Gum swelling and pain is a common oral symptom, manifesting as swollen and painful gums. Gum swelling and pain may occur alone or be accompanied by bleeding, bad breath, loose teeth, periodontal pockets and pus discharge, and weak bite. Patients are advised to seek medical attention promptly to identify the cause and receive appropriate treatment to alleviate the discomfort.
Symptoms
Typical manifestations
1. Swollen gums
The gums may become rounded, swollen, and in some cases may even produce pus. The gums may be bright red or dark red in color, and may become soft, brittle, and lack elasticity.
2. Pain
Pain may be felt in the gum area and may be constant or worsened by brushing or biting hard objects.
Associated symptoms
1. Bleeding
Gums tend to bleed when irritated, such as when brushing your teeth or biting down on something hard.
2. Bad breath
Patients may experience bad breath due to bacterial growth and inflammation in the mouth.
3. Loose teeth
In the case of periodontitis, patients may experience loosening and shifting of teeth as the disease progresses.
4. Periodontal pockets and periodontal abscesses
As periodontitis progresses, periodontal pockets may form and periodontal pus may occur.
5. Weak bite
The patient may experience a weak bite or a dull pain in the tooth.
complication
This symptom generally has no obvious complications.
reason
Overview
Gum swelling and pain are usually caused by oral diseases such as gingivitis, periodontitis, apical periodontitis, and periodontal abscess. In addition, systemic diseases such as blood diseases and vitamin deficiencies, as well as the use of certain medications, may also cause gum swelling and pain.
Symptom Cause
1. Oral diseases
(1) Gingivitis: It is one of the most common causes of gingival swelling and pain. Inflammatory stimulation can cause congestion and edema of the gingival tissue, which in turn causes gingival swelling and pain. Poor oral hygiene habits and food impaction can increase the risk of gingivitis.
(2) Periodontitis: This disease can cause inflammation of the gums, periodontal ligament, alveolar bone and cementum, leading to swollen and painful gums.
(3) Apical periodontitis: Inflammatory lesions will occur in the tissues around the root apex of the tooth. When the inflammatory factors gradually spread to the subperiosteum, it may cause swelling and pain in the posterior gums.
(4) Periodontal abscess: Periodontal abscess is a localized suppurative inflammation that occurs within the periodontal supporting tissue. The inflammation can cause swelling and pain in the gum tissue.
(5) Others: dental caries, pulpitis, gingival trauma, etc. can also cause gingival swelling.
2. Systemic diseases
(1) Blood diseases: such as thrombocytopenic purpura, hemophilia, etc., which affect the coagulation function and cause swollen and painful gums.
(2) Vitamin deficiency: such as vitamin C deficiency (scurvy) and vitamin K deficiency, which may cause brittle, bleeding and swollen gums, increasing the risk of gingival swelling and pain.
(3) Systemic diseases: such as diabetes, which may affect gum health and increase the risk of gingivitis and periodontitis due to poor blood sugar control.
3. Use certain drugs
Certain medications, such as some antihypertensive drugs, may cause gum hyperplasia, leading to swollen and painful gums.
4. Others
During puberty, pregnancy or menopause, hormonal changes in women’s bodies may affect gum health and increase the risk of swollen and painful gums.
Common diseases
Gingivitis, periodontitis, periapical periodontitis, periodontal abscess, dental caries, pulpitis, gingival trauma, thrombocytopenic purpura, hemophilia, vitamin C deficiency, vitamin K deficiency, diabetes
Seeking medical treatment
Outpatient indications
1. The symptoms of swollen and painful gums persist or worsen.
2. Accompanied by bleeding, bad breath, loose teeth, periodontal pockets and periodontal pus, and weak bite.
3. Other severe, persistent or progressive symptoms and signs occur.
All of the above require prompt medical consultation.
Treatment department
Patients can go to the dental department for treatment.
Medical preparation
1. Make an appointment in advance and bring your ID card, medical insurance card, medical card, etc.
2. If you have had medical treatment recently, please bring relevant medical records, examination reports, laboratory test results, etc.
