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Causes of Gum Pain and Finding Relief

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Gum pain can arise from inflammation of the gums, also known as gingivitis, dental irritations from brushing, flossing, or dental procedures. Painful gum can also arise from oral herpes and cold sores. There are many ways to treat your gums and find relief.

6 most common causes

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Common gum pain symptoms

Painful gums are most commonly due to inflammation of the gums or gingiva. This condition is known as gingivitis. The most common cause of gingivitis is buildup of bacteria on the teeth and gums, which is called plaque. However dental infections, mouth infections and other medical illnesses are all causes of painful gums. Some causes of gum pain can be treated at home. Good dental hygiene (brushing and flossing) as well as regular dental visits help prevent gingivitis. Other causes of gum pain, particularly infectious causes, may require treatment by a dentist or doctor.

Common accompanying symptoms of gum pain

Symptoms that can be associated with gum pain include:

What causes sore gums

The most common cause of gum pain is inflammation of the gums or gingivitis. One of the most common causes of gingivitis is the buildup of bacteria (called plaque) on the teeth and gums leading to irritation and pain. Other causes of gingivitis include mechanical irritation, medications, nutritional deficiencies or other systemic illnesses. Infections in the teeth or mouth can also lead to gum pain symptoms. Some infections in the back of the mouth can cause pain as well as life-threatening swelling and require emergency medical treatment. Headache, dysfunction in the jaw joint, or nerve dysfunction in the face are other possible causes of gum pain.

Gingivitis (inflammation of the gums)

Gingivitis is one possible cause of gum pain.

  • Plaque buildup: Plaque is buildup of bacteria that occurs on the teeth and the gums. In some cases, the bacteria and the immune response to the bacteria can cause irritation and inflammation to the gums.
  • Mechanical irritation: Irritation from brushing, flossing, or dental procedures can lead to inflammation of the gums and cause gum pain symptoms.
  • Medications: Certain medications can cause enlargement of the gums which can lead to plaque buildup, irritation, pain, or bleeding. Calcium channel blockers, a common blood pressure medication, phenytoin (Dilantin) and cyclosporine, an immunosuppressant, may cause gum pain symptoms.
  • Systemic conditions: Some chronic medical conditions including diabetes, vitamin deficiency, immunodeficiency disorders, or genetic disorders are associated with gingivitis.
  • Pregnancy: Hormonal fluctuations in pregnancy can lead to gingivitis and cause painful gums.

Infectious causes

Gum pain may be the result of different infections.

  • Dental infection: Plaque buildup on the surface of the tooth can erode into the tooth and cause infection in the tooth itself. Plaque can also get into the space between the tooth and the gum, leading to infections of the gums and tissue and bone that underlie the gums.
  • Soft tissue infections: The soft tissue below the tongue and in the back of the mouth can become infected and may be accompanied by gum or tooth pain. These infections can occasionally cause life-threatening swelling to the airway leading to stridorous or wheezy breathing and respiratory distress and may require emergency medical treatment.
  • Herpetic stomatitis is a viral infection of the mouth that causes fever and red and inflamed gums.
  • A cold sore is a skin lesion caused by the herpes simplex virus (HSV).
  • Sinus infection: Sinus infections may cause referred pain to the mouth, teeth, or gums.
  • Acute necrotizing ulcerative gingivitis (ANUG), also known as trench mouth, is a relatively rare infection of the gums.
  • Dry socket is a common cause of severe pain after you get your tooth pulled.

Other causes

Other various causes of gum pain may include the following.

  • Headache: Headaches, particularly migraines, might present with gum pain or tooth pain.
  • Joint dysfunction: The jaw joint can become inflamed and lead to pain in the teeth, gums, or jaw. This pain is often present with chewing or biting.
  • Nerve dysfunction: Dysfunction to the nerves that supply the face can cause pain to gums, teeth, or jaw. This pain is typically shooting and present only on one side of the face.

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Temporomandibular joint (TMJ) dysfunction disorder

Temporomandibular joint (TMJ) dysfunction disorder refers to long-term pain and dysfunction in the TMJ, the joint that connects the upper and lower jawbones.

The TMJ is a complex joint with complicated movements and is subject to strain and injury. Symptoms may come and go for no apparent reason. Misalignment of the teeth and jaw, and tooth grinding, are no longer believed to be a cause. Women seem to be more susceptible than men.

TMJ disorder has three types:

  • Pain or discomfort in the muscles controlling the TMJ.
  • Dislocation or injury to the jawbone.
  • Arthritis of the TMJ.

Diagnosis is made through patient history, physical examination, and imaging. The goal is to rule out other causes such as sinus infection or facial nerve damage.

Due to the difficulty of diagnosing TMJ disorder, treatment begins with conservative methods that do not permanently change the jaw or teeth. Ice packs, soft foods, gentle stretching of the jaw muscles, and reducing stress are all encouraged. Short-term pain medications may be used. Splints, Botox, implants, and surgery are not recommended.

Oral herpes

Oral herpes infection or HSV-1 is caused by a virus called herpes simplex virus. It transmitted when a person with active sores has intimate or sexual contact, such as kissing or oral sex with another person. The first outbreak tends to be the most painful because people typically get a cluster of mouth sores and other symptoms such as fever, headache, sore throat, and swollen lymph nodes.

