Swollen gums, medically known as gingivitis, are a common side effect of orthodontic treatment. Brackets and wires create numerous surfaces where bacterial plaque accumulates easily. The hardware also makes thorough cleaning difficult, leading to a faster buildup of this bacteria-filled film. This irritation causes the gums to become red, tender, and visibly swollen, a condition often called orthodontic gingivitis.
Immediate At-Home Relief Measures
Immediate relief from tenderness and swelling can be achieved using simple methods. A warm saltwater rinse is effective because the saline solution helps draw excess fluid out of the inflamed gum tissue, temporarily reducing swelling. Dissolve about half a teaspoon of salt in one cup of warm water, swishing the mixture gently around the mouth for 30 seconds multiple times daily.
Applying a cold compress to the outside of the cheek over the swollen area provides rapid relief. The cold temperature constricts local blood vessels, minimizing inflammation and numbing the discomfort. Over-the-counter anti-inflammatory medications, such as ibuprofen, can be taken as directed to target pain and swelling internally. Temporarily adopting a soft-food diet, including items like mashed potatoes, yogurt, or well-cooked pasta, reduces irritation caused by chewing hard foods.
Essential Oral Hygiene Adjustments
Addressing the underlying cause of swollen gums requires a consistent adjustment to the daily oral hygiene routine. The presence of brackets and wires necessitates specialized techniques to remove trapped plaque effectively. Brushing must be done meticulously, utilizing a soft-bristled toothbrush angled at 45 degrees to clean both above and below the brackets and along the gumline. This angling ensures the bristles reach the tight spaces where plaque accumulates.
Specialized tools are necessary to navigate the complex hardware and reach all tooth surfaces. An interdental brush, which resembles a tiny pipe cleaner, cleans the challenging spaces underneath the archwire and around each bracket. Water flossers are also helpful, using a pressurized stream of water to flush away food debris and loose plaque from all surfaces, including difficult-to-reach areas between teeth and under the wires.
Flossing remains a necessary step, even with braces, and requires a floss threader or specialized orthodontic floss, like Superfloss. A floss threader is a small, flexible loop that guides regular dental floss underneath the main archwire. Once threaded, the floss is used in the traditional C-shape motion against the sides of each tooth to scrape away plaque and bacteria from beneath the gumline. This process should be completed for every tooth at least once daily to prevent the chronic plaque buildup that leads to gingivitis.
Recognizing When Professional Care is Needed
While most mild gum swelling is reversible with improved hygiene, certain symptoms indicate a problem beyond home care. Persistent swelling that does not subside after a week of diligent oral hygiene adjustments should be evaluated by an orthodontist or dentist. This lack of improvement may signal a more advanced stage of gingivitis or another underlying issue.
Signs of infection, such as pus, a persistent bad taste, or swelling accompanied by fever, require immediate professional attention. Chronic inflammation can lead to gingival hyperplasia, where gum tissue overgrows in response to irritation. If the gums swell over the brackets, making cleaning difficult, an appointment is necessary for assessment and professional cleaning. If braces hardware, like a broken or protruding wire, is physically irritating the gum tissue, the orthodontist must be contacted immediately to adjust the appliance.