Why Do Gums Swell?
Gum swelling is your body's inflammatory response to irritation or infection in the gum tissue. Healthy gums are firm, pale pink, and fit snugly around each tooth. When bacteria, injury, or other irritants affect the gum tissue, blood flow to the area increases, causing the tissue to become red, puffy, and tender.
Swelling can affect a small area around one tooth or spread across the entire gum line. The pattern and severity of the swelling often help identify the cause. Localized swelling near a single tooth may point to an abscess or ill-fitting restoration. Widespread swelling across many teeth is more typical of gum disease, hormonal changes, or medication effects.
Common Swollen Gums Causes
Several conditions can cause gums to swell. Some are related to oral hygiene habits, while others are systemic, meaning they involve your overall health.
Gingivitis (Early Gum Disease)
Gingivitis is the earliest stage of gum disease. It occurs when bacterial plaque accumulates along the gum line and triggers inflammation. The gums become red, swollen, and may bleed during brushing or flossing. Gingivitis does not cause bone loss and is fully reversible with proper oral hygiene and professional cleaning.
Many people have gingivitis without realizing it because it is usually painless in the early stages. The American Dental Association estimates that nearly half of adults over age 30 have some form of gum disease. Regular dental checkups are important for catching gingivitis before it progresses.
Periodontitis (Advanced Gum Disease)
If gingivitis is left untreated, it can progress to periodontitis. In periodontitis, the infection spreads below the gum line and begins to destroy the bone and connective tissue that support the teeth. The gums may pull away from the teeth, forming pockets that trap more bacteria.
Symptoms of periodontitis include persistent swelling, gums that bleed easily, receding gum lines, loose teeth, and chronic bad breath. Unlike gingivitis, the bone damage caused by periodontitis is not reversible, though treatment can stop further progression and manage the disease.
Dental Abscess
A dental abscess is a pocket of pus caused by bacterial infection. It can form at the tip of the tooth root (periapical abscess) or in the gum tissue beside the root (periodontal abscess). An abscess typically causes localized, intense swelling near the affected tooth, along with throbbing pain.
Abscesses do not resolve on their own and require professional treatment, which may include draining the infection, antibiotics, root canal treatment, or extraction of the tooth. An untreated abscess can spread to the jaw, head, or neck, which is a medical emergency.
Pregnancy and Hormonal Changes
Hormonal shifts during pregnancy, menstruation, and puberty increase blood flow to the gums and change how the body responds to plaque bacteria. Pregnancy gingivitis affects up to 75% of pregnant women, typically appearing in the second trimester. The gums become swollen, red, and bleed more easily than usual.
Pregnancy gingivitis usually improves after delivery, but it still requires attention. Untreated gum disease during pregnancy has been associated with preterm birth and low birth weight in some studies. Dental cleanings during pregnancy are safe and recommended.
Medication Side Effects
Certain medications can cause gum tissue to overgrow, a condition called gingival hyperplasia. The gums become swollen and may partially cover the teeth. Medications known to cause this include phenytoin (used for seizures), cyclosporine (an immunosuppressant), and some calcium channel blockers used to treat high blood pressure, such as nifedipine and amlodipine.
If you notice gum swelling after starting a new medication, tell your dentist and your prescribing physician. Adjusting the medication or adding more frequent dental cleanings may help manage the swelling.
Vitamin Deficiency
Severe deficiency in vitamin C (scurvy) causes gum swelling, bleeding, and tissue breakdown. While full-blown scurvy is rare in developed countries, mild vitamin C deficiency can contribute to gum inflammation. Vitamin B deficiencies and poor overall nutrition can also weaken gum tissue and slow healing.
If your gums are swollen and your oral hygiene is good, your dentist may suggest blood work to check for nutritional deficiencies, especially if other symptoms like fatigue or easy bruising are present.
Ill-Fitting Dental Work
Crowns, bridges, dentures, or fillings that do not fit properly can irritate the surrounding gum tissue and trap bacteria. This leads to localized swelling, redness, and sometimes infection around the restoration. Orthodontic appliances and braces can also make it harder to clean effectively, increasing plaque buildup along the gum line.