Gingivitis

Gingivitis is the infection of the gums surrounding the teeth. It is caused by plaque and/or tartar that has built up on your teeth. Plaque is a sticky layer of gunk made by food particles, mucus, and bacteria. After a while, plaque hardens to become tartar (or calculus). Plaque and tartar at the bottom of the teeth causes the gums to become irritated and infected.

You should go to the nearest dentist in the next few weeks. There, the dentist or dental hygenist will clean your teeth, getting rid of that nasty plaque/tartar. Once cleaned, you should rinse your mouth twice-a-day with chlorhexidine 0.12% oral rinse (PerioGard) or half-strength hydrogen peroxide. Flossing and brushing your teeth are also essential.

Giant cell arteritis

Giant cell arteritis is a disorder that affects the blood vessels in the head and neck and can cause headaches, vision problems, jaw pain, and arm pain.

Giant cell arteritis is usually evaluated by a primary care doctor who might perform a physical exam and order a blood test to look for inflammation. They might prescribe steroids to help lower the inflammation.

Dental cavity

Dental cavities are bacterial infections of the tooth. The bacteria produce acid that breaks down the tooth.

You should visit your dentist within the next 24 hours. Once a toothache presents, the tooth might already be in big trouble, and it needs attention right away.

Canker sore

Canker sores are small, grayish-white sores in the mouth, often on the inside of the cheeks, lips, and on the tongue. No one really knows why canker sores happen, but it seems to be inherited and susceptible to vitamin deficiencies and allergies.

You can safely treat this condition on your own using Chlorhexidine mouth washes (Peridex or Periogard) or steroid medications (Orabase, Betnesol, or Ovar).

Treatments for painful, swollen gums

When it is an emergency

Seek emergency gum pain treatment if:

  • You have significant swelling in the mouth that may compromise breathing
  • You are unable to open your mouth

At-home treatments

The following remedies for gum pain can be tried at home.

  • Brushing and flossing: Regular brushing with toothpaste that contains fluoride and regular dental flossing are the best ways to prevent plaque buildup and dental infection.
  • Antiseptic mouth rinse: People who have had dental infections or gingivitis in the past should use antimicrobial mouth rinses like chlorhexidine to prevent recurrence.
  • Smoking cessation: Smoking tobacco can contribute to plaque buildup and dental infections.
  • Avoidance of sugar-rich food and drink: Consuming sugary foods and drinks can contribute to plaque buildup and dental infections.

Medical treatments

Medical or professional treatments for gum pain include the following.

  • Regular dental visits: Regular visits to a dentist for hygiene are important for prevention of gingivitis, plaque buildup, and dental infections.
  • Antibiotics: If a dental infection is causing gum pain, a doctor or dentist may prescribe antibiotics to treat the infection.
  • Drainage or tissue removal: If a mouth infection is causing gum pain, a doctor or dentist may need to drain the infection with a needle or remove infected tissue from the area.
  • Tooth removal: In some cases, infected teeth need to be removed by a doctor or dentist.
  • Medications: If a doctor suspects gum irritation and pain due to medications, they may change your prescription. Do not stop or change your medications without consulting a doctor. If a doctor suspects your gum pain is due to an underlying illness, they may prescribe medications to treat the underlying cause.

Gum pain quiz

Take a quiz to find out what's causing your pain.

Take gum pain quiz

FAQs about gum pain

Can cavities cause gum pain?

Yes. Cavities, especially if they penetrate the root of the tooth, can cause gum pain along the gum just below the affected tooth. Usually, the pain is so severe that it is often results in dental care prior to the development of gum pain, but if it is not, the nerve will die, the tooth may fall out, and the infection can often track down into the gum.

Why do my gums hurt in one spot?

Gums may hurt in one spot if you have a sore anywhere along the gums. This can occur from consumption of hard or sharp foods, a gum abscess, or from an infection trapped within the gums. Food trapped between teeth can also exert pressure upon the gums, and if not removed by flossing, it can cause pain in the gums.

Why are my gums bleeding and painful?

Bleeding, swollen, or painful gums can be a sign of early periodontal disease or periodontitis. Inflammation can cause a loss of supportive connective tissue or bone and disconnection of teeth from gums. It may cause bleeding upon brushing or probing and increased tooth mobility as well as increased systemic illness from bacteria in the mouth entering the blood streams.

Why do I have pain in the gums between my teeth?

Buildup of food between the teeth can contribute significantly to pain and can be alleviated by regular flossing once or twice per day. Making sure that plaque and excess food debris is removed is very important for proper dental health and hygiene. Daily flossing in addition to brushing is recommended.

Can bleeding gums become infected?

Yes, bleeding gums can become infected and often are exposed to different bacteria on the food that we eat. Gums that are inflamed and bleed on probing may have early stage periodontal disease which is often caused by bacterial colonization of teeth and consumption of foods that promote bacterial growth without adequate hygiene.

Questions your doctor may ask about gum pain

  • Where specifically is your mouth pain?
  • Have you ever been diagnosed with HIV or AIDS?
  • Have you ever been diagnosed with cancer?
  • Any fever today or during the last week?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

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Dr. Rothschild has been a faculty member at Brigham and Women’s Hospital where he is an Associate Professor of Medicine at Harvard Medical School. He currently practices as a hospitalist at Newton Wellesley Hospital. In 1978, Dr. Rothschild received his MD at the Medical College of Wisconsin and trained in internal medicine followed by a fellowship in critical care medicine. He also received an MP...
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