Swollen gums usually start around the tooth margins
Healthy gums are firm, pale pink, and fit snugly around the teeth. When gums become swollen, red, tender, or bleed when you brush, something is irritating them.
In most cases, the cause is straightforward and treatable. In some cases, swollen gums are an early warning sign of something that needs professional attention before it progresses.
This guide is about gum tissue around the teeth. If you have a discrete sore or non-healing ulcer on the cheek, lip, tongue, or floor of the mouth, read our mouth ulcer guide.
Common Causes of Swollen Gums
Gingivitis
Gingivitis is the most frequent cause of gum swelling. It's inflammation of the gum tissue caused by plaque buildup along the gum line.
Plaque is a sticky film of bacteria that forms on teeth throughout the day. When it isn't removed by brushing and flossing, it irritates the gum tissue. The gums respond with inflammation: redness, swelling, and bleeding during brushing or flossing.
The good news is that gingivitis is reversible. Improved oral hygiene, combined with a professional clean to remove hardened plaque (calculus) that home care can't shift, typically resolves gingivitis within a few weeks.
Left untreated, gingivitis can progress to periodontitis, a more serious form of gum disease that involves bone loss and can lead to tooth loosening. Early treatment is important.
Food Debris and Impaction
A piece of food wedged between teeth or under the gum line can cause localised swelling and pain. Popcorn husks, seed fragments, and fibrous foods are frequent culprits.
This type of swelling usually affects one specific area rather than the gums generally. Careful flossing or using an interdental brush may dislodge the debris and resolve the problem within a day or two.
Pregnancy
Hormonal changes during pregnancy increase blood flow to the gums and alter the body's inflammatory response to plaque bacteria. This can cause gums to swell, bleed, and feel tender, even with good oral hygiene. It's common enough to have its own name: pregnancy gingivitis.
It typically appears in the second trimester and resolves after delivery. Maintaining thorough oral hygiene during pregnancy is especially important. Dental check-ups during pregnancy are safe and recommended.
Medical and appliance-related causes
Medications
Several common medications list gum swelling or overgrowth as a side effect:
- Calcium channel blockers (used for blood pressure), particularly nifedipine and amlodipine.
- Anticonvulsants such as phenytoin.
- Immunosuppressants such as cyclosporine.
Medication-related gum overgrowth (gingival hyperplasia) causes the gum tissue to enlarge, sometimes significantly. It's made worse by poor plaque control. If you take any of these medications and notice gum changes, mention it to both your dentist and your doctor.
Mouth Infections
A dental abscess, whether originating from a tooth or from the gum itself, can cause significant localised swelling. This may be accompanied by:
- Throbbing pain.
- A bad taste in the mouth.
- Swelling of the face or cheek.
- Fever or feeling unwell.
An abscess is a dental emergency. It requires professional treatment. Do not wait for it to resolve on its own.
Ill-Fitting Dental Appliances
Dentures, retainers, or orthodontic appliances that rub or press against the gums can cause localised irritation and swelling. If you've recently had an appliance fitted or adjusted, contact your dentist for modification.
Nutritional Deficiencies
Severe vitamin C deficiency (scurvy) causes swollen, bleeding gums. While uncommon in Australia, it does occur in people with very restricted diets. Vitamin B and vitamin K deficiencies can also affect gum health.
Smoking
Smoking reduces blood flow to the gums, impairs healing, and increases susceptibility to gum disease. Smokers are more likely to develop periodontal disease and may notice less bleeding than expected because nicotine constricts blood vessels, masking early warning signs.
Book a gum health assessment if your gums have been swollen or bleeding for more than two weeks.
Home Care for Swollen Gums
If the swelling is mild and you suspect plaque buildup is the cause, these steps can help:
Improve your brushing. Use a soft-bristled toothbrush and angle it at 45 degrees toward the gum line. Brush for two full minutes, twice daily. Don't avoid swollen areas. They need cleaning more, not less.
Start or resume flossing. If you don't floss regularly, your gums may bleed when you start. This is normal and typically improves within a week or two of consistent daily flossing. Be gentle but thorough.
Saltwater rinse. Dissolve half a teaspoon of salt in a glass of warm water. Rinse gently for 30 seconds, two to three times daily. Saltwater can help reduce inflammation and bacterial load.
Antiseptic mouthwash. A chlorhexidine-based rinse (available from pharmacies) can reduce plaque and gingivitis. It's effective short-term but can stain teeth with prolonged use. Use it as directed, typically for one to two weeks.
Avoid irritants. Alcohol-based mouthwashes, very hot foods and drinks, and acidic foods may increase irritation. Stick to gentle products during a flare-up.
Stay hydrated. Dehydration reduces saliva flow, which is your mouth's natural defence against bacteria. Brisbane's warm climate makes this particularly relevant.
When to See a Dentist
Home care is appropriate for mild gingivitis and minor irritation. See your dentist if:
- Swelling persists for more than two weeks despite improved oral hygiene.
- Gums bleed heavily or spontaneously (without brushing or flossing).
- You notice pus between the gums and teeth.
- Gums are pulling away from the teeth (recession).
- Teeth feel loose or have shifted position.
- Facial swelling accompanies the gum swelling.
- You have pain that's getting worse, not better.
- You have a fever or feel systemically unwell.
Any of these warrant professional assessment. At Ivy Dental, we can diagnose the cause, provide professional cleaning if needed, and refer to a periodontist for advanced cases.
For more on gum recession specifically, see our guide on gum recession causes and treatment.
Professional Treatment
Depending on the cause and severity, your dentist may recommend:
Professional clean (scale and clean). Removes calculus and plaque buildup that home care can't address. This is the first-line treatment for gingivitis.
Deep cleaning (root planing). For early periodontitis, cleaning below the gum line removes bacterial deposits from root surfaces. This may be done under local anaesthetic.
Medication review. If medication is contributing to gum overgrowth, your dentist may liaise with your doctor about alternatives.
Abscess drainage. If an infection is present, it may need to be drained and treated with antibiotics.
Referral. Advanced gum disease may be referred to a periodontist (a specialist in gum and bone conditions) for treatment.
Prevention
Preventing gum problems is more effective and less expensive than treating them:
- Brush twice daily with fluoride toothpaste using the correct technique.
- Floss or use interdental brushes once daily.
- Attend six-monthly dental check-ups and cleans to catch early changes before they progress.
- Don't smoke. Smoking is the strongest modifiable risk factor for gum disease.
- Manage underlying health conditions. Diabetes, in particular, has a strong link with gum disease. Controlling blood sugar helps protect your gums.
- Stay hydrated and eat a balanced diet.
Next Steps
If your gums are swollen, bleeding, or uncomfortable, don't ignore it. Early gum disease is reversible. Advanced gum disease involves permanent bone loss that can't be fully restored.
Book a check-up at Ivy Dental in Everton Park or Nundah, or call (07) 3266 7120. We'll assess your gum health, provide a professional clean if needed, and give you a clear home care plan to get things back on track.
