While we’re all aware of the importance of good oral hygiene, many of us only look at one end result — clean, shiny, healthy, white teeth — and pay little attention to what holds those teeth in place — our gums. Sore, painful, or swollen gums may seem like a minor annoyance that will soon go away, but sometimes, less-than-stellar gums indicate that a more serious health problem may be at hand. A number of studies have indicated that there may be links between advanced gum disease and some types of cardiac disease and cancers. In other words, it’s important to pay attention to unhealthy gums because they may be an early indication of an unhealthy body.
Don’t start worrying just yet, though — in most cases, gum discomfort is temporary and can be treated with some simple home remedies. Applying alternating warm and cold compresses to your face can be a source of relief. Salt water rinses or a rinse of equal parts of water and hydrogen peroxide are other options to soothe sore gums. But if the pain or swelling persists, a visit to your dentist is in order so you can determine which of the following issues you’re dealing with.
Let’s dive into the full list of possibilities:
Poor Brushing or Flossing Techniques
Sometimes, too vigorous brushing or flossing can bruise gums, causing them to swell or become sore. Toothbrushes with soft bristles used gently greatly decrease the chance of harming gums. Likewise, careful, gentle flossing between teeth limits potential damage to gums.
Toothpaste or Mouthwash Choice
Some people may experience sensitivity to certain toothpastes or mouthwashes that results in sore or swollen gums. The cause is probably due to the particular formulation of that specific product. Switching to an alternative product usually helps the discomfort to resolve.
Complications Following Dental Treatment
Although certain dental procedures, such as tooth removal, can alleviate the primary problem, a secondary problem such as swollen, tender, or painful gums may arise. This usually can be treated with applying an ice pack to the face post-procedure. However, if the swelling or pain persists or increases, an infection may have developed and it’s best to contact your dentist.
Gingivitis is the mildest form of periodontal disease, which is an infection of the tissues that surround and support the teeth — the gums. It’s usually caused by less-than-ideal oral hygiene, such as poor brushing and flossing habits and techniques, that leads to a buildup of plaque on the teeth. Plaque, a filmy, sticky material made of bacteria, mucus and food debris, can, over time, harden into tartar, which collects damaging bacteria. Both plaque and tartar irritate the gums, causing them to swell, redden, become sore, and, sometimes, bleed. Gingivitis can be reversed, however, with professional dental cleanings and improved oral hygiene.
If gingivitis is left untreated, it can advance to periodontitis. Plaque and tartar — and the bacteria they contain — spread below the gum line, ultimately severely damaging or destroying the tissue and bone around the teeth. Gums become puffy, red or purplish, tender, and prone to bleeding, and recession from the teeth. Teeth become loose and may fall out or must be removed. The bacteria responsible for periodontitis can cause even more serious health problems. It can travel through the bloodstream to the heart and lungs, for example, increasing the risk of cardiac and respiratory disease. Periodontitis is preventable, however, with good oral hygiene and regular dental visits.
Not only bacteria but viruses and fungi can infect gums, causing swelling and pain. The herpes simplex virus, which causes cold sores, can also affect gums, making them tender and swollen. Oral candidiasis, otherwise known as oral thrush, is caused by the fungus Candida albicans and results in swollen, often tender gums, along with creamy white lesions. While viral infections can be treated symptomatically, fungal infections require a prescription for the appropriate antifungal medication.
Malformed or misaligned teeth, if left untreated, can cause swollen painful gums. Likewise, poorly performed tooth restorations, such as the placing of implants, or poorly installed corrective measures, such as braces, can provide opportunities for bacterial growth and the resulting gum pain and swelling. Improperly fitted dentures can irritate the gums as well. Contact your dentist if these gum symptoms occur.
Both seasonal allergies and chronic sinusitis (a long-term sinus infection) can be a source of concern and irritation for its sufferers. In addition to the nasal nastiness, these conditions can cause sore or swollen gums. Allergies and chronic sinusitis can cause dry mouth, either due to increased mouth breathing (because of nasal "stuffiness") or antihistamine and decongestant use. The resulting decreased saliva production promotes bacterial growth in the mouth. Recent studies have shown that many cases of chronic sinusitis are caused by a fungal infection, rather than by bacteria or viruses. If your allergies or chronic sinusitis are accompanied by sore, painful, or swollen gums, it’s best to contact your doctor or dentist.