3. If you have taken some medicine to relieve symptoms recently, you can bring the medicine box with you.
4. Family members can be arranged to accompany the patient to seek medical treatment.
5. Prepare a list of questions you want to ask in advance.
What questions might a doctor ask a patient?
1. When did the symptoms of swollen and painful gums begin?
2. Is the symptom constant or occasional? Has the symptom worsened or improved?
3. Is the pain mild, moderate, or severe? Does it affect your daily life, such as eating, talking, or sleeping?
4. In addition to swollen and painful gums, are there any other symptoms, such as bleeding, bad breath, loose teeth, etc.?
5. How often and how often do you brush your teeth? Do you have a regular teeth cleaning habit?
6. Do you have other chronic diseases, such as diabetes, blood system diseases, etc.?
7. Have you taken any medications recently?
8. What are your recent eating habits like? Do you often eat sweets, spicy foods, or hard foods?
9. Do you smoke or drink alcohol?
10. Do you have the habit of biting hard objects or brushing your teeth hard?
What questions can patients ask their doctor?
1. Is my condition serious? Can it be cured?
2. Why does this happen to me?
3. What treatment do I need? Do I need to be hospitalized? How long will it take to recover?
4. What are the risks of these treatments?
5. If medication is used for treatment, what are the usage, dosage and precautions of the medication?
6. What tests do I need? Are they covered by medical insurance?
7. I have other diseases. Will this affect my treatment?
8. How should I take care of myself after returning home?
9. Do I need follow-up examinations? How often?
examine
Scheduled inspection
The doctor will first perform a physical examination on the patient, and may then recommend a blood test, oral surface swab, coagulation function test, vitamin C level test, X-ray, CT, pulp vitality temperature test, fiber optic transillumination and other tests to determine the cause of the disease.
Physical examination
1. Visual examination
Observe the changes in the color, shape, and touch of the gums to determine whether there is redness, swelling, or ulceration; at the same time, observe whether the teeth have cavities or residual roots or crowns.
2. Probing
Use a probe to test the local gums to find out whether there is local tenderness or bleeding. It can also detect the depth of periodontal pockets and determine the degree of periodontitis.
3. Percussion
Use special instruments to tap the tooth perpendicular to the long axis of the tooth, and judge whether the affected tooth is normal, or whether there are problems such as pain, looseness, etc. based on the amount of force and the reaction.
4. Bite diagnosis
Have the patient bite something to check for abnormalities in bite relationship and function.
Laboratory tests
1. Blood routine test
Check white blood cells, red blood cells, platelets, hemoglobin, etc. to rule out gum swelling and pain caused by infection.
2. Oral Surface Swab
When there is an odontogenic infection, it can help identify the pathogen of the odontogenic infection.
3. Coagulation function test
Including platelet count, prothrombin time, activated partial thromboplastin time, fibrinogen, etc., it can evaluate whether there are abnormalities in coagulation function and be used for auxiliary diagnosis of blood system diseases.
4. Vitamin C level test
Vitamin C deficiency may cause gums to be fragile and prone to bleeding. Testing can confirm the amount of vitamin C in the body.
Imaging examinations
1. X-ray
Determine whether bone resorption occurs, observe whether there are dental tissue lesions such as caries that are difficult to detect, and also see the damage to periodontal tissues.
2、CT
It is used to understand the condition of teeth and periodontal tissues, but is rarely used in clinical practice.
Other tests
1. Pulp vitality temperature test
When the tooth is painful in response to sweet, sour, cold or hot stimuli, it helps to determine the condition of the dental pulp.
2. Fiber optic transillumination
A fiber-optic light is used to illuminate the teeth to check for cavities in adjacent surfaces.
diagnosis
Diagnostic principles
Diagnosis of swollen and painful gums is primarily based on a physical examination, laboratory tests (such as a blood test), and imaging studies (such as X-rays). This comprehensive assessment of the gum texture, color, and shape, as well as its relationship to periodontal disease, aims to identify the cause. During diagnosis, doctors often identify common conditions that can cause swollen and painful gums, such as gingivitis, periodontitis, apical periodontitis, and periodontal abscesses.