If swelling started after a dental procedure or is concentrated around a specific restoration, have your dentist evaluate the fit of the dental work.
Home Care for Swollen Gums
Mild gum swelling related to plaque buildup often improves with consistent home care. These steps can reduce inflammation and help your gums heal.
- Brush twice daily with a soft-bristle toothbrush, angling the bristles toward the gum line at a 45-degree angle
- Floss daily to remove plaque and food debris from between teeth where your toothbrush cannot reach
- Rinse with an antiseptic mouthwash containing chlorhexidine or cetylpyridinium chloride to reduce bacteria
- Rinse with warm salt water (half a teaspoon of salt in 8 ounces of warm water) to soothe inflamed tissue
- Avoid tobacco products, which worsen gum inflammation and slow healing
When Swollen Gums Are an Emergency
Most cases of swollen gums are not emergencies, but certain symptoms require urgent care. Seek treatment the same day if you experience any of the following.
- Severe swelling that is spreading to the jaw, cheek, or under the eye
- Fever along with gum swelling (this may indicate the infection is spreading)
- Pus draining from the gums
- Difficulty swallowing or breathing
- A swollen area that is hot to the touch and intensely painful
Professional Treatment Options
The right treatment depends on what is causing the swelling. Your dentist or periodontist will examine your gums, take X-rays, and may measure the depth of the pockets between your gums and teeth to determine the severity.
Professional Cleaning and Scaling
For gingivitis, a professional dental cleaning removes plaque and tartar (hardened plaque) that brushing and flossing cannot. This is often enough to resolve the swelling if you maintain good oral hygiene at home afterward. Most dental offices recommend cleanings every 6 months, but patients with gum disease may need them every 3 to 4 months.
Scaling and Root Planing (Deep Cleaning)
For periodontitis, scaling and root planing is a non-surgical deep cleaning performed under local anesthesia. The periodontist or dental hygienist removes plaque and tartar from below the gum line (scaling) and smooths the root surfaces (planing) so the gum tissue can reattach to the tooth. This procedure is typically done in two to four appointments, treating one section of the mouth at a time.
Abscess Drainage and Antibiotics
A dental abscess needs to be drained and the source of infection treated. Depending on the type and location, this may involve incision and drainage, root canal treatment, periodontal treatment, or extraction of the affected tooth. Antibiotics may be prescribed to control the infection, but antibiotics alone do not cure a dental abscess. The source of the infection must be addressed.
Periodontal Surgery
In advanced cases of periodontitis where deep pockets remain after scaling and root planing, a periodontist may recommend surgical treatment. Flap surgery lifts the gum tissue to remove tartar from deep pockets and then repositions the tissue more snugly around the tooth. Bone grafts or tissue regeneration procedures may be used when significant bone has been lost.
What Treatment Costs
A routine dental cleaning typically costs $75 to $200 without insurance. Scaling and root planing (deep cleaning) ranges from $150 to $350 per quadrant, with most patients needing two to four quadrants treated. Periodontal surgery may cost $500 to $3,000 or more per area depending on the complexity.
Most dental insurance plans cover preventive cleanings and a portion of periodontal treatment when medically necessary. Costs vary by location, provider, and case complexity. Ask your dental office about payment plans if cost is a concern.
When to See a Periodontist
Your general dentist can diagnose and treat gingivitis and perform routine cleanings. However, a periodontist is the right specialist when gum disease has progressed beyond the early stages or when standard treatment has not resolved the problem.
Consider seeing a periodontist if your gums have been swollen for more than 2 weeks despite good home care, if your dentist has measured deep pockets (4 millimeters or greater) around your teeth, if you have receding gums or loose teeth, or if you have a medical condition or take medications that affect your gum health. Periodontists complete 3 additional years of residency training beyond dental school, focused entirely on the gums, bone, and supporting structures of the teeth.
Find a Periodontist Near You
If your swollen gums have not improved with home care, or if you have been told you have gum disease, a periodontist can provide specialized evaluation and treatment. Search the My Specialty Dentist directory to find verified periodontists in your area.
Search Periodontists in Your Area