Swollen Gums: Causes, Symptoms & Treatment

Overview: Swollen Gums 

The gums are pink tissue lining your upper and lower jaws. They help hold your teeth in place. 

Through poor oral hygiene, the gums can become infected by bacteria. This can lead to inflammation, swelling, and bleeding. 

Swollen gums are larger than usual and often appear red. They may bleed when you brush or floss. 

Gum inflammation is painful and can be a warning sign of gum disease. Diseased gums can lead to tooth decay and tooth loss (if left untreated). 

There are other triggers of swollen gums besides gum disease. If you have been experiencing swollen gums for more than a few days, you should see a dental professional to find out the cause.

Causes of Swollen Gums

Here are the main causes of swollen gums:

Gum Disease (Gingivitis/Periodontitis)

The most common cause of swollen gums is gum disease, of which there are two main types: gingivitis and periodontitis.

Gingivitis is a mild form of gum disease. The more advanced stage of gum disease is known as periodontitis. 

Symptoms of gum disease include: 

• Sore, swollen gums
• Gums that bleed when you brush or floss
• Continual bad breath
• Receding gum line
• Loose teeth

Gingivitis will cause your gums to become inflamed and sensitive. It’s caused by a bacterial infection that occurs through the buildup of plaque, a sticky film that forms on teeth after eating. 

Bacteria in plaque feed on the sugars and starches on and between your teeth. 

Left untreated, gingivitis can progress to periodontitis, also known as periodontal disease. This disease can cause the gums to recede, damaging the bones and tissues holding the teeth in place. 

Besides damaged bones and loose teeth, bleeding after brushing and pus are common symptoms of periodontitis. 

Other risk factors for periodontitis include smoking, certain drugs, a weakened immune system, and obesity. 

Diabetes is also a risk factor for periodontitis. There are three reasons for this: 

1. Diabetics produce saliva, which contains more sugar than average, allowing more bacteria to feed. 
2. Diabetes can also worsen the inflammation caused by gingivitis. 
3. Diabetes can cause xerostomia (or dry mouth), which is a risk factor for gingivitis.

Cancer Treatment

Radiation treatment for cancer can also cause inflamed gums. The technical term for this is oral mucositis — commonly known as “chemo-mouth.” 

Inflammation and sores can occur as a side effect of chemotherapy, usually in the first 5 to 10 days following treatment.

Tobacco Products

Tobacco is bad for your gums. Smokers have double the risk for gum disease compared to non-smokers.⁴

This is for two reasons:

1. Nicotine constricts the blood vessels in the gums, interfering with their ability to heal themselves or fight off infections.
2. The restricted blood flow can also make smokers' gums look pale pink and prevent bleeding while brushing. This masks symptoms and delays treatment, allowing infections to get worse.

Smokeless tobacco can also raise your risk for gum problems, including periodontitis.⁹

Hormonal Changes

Women are at higher risk for gum infections due to hormonal changes that occur throughout their lives. The two main hormones linked to gum inflammation are estrogen and progesterone.

There are four major life stages where hormonal changes occur:

1. Puberty 
2. Menstruation
3. Pregnancy 
4. Menopause

These events all cause blood flow to increase to the gums. This makes them  more red, tender, and inflamed.

The use of oral contraceptives also causes hormonal changes, which can affect the gums.

Canker Sore

Canker sores are painful ulcers that can form on the inside of the mouth, including the gums. 

The cause of canker sores is often unknown. Some risk factors include a weak immune system, hormonal changes, and dietary issues. 

Canker sore symptoms include:

• Painful sore on tongue, gums, inside lips, palette, or inside the cheeks
• Uncomfortable sensation prior to the appearance of the sores
• Red or grey round-shaped sores

Canker sores are not contagious.

Tooth Abscess

A tooth abscess is a collection of pus that forms inside the tooth from a bacterial infection. The gums surrounding this tooth will often appear swollen.

An abscess is often painful and can be severe.

Some symptoms include:

• Unpleasant taste in the mouth
• Bad breath
• Fever
• Fatigue, nausea, or general ill feeling
• Inflamed gums
• Swollen neck glands
• Heightened tooth sensitivity to hot and cold temperatures

Medications

Certain medications are known to cause gingival overgrowth and swollen gums. 

