Swollen gums are almost always a sign of inflammation, and the most common trigger is plaque buildup along the gumline. The good news is that mild cases often improve within a week or two with better oral hygiene and a few simple home remedies. But swelling that persists, spreads, or comes with fever needs professional attention. Here’s how to handle it.
Why Your Gums Are Swollen
Plaque, a sticky colorless film of bacteria, forms on your teeth every time you eat sugars or starches. If it isn’t removed regularly, it hardens into tartar beneath the gumline, creating a shield that traps even more bacteria. The longer plaque and tartar sit there, the more they irritate your gum tissue. Eventually your gums become puffy, red, and bleed easily. This early stage of gum disease is called gingivitis, and it’s the single most common reason gums swell.
Left untreated, gingivitis can progress to periodontitis, where inflammation spreads into the bone and connective tissue supporting your teeth. At that point, home care alone won’t reverse the damage.
Plaque isn’t the only culprit, though. Several other situations can cause or worsen gum swelling:
- Hormonal changes during pregnancy. Pregnancy gingivitis affects 60% to 75% of pregnancies in the U.S., with symptoms typically peaking in the second or third trimester. Increased blood flow and hormonal shifts make gum tissue more reactive to plaque.
- Certain medications. Some blood pressure drugs (particularly nifedipine, which causes gum overgrowth in roughly 38% of users), seizure medications like phenytoin and carbamazepine, and immunosuppressants can all trigger excess gum tissue growth. If your gums started swelling after beginning a new medication, that connection is worth exploring with your prescriber.
- Vitamin C deficiency. Your body needs vitamin C to maintain connective tissue, blood vessels, and healthy gums. Severe deficiency (scurvy) causes swollen, bleeding gums along with fatigue and slow wound healing. This is rare in developed countries but can show up in people with very restricted diets.
- Localized infections. An abscessed tooth or a trapped food particle can cause swelling in one specific spot rather than across the whole gumline.
Home Remedies That Help
Salt Water Rinse
A warm salt water rinse is one of the simplest ways to reduce mild gum inflammation. Mix half a teaspoon of salt into one cup of warm (not hot) water, swish it around your mouth for 30 seconds, and spit. Do this once or twice a day, especially after meals or brushing. Salt water draws fluid out of swollen tissue and creates an environment that’s less hospitable to bacteria. It won’t cure an infection, but it can ease discomfort and support healing alongside good brushing habits.
Cold Compress
If your gums are swollen and your cheek or jaw feels puffy, apply an ice pack or cold compress to the outside of your face for 10 to 20 minutes at a time. Place a thin cloth between the ice and your skin. Cold reduces blood flow to the area, which limits swelling and numbs pain. This is especially useful for localized swelling from an abscess or after a dental procedure.
Improved Brushing and Flossing
If plaque buildup is driving the swelling, the fix starts with your toothbrush. Brush twice a day with a soft-bristled brush, angling the bristles toward the gumline at about 45 degrees. Floss once daily, gently working the floss along the curve of each tooth rather than snapping it straight down into the gum. If your gums bleed when you floss, that’s typically a sign of inflammation, not a reason to stop. The bleeding usually decreases within a week or two of consistent flossing as the tissue heals.
Over-the-Counter Pain Relief
For gum pain and swelling, ibuprofen is generally more effective than acetaminophen on its own because it reduces inflammation at the source rather than just blocking pain signals in the brain. But combining the two works even better. The American Dental Association recommends 400 mg of ibuprofen plus 500 mg of acetaminophen every six hours for acute dental pain. This combination blocks the pain pathway at both ends and doesn’t appear to increase side effects beyond what either drug causes individually.
There’s also an FDA-approved over-the-counter product combining 250 mg ibuprofen with 500 mg acetaminophen per dose, if you prefer a single pill. Whichever approach you use, these medications are meant for short-term relief while you address the underlying cause. If you’re still relying on pain relievers after a few days, it’s time to see a dentist.
When Swollen Gums Need Professional Care
Mild, generalized gum swelling that responds to better hygiene within a couple of weeks is usually manageable at home. But certain symptoms signal something more serious.
See a dentist promptly if your gums have been swollen for more than two weeks despite improved brushing and flossing, if you notice pus draining from the gumline, or if you have severe pain that doesn’t respond to over-the-counter medication. Intense, sudden pain in one area often points to an abscess, which requires professional drainage and possibly antibiotics.
Head to an emergency room if you develop a fever above 100.4°F alongside dental swelling. Fever means the infection has likely spread beyond the tooth. Rapid facial swelling that extends toward your eye or down your neck is also an emergency. Swelling in the soft tissues of the throat can restrict your airway, and this can become life-threatening within hours. Difficulty swallowing, breathing, or opening your mouth warrants immediate medical attention.
What a Dentist Will Check
A dentist evaluates gum health by measuring the depth of the pockets between your teeth and gums, checking how much of the gumline bleeds when probed, and looking at X-rays for bone loss. If bleeding shows up in more than 10% of the sites tested, gum inflammation is confirmed. The depth of the pockets and the amount of bone loss determine whether you’re dealing with reversible gingivitis or one of the more advanced stages of periodontitis.
Early periodontitis involves 1 to 2 millimeters of attachment loss and less than 15% bone loss. At the other end of the spectrum, advanced periodontitis means 5 or more millimeters of attachment loss with bone damage extending into the middle third of the tooth root. At that stage, teeth may start drifting or loosening. The stage your dentist identifies determines the treatment plan, which can range from a professional cleaning for mild gingivitis to deep cleaning (scaling and root planing) for moderate disease, or surgical intervention for advanced cases.
If a medication is causing the swelling, your dentist and prescribing doctor can work together to explore alternatives. Switching from nifedipine to a different blood pressure medication, for instance, often allows the gum tissue to return to normal over several months.