or bumps you can see or feel early on. A papilloma isn't a sign that you have it.
The HPV-related throat cancers usually show up as a lasting sore throat, a lump in the neck, ear pain, hoarseness or trouble swallowing, not as a wart in the front of the mouth. If you have those symptoms for more than 2 or 3 weeks, see your physician, an ENT, or us. Our page on signs of oral cancer walks through what's worth getting checked, and the head and neck cancer page covers dental care during and after treatment.
Very rarely, a cancer in the mouth can have a warty surface. That's the honest reason we recommend removing papillomas and having them examined rather than just watching. A biopsy is the only way to know what any growth is.
HPV mouth symptoms
There often aren't any. A papilloma is usually discovered by touch or at a checkup, not because it hurts. When people do notice something, it's usually:
- A small bump the tongue keeps finding
- A rough or "tag-like" spot on the palate, uvula, tongue, gums or lip
- Tenderness or a little bleeding if you bite it or catch it with food
- A tickle or a feeling of something in the throat when it's on the uvula
Pain, a fast-growing lump, a sore that won't heal, numbness, or a lump in the neck aren't typical of a papilloma. Those need a prompt exam.
Does an oral papilloma go away?
Sometimes, but usually not. Most papillomas reach a small size and then stay the same for months or years. A few shrink. Some kinds of oral warts in children, like focal epithelial hyperplasia, often fade on their own over time.
Once a papilloma is fully removed, it rarely comes back. When one does reappear, it's usually because a bit of the base was left behind, or because the virus is still active and another one forms nearby. People with weakened immune systems are more likely to get several or to have them return.
What to do if you find a wart in your mouth
There isn't a home treatment for an oral papilloma. The useful steps are about leaving it alone and getting it looked at.
- Take a photo and note the date. Use your phone with good light. If it changes size or color, that's helpful for us to know.
- Leave it alone. Don't pick, pinch, tie off, or try to cut it. You can cause bleeding and infection, and you may leave the base behind.
- Don't use wart removers. Skin wart products and freezing kits are made for thick skin, not the thin lining of the mouth. They can cause painful chemical burns or frostbite.
- Keep brushing normally. A soft brush is fine. If it bleeds a little when you brush, gentle pressure with clean gauze stops it.
- If it gets caught on your teeth, rinse with warm salt water (½ teaspoon of salt in a cup of water) to keep the spot clean while you wait for your visit.
- Book an exam. Mention where it is and how long you've noticed it. It doesn't need to be an emergency visit.
Myths worth skipping
- Apple cider vinegar, tea tree oil, garlic or duct tape won't remove a mouth papilloma and can irritate or burn the tissue.
- Antibiotics and antivirals don't treat HPV.
- A papilloma doesn't mean you have HPV-related cancer, and it doesn't say anything about a partner's faithfulness. HPV can stay quiet for years.
Over-the-counter products: what helps and what to skip
Nothing over the counter treats a papilloma. A few things can help if it's irritated, and a few should stay out of your mouth.
| Product | Use it? | Things to know |
|---|---|---|
| Salicylic acid wart removers (liquids, pads) | No | Made for skin. Causes chemical burns on the inside of the mouth. |
| Home freezing kits | No | Hard to control in the mouth. Can damage healthy tissue nearby. |
| Numbing gel (benzocaine, lidocaine) | Only if it's sore from biting | Short-term comfort. Do not use benzocaine in children under 2. The FDA warns it can cause a rare but dangerous blood condition (methemoglobinemia). Ask your doctor before use in pregnancy. |
| Salt-water rinse | Yes | Keeps an irritated spot clean. Swish and spit. |
| Pain relievers (acetaminophen, ibuprofen) | If needed after removal | Take as the label directs. In pregnancy, check with your doctor before taking ibuprofen. |
Papilloma removal and treatment
For most people, the plan is simple: confirm what it is, remove it, and let the lab have the final word.
- A careful exam. We look at the size, surface, base and location, check the rest of your mouth, and feel the neck. A thorough oral cancer screening is part of every exam like this. If we've seen you before, we compare against earlier photos.
