Swollen gums are almost always a sign of inflammation, and the most common cause is a buildup of plaque along the gumline. The good news: in most cases, you can reduce the swelling at home within a few days while figuring out whether you need professional treatment. Here’s what’s likely going on and what to do about it.
Why Your Gums Are Swollen
The most likely culprit is gingivitis, the earliest stage of gum disease. Bacteria in plaque irritate the gum tissue, causing redness, puffiness, and bleeding when you brush or floss. Gingivitis is extremely common and fully reversible with better oral care and a professional cleaning.
If the swelling is limited to one spot rather than spread across your gums, you may be dealing with something more localized. A periodontal abscess, which looks like a small boil or pimple on the gum, forms when bacteria invade the space between a tooth and the surrounding tissue. Food trapped under the gumline, a cracked filling, or an injury to the area can also trigger swelling in a single location.
Several other factors cause gum swelling that has nothing to do with how well you brush:
- Hormonal changes. Pregnancy gingivitis affects many pregnant people, sometimes starting in the first trimester. Rising estrogen and progesterone levels increase blood flow to the gums and make them more sensitive to plaque. Symptoms often peak in the second or third trimester.
- Medications. Certain drugs are well known for causing gum overgrowth. About 40 to 50% of people taking phenytoin (a seizure medication), cyclosporine (an immune suppressant), or calcium channel blockers like nifedipine will develop some degree of gum enlargement. If your gums started swelling after beginning a new medication, that connection is worth exploring with your prescriber.
- Vitamin C deficiency. Research involving over 8,000 people in a CDC nutrition survey found that even mildly low vitamin C levels in the blood were associated with increased gum bleeding. You don’t need to have full-blown scurvy for a shortfall to affect your gums.
What You Can Do Right Now
A warm saltwater rinse is one of the simplest ways to calm inflamed gums. Mix 1 teaspoon of salt into 8 ounces of warm water, swish it around your mouth for 15 to 30 seconds, and spit it out. You can do this up to four times a day. If it stings, cut the salt to half a teaspoon.
While the rinse helps in the short term, the real fix is disrupting the plaque that’s causing the inflammation. Brush twice a day using a soft-bristled toothbrush angled at 45 degrees to the gumline, making short, gentle back-and-forth strokes before sweeping the brush away from the gums toward the edge of each tooth. This technique, recommended by the American Dental Association, is specifically designed to clean the shallow crevice where the gum meets the tooth, exactly where plaque does the most damage.
Floss or use an interdental brush daily. If your gums bleed when you floss, that’s a sign of inflammation, not a reason to stop. The bleeding typically decreases within a week or two of consistent flossing as the tissue heals. You can also apply a cold compress to the outside of your cheek for 15 to 20 minutes to reduce swelling and discomfort.
When Swollen Gums Need Professional Treatment
Gingivitis that doesn’t improve after a couple of weeks of diligent home care needs a professional cleaning. A dentist or hygienist removes hardened plaque (tartar) that your toothbrush can’t reach, and in many cases that single visit is enough to resolve things. The ADA notes that gingivitis “can usually be eliminated by a professional cleaning at your dental office, followed by daily brushing and flossing.”
If the disease has progressed to periodontitis, where the gums have started pulling away from the teeth and forming deep pockets, you’ll likely need scaling and root planing. This is a deeper cleaning done under local anesthesia. Your provider uses hand instruments or ultrasonic tools to remove tartar from below the gumline and smooth the root surfaces so bacteria have a harder time reattaching. Antibiotics may be placed directly into the pockets or prescribed afterward. Signs that you may have crossed into periodontitis include gums that bleed during gentle brushing, persistent bad breath that doesn’t respond to brushing or mouthwash, teeth that feel loose, or pus between your teeth and gums.
Signs That Need Urgent Attention
Most gum swelling is not an emergency, but a few situations require prompt care. If the swelling is spreading rapidly into your jaw, cheek, or under your tongue, you may have a spreading infection called cellulitis. Fever, swollen lymph nodes in your neck, difficulty opening your mouth fully, or any trouble swallowing or breathing are red flags. These symptoms indicate the infection is moving into deeper tissues, and treatment typically needs to start the same day. A localized abscess that’s painful, throbbing, and accompanied by a bad taste in your mouth also warrants a dental visit soon rather than a wait-and-see approach, since abscesses don’t resolve on their own.
Keeping the Swelling From Coming Back
Once your gums heal, the goal shifts to prevention. Brush twice daily with that 45-degree angle, clean between your teeth every day, and keep up with regular dental visits. A balanced diet matters more than most people realize. High-sugar foods and drinks feed the bacteria that cause gum disease, and getting enough vitamin C from fruits, vegetables, or a supplement supports the tissue integrity of your gums.
If you grind or clench your teeth, that habit is a risk factor for both gum damage and abscesses. A night guard can help protect the tissue. And if you’re pregnant, don’t assume swollen gums are just something you have to tolerate. Keeping up with dental cleanings during pregnancy, and being extra thorough with brushing along the gumline, can keep pregnancy gingivitis from worsening as your hormones shift through each trimester.