Ingestion of nicotine, most commonly through smoking (but also through vaping and using chewing tobacco) weakens the immune system and reduces blood flow, making it more difficult for your body to fight infections. This allows the bacteria associated with plaque and tartar a greater opportunity to grow, leading to painful, swollen gums. Viral and fungal oral infections also reap the benefit of nicotine ingestion, as these infections then gain a stronger foothold. Smokers have twice the risk for gum disease compared with nonsmokers. And the more cigarettes you smoke, or the longer you smoke, the higher the significantly increases the risk for gum disease. Seeing your dentist in order to deal with the underlying infection as well as giving up smoking, vaping or chewing tobacco and good oral hygiene habits can help bring your gums back to a healthy condition.
Numerous medications — both prescription and over-the-counter — can reduce the amount of saliva in the mouth and create a condition known as dry mouth or xerostomia. And without enough saliva, the gums become drier and more susceptible to gingivitis. These medications include antihypertensives, antihistamines, decongestants, painkillers, muscle relaxants, antidepressants and drugs for urinary incontinence or Parkinson’s disease. Sucking on ice chips, drinking water or caffeine-free beverages or the use of over-the-counter dry mouth rinses or sprays can often help. Some oral inhalers for asthma can cause a fungal infection in some patients, which also can result in swollen or painful gums. Overgrown, swollen, and sometimes tender gum tissue may result from some anti-seizure and immunosuppressant drugs, as well as from calcium channel blockers used by some cardiac patients. Notifying your doctor or dentist is best if you experience these gum symptoms.
Mouth Ulcers/Canker Sores
Canker sores are a type of mouth ulcer called aphthous ulcer. They usually appear at the base of the gums, are painful and can interfere with eating, drinking, and talking. Although most disappear within a week, it’s best to check with your dentist if they persist, recur, cause considerable pain or severely interfere with eating or drinking.
Trench Mouth/Acute Necrotizing Ulcerative Gingivitis (ANUG)
A very painful but rare form of gingivitis, its name harkens back to World War I, when soldiers in the trenches frequently developed this infection. Poor nutrition or oral hygiene, smoking, stress, or other oral infections can alter the bacterial makeup of the mouth, resulting in an overabundance of normal mouth bacteria. Red, swollen, ulcerative gums accompanied by bad breath and occasional fever are the signs. Fortunately, this uncommon infection usually responds to treatment. Good oral hygiene, salt water or hydrogen peroxide rinses, a professional cleaning and possible antibiotics are recommended.
Good nutrition is essential for optimal oral health. Poor nutrition or the resulting malnutrition lead to vitamin deficiencies, which can impact the gums. Although rare, Vitamin C deficiency can lead to scurvy, whose symptoms include bruised, irritated, swollen gums. Luckily, scurvy can be quite successfully and quickly treated with Vitamin C supplements and a diet filled with fruits and vegetables. Lack of folic acid can cause gums to swell. Vitamin K deficiency can lead to swollen and eventually bleeding gums. Both deficiencies can be treated with appropriate supplements and dietary changes.
Hormonal changes, particularly for women, can impact gum health. The higher levels of progesterone and estrogen associated with puberty cause an increase in blood circulation to the gums. The resulting heightened sensitivity can make reactions to irritations caused by rough tooth brushing or flossing, food particles or plaque much greater. This overreaction can cause the gums to become tender, swollen, or painful. Good oral hygiene, including twice-daily brushing, can help prevent the problem. Some women also experience swollen, painful gums a few days before their period begins and which resolve once it does begin. Pregnancy, too, with its surge of hormones, can result in gingivitis for some women. It usually occurs between the second and eighth month of gestation. Good oral hygiene as well as regular dental visits during pregnancy for frequent cleanings can keep the gingivitis in check. Menopause is another hormonal challenge that can affect gum health. Dry mouth is sometimes associated with menopause; dry mouth results in reduced amounts of saliva, which cleans teeth of infection-causing bacteria. Drinking water or caffeine-free beverages, sucking on ice chips or using over-the-counter dry mouth sprays or rinses can reduce the dryness.
Uncontrolled or poorly controlled diabetes can lead to gum disease due to high glucose levels — a hallmark of the disease. Increased levels of glucose in saliva are an invitation for bacteria, leading to an overproduction of harmful plaque. The resulting gingivitis and, if not treated, periodontitis, are characterized by changes in the gums — swelling, redness, soreness and pain. Proper diet, exercise, weight loss and the use of appropriate medications can do much to keep diabetes under control. Diabetes, even when it is controlled, can cause gum problems. Some patients experience dry mouth or reduced saliva production, which predisposes them to develop gingivitis.Disclaimer: The article does not replace an evaluation by a physician. Information on this page is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes.