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Doctors Explain Why You Should Never Ignore Your Painful, Swollen Gums

Krissy Brady
Photo credit: mihailomilovanovic - Getty Images

From Prevention

The discussion surrounding oral health tends to revolve around how to keep our pearly whites, well, white, and free of cavities. Not much attention is given to our gums—in fact, the only time many of us remember they’re even there is when they demand our attention in the form of bleeding or swelling.

So what causes swollen gums, exactly? Usually, poor oral hygiene: “Plaque is a soft, sticky substance that constantly forms in the mouth through the day and contains millions of bacteria,” says New York City-based cosmetic dentist Catrise Austin, DDS. “When plaque isn’t removed daily by brushing and flossing, it releases toxins that infect the gums and cause swelling.”

You can start turning things around by brushing up on your teeth cleaning skills (pun totally intended), which involves brushing and flossing twice a day to keep plaque from camping out below the gums.

Any plaque that isn’t removed between the teeth will eventually harden, becoming tartar—which, unfortunately, can’t be dealt with by a toothbrush alone, says Dr. Austin. You’ll need to take a trip to your dentist for a professional cleaning, which pros recommend you schedule every six months or so.

But even with all of this cleaning action, your gums might swell anyway, and that could be a sign of an underlying issue. “Swelling of the gums is never a normal thing and should be seen by a dentist or physician, who can properly diagnose and help with an appropriate treatment course,” says Kari L. Sakurai, DDS, general and cosmetic dentist at Providence Saint John’s Health Center in Santa Monica, California.

If your pillowy gums haven’t gone back to normal within two weeks time, experts recommend checking in with your dentist for a consult. Curious as to what the problem might be? Here are 10 possible reasons your gums are swollen, according to experts.

1. Gingivitis could be to blame.

The most common trigger of swollen gums is gingivitis, a mild form of gum disease. “Over time, bacteria and food particles form a film of plaque over teeth,” says New York-based endodontist Adam S. Harwood, DMD. “Left untreated, the plaque becomes tartar, which can be impervious to your at-home brushing efforts.”

Because it’s not painful at first, most people don’t realize the plaque is setting up shop until it’s too late. If left untreated, gingivitis can morph into periodontitis (advanced gum disease) and lead to tooth loss.

“That’s why it’s important that whenever you experience swollen or bleeding gums, you have a dental professional check it out and get to the underlying cause,” says Dr. Harwood. Depending on severity, your dentist can show you the best way to brush and may prescribe low-dose oral antibiotics or a medicated mouthwash.

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2. You’ve got something stuck in your teeth (like, really stuck).

If only one tooth or region of your mouth is swollen, this may be a sign that a food particle (say, a pesky popcorn kernel) is trapped below the gum line. This causes the body to attempt to fight off the bacteria of the unwelcome food, resulting in the surrounding tissue becoming inflamed, says Daniel Reich, DMD, director of periodontics and clinical associate professor of dental medicine at Touro College of Dental Medicine in New York.

If the inflammation goes from being a minor discomfort to significant pain (especially if it threatens the health of the tooth itself), check in with your dentist, says Dr. Harwood, who will be able to hunt down the cause and eradicate it.

3. An infection could be brewing.

One of the most common infections that can cause gums to swell—especially in children, but it happens to adults, too—is called gingivostomatitis (whew). “This infection may be the result of a viral or bacterial infection, and is often accompanied by the appearance of oral canker sores,” says Dr. Harwood.

While the body can generally fight the infection off on its own in time, the discomfort may send you straight to your dentist’s chair, who will sanitize the infected area, and in most cases, prescribe an antibiotic.

4. A new medication is causing odd side effects.

Some commonly prescribed medications can cause gum swelling as a side effect, including blood pressure drugs that contain calcium channel blockers, like verapamil and diltiazem. “These and other families of medications, like phenytoin, a seizure medication, can cause a buildup of gum tissue, resulting in a condition known as gingival overgrowth, where tissue actually grows over the teeth,” says Dr. Harwood.

If you find that your gums are giving you 'tude following the start of a new medication, get in touch with your dentist, who may know alternative treatments or modified dosages to regulate the gum’s reaction.

5. You have a vitamin deficiency.

Vitamin deficiencies aren’t as prevalent as they used to be, but “we still see swollen gums resulting from malnutrition, especially among older patients who may not be following a balanced diet,” says Dr. Harwood.

Many vitamins play a role in good oral health, but insufficient intake of vitamins B and C generally result in swollen gums, with vitamin C being a key player in gum restoration. “It can protect your gums from getting infected and swollen by any plaque that’s hidden under the gum,” says Dr. Austin.

Upping your vitamin K intake may also be helpful: “If you lack vitamin K, your gums may swell and bleed easier when they come into contact with bacterial plaque and tartar,” says Dr. Austin.

Only your dentist, in consultation with your general practitioner, can determine if malnutrition is causing your gum problems. Once confirmed, you can pop supplements to replenish your stores while adopting better food choices.

6. …or you’re going through hormonal changes.

Women can experience swollen gums during unique periods in their life where there are hormonal changes, like during puberty, menstruation, pregnancy, menopause, and the use of birth control pills,” says Dr. Austin.

This is because hormones affect how your gum tissues react to the toxins released from the bacterial plaque and tartar, she explains. An uptick in the hormones estrogen and progesterone increases the chance of gum irritation and swelling caused by plaque.

If you’ve already got your brushing and flossing routine on lockdown and are on top of your teeth cleanings, yet swollen gums are still giving you trouble, Dr. Austin recommends consulting with your doctor. “They may recommend hormonal or vitamin therapy to help,” she says.

7. Switching to a new toothpaste is causing irritation.

Ingredients in toothpaste and mouthwash can irritate gum tissue and even cause allergic reactions, especially with continued use (like when you don’t know it’s your oral care products causing the reaction).

“Identifying the ingredient and removing it from your daily routine is often enough to help your gums heal up,” says Los Angeles-based board-certified dermatologist Tsippora Shainhouse, MD. Common ingredients that can cause pesky oral contact dermatitis include hydrogen peroxide (teeth-whitening), alcohol (mouthwashes), baking soda (toothpaste), and cinnamates (chewing gum).

8. You’re experiencing dental device drama.

“Poorly fitting dentures, or even Invisalign-type teeth straighteners, can irritate the gums, leading to inflammation and secondary swelling,” says Dr. Shainhouse. Removal of the device or having them properly fitted so they fit snugly (dentures) or don’t touch the gums (straighteners) can usually undo the damage and swelling.

9. A crooked tooth or two is causing trouble.

Misalignment of teeth can affect how well you can access them and properly brush and floss to remove bacterial plaque. “By realigning and straightening your teeth (with either traditional braces, clear aligners, or porcelain veneers), you can gain better access to clean below the gums where plaque buildup is causing gum infections and swelling,” says Dr. Austin.

10. You have an underlying health condition.

Swollen gums may be a sign of an underlying health condition, such as diabetes. Glucose is present in saliva, so when your blood sugar’s out of whack, the higher glucose level in your spit helps bacteria to grow that can eventually lead to gum disease, according to the National Institute of Diabetes and Digestive and Kidney Diseases.

Another less common, but serious, cause of gum swelling and bleeding is leukemia (sometimes, in the form of a single swollen lump or completely swollen gums). “The leukemia cells concentrate in the gums, making them puffy,” says Dr. Sakurai.

If the swelling persists—especially if it’s associated with other systemic signs like fevers, night sweats, fatigue, and unexplained weight loss, says Dr. Shainhouse—see your doctor right away for a blood test.

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