- Removal with a lab check. A papilloma on a stalk is usually a quick procedure under local anesthetic. The whole growth and its base are removed, sometimes with a stitch or two. The tissue goes to a pathology lab. We can do this in our office in many cases, or refer you to an oral surgeon depending on size and location.
- Clear results. The lab confirms whether it's a squamous papilloma, a different HPV lesion, or something else. We go over the report with you.
- Other methods. Some specialists remove papillomas with a laser or by freezing. Those work too, but the tissue is usually still sent for testing when possible.
- Healing. The spot is usually sore for a few days and heals in about 1 to 2 weeks. Soft foods and salt-water rinses help. Our home care instructions cover the basics.
- Coordinating care. If there are many growths, if they keep coming back, or if your immune system is weakened, we work with your physician or a specialist. Our approach to diagnosing unusual mouth problems explains how we sort these out.
Preventing oral HPV and papillomas
You can't control every exposure to a virus this common, but a few things lower the odds.
- HPV vaccination. The vaccine used in the U.S. protects against the types behind most papillomas and warts (6 and 11) and the main cancer-causing types (16 and 18, among others). The CDC recommends it at ages 11 to 12, and it can start at 9. Everyone through age 26 should get it if they didn't as a kid. Adults 27 to 45 can talk with their doctor about whether it makes sense for them. It protects most when given before any exposure.
- Don't smoke. Smoking is linked to a higher chance of having oral HPV, and it raises the risk of mouth and throat cancer on its own.
- Treat warts on the hands, and discourage nail biting and finger sucking in kids who have them.
- Fewer partners and barrier methods for oral sex reduce exposure. They don't remove it completely.
- Regular checkups. A comprehensive dental exam includes a look at every surface of the mouth, which is how many papillomas get found while they're still tiny.
Kids, pregnancy and weakened immune systems
Wart in a child's mouth
In children, a wart in the mouth often comes from a wart on the fingers, carried there by nail biting or thumb sucking. Common warts on the lips and focal epithelial hyperplasia (many soft, flat bumps) are both seen in kids, and the second one often fades without treatment. We still like to see any growth in a child's mouth to confirm what it is. Treating hand warts with your pediatrician helps stop the cycle.
Pregnancy
A papilloma that isn't bothering you can usually wait until after the baby is born. If it needs to come off sooner, minor procedures with local anesthetic are generally considered safe during pregnancy, often in the second trimester. The HPV vaccine isn't recommended during pregnancy, so it's usually put off until afterward. Bleeding gum growths in pregnancy are more often a pyogenic granuloma, not a papilloma.
Weakened immune system
People with HIV, transplant patients, and others on immune-suppressing medicine can get more papillomas and oral warts, larger ones, and more frequent regrowth. These are still usually benign, but they're harder to manage, so we coordinate with your medical team. Our pages on HIV and the mouth and dental care for medically complex patients have more detail.
When to see a dentist about an oral papilloma
Make an appointment if:
- You've found any new bump, wart, or tag in your mouth
- A known papilloma changes size, color or shape
- It keeps getting bitten, bleeds or gets in the way of eating
- You have more than one, or one has come back after removal
- Your immune system is weakened
Get care quickly if:
- A lump is growing fast, is hard and fixed in place, or has an open sore on it
- There's a white or red patch that's spreading or rough
- You have a lump in your neck, a sore throat, ear pain, or trouble swallowing that has lasted more than 2 to 3 weeks
- You have numbness in your lip, tongue or chin
Oral papilloma FAQ
What is an oral papilloma?
An oral papilloma, also called a squamous papilloma, is a small, benign growth of the lining of the mouth with a rough, finger-like or cauliflower-like surface. Most are linked to low-risk HPV types 6 and 11. They're usually painless, under 1 cm, and most often found on the tongue, soft palate, lips or gums.
Is oral papilloma cancerous?
No. A squamous papilloma is benign and isn't considered precancerous. The HPV types that cause it (6 and 11) are not the types linked to cancer. Because a rare cancer can look warty, dentists still recommend removing a papilloma and sending it to a lab to confirm the diagnosis.
Does oral papilloma go away on its own?
