Why Are My Gums Swollen?

The most useful question is whether the swelling is around one tooth or spread across many. Look in a mirror in good light. Gums that are puffy, red or shiny across the whole of one or both jaws point to a general cause. A single lump or a swollen patch beside one tooth points to a local problem with that tooth.

Also notice what else is going on. Bleeding when you brush, a bad taste, a bad smell, a bump that looks like a pimple, pain on biting, or a tooth that feels higher or looser than its neighbours all help narrow it down. Write these down before you see a dentist, because they change the diagnosis.

The commonest cause is gingivitis, where plaque left along the gum line irritates the gum until it swells, reddens and bleeds easily. It is fully reversible when plaque is removed. Our page on the stages of gum disease explains how it differs from the deeper forms that involve bone.

Pregnancy makes gums react more strongly to the same amount of plaque, so swelling and bleeding are common from the second trimester. Puberty can do the same. Careful cleaning and a scaling usually keep it under control, and it often settles after delivery.

A few medicines can make gum tissue overgrow, including some used for high blood pressure, epilepsy and after organ transplants. Do not stop a prescribed medicine on your own. Tell the dentist and your doctor, because cleaning needs to be very thorough and the doctor may be able to adjust the treatment.

Braces, aligner attachments and ill-fitting dentures trap plaque or rub the gum. Mouth breathing dries the front gums and makes them puffy. In each case the fix is better cleaning around the appliance, a fit check, and sometimes treating the habit behind it.

A fibre of meat or a seed pushed under the gum edge, or a piece of floss or a toothpick tip left behind, can swell a single gum point within a day. It is tender but usually not throbbing. Gentle cleaning with floss or an interdental brush often removes it, and the swelling goes down in a day or two.

A gum abscess is a pocket of pus beside a tooth, either from a deep gum pocket or from an infected tooth. The swelling is usually firmer, throbbing and tender to bite on, and may have a small bump on it. It does not settle on its own for good. Our page on the gum boil explains what that bump is and why it needs treating.

A tooth coming through the gum, a child's or a wisdom tooth, swells the gum over it. Around a partly erupted lower wisdom tooth, a flap of gum can trap food and become infected, which is called pericoronitis. It can spread, so repeated or worsening swelling there needs a dentist.

Brush gently along the gum line twice a day with a soft brush. Do not skip the swollen area, because plaque is the cause and avoiding it makes things worse. Clean between the teeth once a day, and rinse with warm salt water a few times daily to soothe the gum. Our guide on toothpaste and mouthwash for gum disease covers what rinses add.

For discomfort, paracetamol or ibuprofen as directed on the label is reasonable. Avoid ibuprofen if you have stomach ulcers, kidney disease or asthma, or if you take blood thinners, and ask a doctor first if you are pregnant. Do not put aspirin on the gum, do not apply heat to a swollen face, and do not start antibiotics on your own.

Swelling from plaque or trapped food should clearly improve within a week, and be settled in one to two weeks. If it has not, or if it keeps coming back, it needs examination and probably a professional cleaning. Swelling that came with a throbbing pain, a bump or a loose tooth should be seen sooner rather than waiting out the fortnight.

Get same-day care if the swelling spreads onto the cheek, face or under the jaw, if you have a fever, or if you are feeling generally unwell. A dental infection can track through the tissues of the face and neck, and antibiotics alone do not fix it because the infection has to be drained and the source treated.

Go to a hospital emergency department straight away if swelling is closing an eye, if you have difficulty swallowing, if you cannot open your mouth properly, or if breathing is affected. Do not wait for a dental appointment in those cases. Our symptom page on face swelling due to tooth infection lists the signs in full.

The dentist looks at the pattern, probes the gum pockets, checks the nearby teeth for decay or infection, and usually takes an X-ray if one tooth is involved. Treatment follows the cause: a scaling for plaque, removal of trapped debris, drainage and root canal treatment or extraction for an abscess, or a plan for a wisdom tooth.

If your main problem is gums that bleed rather than swell, the separate page on bleeding gums is the better place to start. Our gum treatment page shows the steps when swelling comes from established gum disease.