Differential diagnosis
1. Gingivitis
Gingivitis is an inflammation of the gum tissue caused by dental plaque and other factors. It is the most common gum disease. Symptoms include painful and swollen gums, coronal and buccal swelling, bleeding on probing or after stimulation, and may be accompanied by bleeding gums, bad breath, and increased gingival crevicular fluid. An oral examination and X-rays can help diagnose this condition.
2. Periodontitis
Symptoms include swollen and painful gums, periodontal abscesses, bleeding gums, and periodontal pocket formation. Some patients may also experience pus discharge from the periodontal pockets and gradual tooth loosening. Patients often have a history of poor oral hygiene and plaque accumulation. X-rays can reveal the destruction of periodontal tissue and the resorption of bone surrounding the teeth.
3. Apical periodontitis
When the dental pulp (the nerves and blood vessels inside the tooth) becomes infected or damaged, inflammation may spread to the tissues surrounding the root apex, causing apical periodontitis. Patients experience severe gum swelling and pain, especially when biting down. In severe cases, facial swelling and fever may occur. X-rays are essential for diagnosis.
4. Periodontal abscess
This disease is a localized, suppurative inflammation that occurs in the periodontal pockets or deep within the periodontal connective tissue. In the acute phase, it manifests as an oval or hemispherical swelling of the gums, which is red and shiny, and may be accompanied by throbbing pain. An oral examination and X-rays are helpful in diagnosing this disease.
treat
Expected treatment
The treatment methods for swollen and painful gums mainly include daily care and professional treatment, which aim to eliminate inflammation, prevent infection, relieve patient pain, and adjust the underlying disease.
General treatment
1. Maintain oral hygiene. Use a soft-bristled toothbrush and appropriate toothpaste, brushing your teeth at least twice a day for at least two minutes each time, ensuring thorough cleaning of the tooth surface and gum margin of each tooth. Although rinsing your mouth cannot directly remove plaque, using a mouthwash containing antibacterial ingredients can help reduce oral bacteria.
2. Use ice cubes to cool swollen and painful gums to reduce swelling and eliminate pain.
Drug treatment
1. Antibiotics
Amoxicillin, metronidazole (such as Shuanghe Pharmaceutical’s metronidazole tablets), etc., have significant effects on gingivitis, periodontitis, apical periodontitis, and periodontal abscesses caused by bacterial infections.
2. Nonsteroidal anti-inflammatory drugs
Such as ibuprofen, acetaminophen, etc., which have analgesic and anti-inflammatory effects and can relieve the symptoms of swollen and painful gums.
Related drugs
Amoxicillin, metronidazole (such as Shuanghe Pharmaceutical’s metronidazole tablets), ibuprofen, acetaminophen
Surgical treatment
1. For patients with swollen and painful gums caused by periodontitis, if the condition is serious, periodontal flap surgery, soft tissue transplantation, bone grafting, guided tissue regeneration, tooth extraction and other treatments can be performed according to the specific situation.
2. For patients with gingival swelling and pain caused by apical periodontitis, pulp drainage can be performed in the acute phase to promote the discharge of inflammatory substances and relieve swelling and pain; after the acute phase is relieved, root canal treatment can be performed to completely remove the infection in the root canal and repair the defect.
3. For patients with swollen and painful gums caused by periodontal abscess, when pus is formed and localized and fluctuates, abscess incision and drainage can be performed, and the abscess cavity can be thoroughly flushed.
Other treatments
1. Scaling (teeth cleaning)
Use ultrasonic or manual instruments to remove plaque and tartar and reduce local irritation.
2. Curettage
Penetrate deep into the subgingival area to remove hardened plaque and calculus and control bacterial infection.
3. Root planing
Thoroughly clean the affected area, including scraping away diseased tissue and disinfecting it, to promote healing.
Treatment cycle
The treatment cycle is affected by factors such as the severity of the disease, treatment plan, treatment timing, age and physical condition, and may vary from person to person.
Estimated treatment costs
There may be significant individual differences in treatment costs, and the specific costs are related to the selected hospital, treatment plan, medical insurance policy, etc.