Usually not. Most stay about the same size for months or years, and only some shrink. Once a papilloma is completely removed, it rarely comes back.
Is oral papilloma contagious?
Only weakly, as far as anyone knows. The HPV types involved can spread through close contact, but papillomas are considered to have low infectivity, and most people exposed to oral HPV never get one. Avoid picking at it, and have it removed if you're worried about passing it on.
Can you get HPV in your mouth?
Yes. Oral HPV is common, and a national U.S. survey found it in roughly 7 in 100 people ages 14 to 69. It spreads mainly through kissing and oral sex, and most infections clear on their own within a year or two without causing any symptoms.
What does HPV in the mouth look like?
Most of the time it doesn't look like anything, because the virus usually causes no visible change. When low-risk types cause a growth, it looks like a small white or pink bump with a rough, cauliflower-like surface, often on a narrow stalk. High-risk HPV linked to throat cancer doesn't cause visible warts.
Does oral HPV cause cancer?
Some types can. High-risk HPV, mainly type 16, causes most oropharyngeal cancers (the tonsils and base of the tongue) in the U.S. The low-risk types that cause papillomas and oral warts aren't linked to cancer. Having a papilloma doesn't mean you have a high-risk type.
How is a papilloma in the mouth removed?
Usually with a quick procedure under local anesthetic that removes the growth along with its base, sometimes with a stitch or two. Some specialists use a laser or freezing instead. The tissue is sent to a pathology lab to confirm what it is, and the spot usually heals in 1 to 2 weeks.
Can I remove a wart in my mouth at home?
No. Skin wart removers and freezing kits can badly burn the thin lining of the mouth, and cutting or tying it off risks bleeding, infection and leaving the base behind. Home removal also means the tissue never gets checked, so you won't know for sure what it was.
Can a wart in the mouth not be HPV?
Yes. HPV is found in only about half of oral papillomas, depending on the lab test used. Many bumps people call warts are actually fibromas from cheek biting, irritated papillae, or other harmless growths. A lab exam of the removed tissue is the only way to know.
What causes warts in a child's mouth?
Often a wart on the fingers that reaches the mouth through nail biting or thumb sucking. Children can also get focal epithelial hyperplasia, which causes many soft, flat bumps and often fades on its own. Any growth in a child's mouth is worth having a dentist look at.
Is there a test for HPV in the mouth?
There's no FDA-approved screening test for oral HPV. A papilloma is diagnosed by removing it and examining it under a microscope, and the lab can test for HPV if needed. Throat cancers are checked for HPV as part of cancer care, not through routine screening.
Does the HPV vaccine help if I already have a papilloma?
The vaccine isn't a treatment for a papilloma you already have, which still needs to be removed. It can protect you against other HPV types you haven't been exposed to yet, including the high-risk ones. Ask your physician whether it makes sense at your age.
Found a bump you can't explain?
If you're in the Jacksonville area and you've found a wart-like spot in your mouth, we're glad to take a look, explain what we think it is, and talk through removal and lab testing. Most of these turn out to be harmless, and it helps to know for sure.
Related conditions
Sources
- Betz SJ. HPV-related papillary lesions of the oral mucosa: a review. Head Neck Pathol. 2019;13(1):80–90.
- Gillison ML, Broutian T, Pickard RK, et al. Prevalence of oral HPV infection in the United States, 2009–2010. JAMA. 2012;307(7):693–703.
- Chaturvedi AK, Engels EA, Pfeiffer RM, et al. Human papillomavirus and rising oropharyngeal cancer incidence in the United States. J Clin Oncol. 2011;29(32):4294–4301.
- Centers for Disease Control and Prevention. HPV and oropharyngeal cancer.
- Centers for Disease Control and Prevention. HPV vaccination.
- U.S. Food and Drug Administration. Risk of serious and potentially fatal blood disorder prompts FDA action on oral over-the-counter benzocaine products. 2018.
This page is for general education and isn't a diagnosis. Every mouth is different. If you have a sore you're worried about, see your dentist or physician. Photos marked Wikimedia Commons are used under their listed licenses and may have been cropped or resized.