If a person takes a medication for blood pressure control (like calcium channel blockers or seizure medication), they may experience gum swelling. 

Others medicines commonly known to cause swollen gums include:

• Phenytoin (seizure medication)
• Cyclosporine (immunosuppression medication)
• Verapamil, Diltiazem (antihypertensive medication)

Other Oral Infections

Some other oral infections that can lead to gum swelling include:

• Trench mouth — Getting its name from World War I, Trench Mouth is a particularly severe form of gingivitis. Its symptoms include bleeding and inflamed gums, often covered with painful ulcers. 
• Thrush — This is a fungal yeast infection that occurs in the mouth and throat. It is transmissible but usually contracted by those with weakened immune systems, such as infants or those with HIV. 
• Oral herpes — The herpes simplex virus, the cause of cold sores, can also cause an infection called gingivostomatitis. It is relatively common in children. Symptoms last around 2-3 weeks and include sores or swelling in the mouth and gums. 
• Strep bacteria and other germs — Streptococcus and other bacteria can also cause gingivostomatitis. 
• Hand, foot, and mouth disease — This is common in children under five years old. Symptoms include mouth sores, skin rash, and fever or flu-like symptoms. It is highly contagious but usually not serious.

What Causes Gum Swelling Around One Tooth? 

There are a variety of things that can cause the gum to swell around one tooth. The most common reasons are a tooth abscess, gum disease, and poor oral hygiene. There may also be trapped food particles around the tooth. 

It is also possible that brushing or flossing too forcefully may be the cause. A more gentle brushing technique can solve this.

When to See a Dentist for Swollen Gums

Gum swelling usually goes away within two weeks. If it doesn’t, you should consult your dentist.

Swollen gums can be a sign of gingivitis or other gum health issues. While this may go away on its own, if it lasts more than a few days, seek the advice of a professional. 

Severe ulcers, canker sores, or persistent gum soreness are all issues that require professional attention as well.

Swollen Gums Treatment 

A variety of treatments exist for swollen gums. Here are some home remedies to try:

At-Home Treatments 

• Brushing and flossing — If you are experiencing swollen gums, you can brush and floss to treat the problem. Carefully slide the floss between your teeth to remove stuck food particles and brush gently around the gum area.
• Saltwater — Rinsing with a saltwater solution has been shown to be an effective way to treat inflamed gums, canker sores, and other mouth wounds.⁸
• Essential oils — Some mouthwashes use essential oils such as thyme, peppermint, lemongrass, tea tree, or clove. Multiple studies have found that these mouthwashes can effectively reduce plaque and treat gingivitis.^{7, 13, 14,}
• Compresses — Using a warm compress can reduce gum pain. You can use a cold compress to reduce gingival swelling.

Professional Treatments

If your gums have been swollen for over two weeks, it is time to see your dentist. The dentist will start by asking questions about when the symptoms began. 

Then, they may order an x-ray and blood tests to check for further infection. After that, they will likely prescribe oral rinses or a special kind of toothpaste.

Professional teeth cleanings are necessary if tartar has formed.

Tartar is a hard substance that forms when plaque is not removed. It collects along your gum line and can lead to cavities and gum disease. It cannot be removed at home with a standard toothbrush.

If the gums are seriously infected, treatment by a gum specialist called a periodontist may be necessary.

How to Prevent Swollen, Red, and Bleeding Gums

There are several ways to prevent gum infections. The most important is basic oral hygiene. Brushing and flossing are essential to promote good dental health. 

Plaque forms not only on but also between teeth in hard-to-reach gaps. This is called interproximal plaque. This is difficult to remove through brushing alone. If untreated, plaque-causing bacteria will spread to the gums below.

To remove interproximal plaque, floss regularly. You can also use interdental brushes, which have tree-shaped bristled heads specially designed to remove plaque.

You should also avoid tobacco products, including chewing tobacco. 

Follow other healthy habits like eating well and drinking plenty of water. If you have diabetes, follow your doctor's advice closely.