Swollen gums usually respond well to a combination of home care and improved oral hygiene, though persistent swelling that lasts more than two weeks typically needs professional treatment. The cause matters: gum disease accounts for most cases, affecting about 42% of U.S. adults over 30, but infections, hormonal changes, and certain medications can also be responsible. Here’s how to address it.
Immediate Relief at Home
A warm saltwater rinse is the simplest first step. Mix one teaspoon of salt into eight ounces of warm water and swish it around your mouth for 15 to 20 seconds. If your gums are especially tender and the rinse stings, cut back to half a teaspoon of salt for the first day or two. You can repeat this several times a day, particularly after meals.
For pain, ibuprofen is the strongest over-the-counter option because it reduces both pain and inflammation at the same time. A dose of 200 to 400 milligrams every four to six hours handles mild gum pain for most people. If the discomfort is more intense, combining ibuprofen (400 mg) with acetaminophen (500 mg) every six hours is more effective than either one alone. The American Dental Association considers this combination the top-performing non-prescription pain strategy, outperforming even opioid-based regimens in clinical data covering more than 58,000 patients.
Applying a cold compress to the outside of your cheek in 15-minute intervals can also reduce swelling in the short term.
Adjust Your Brushing Technique
When gums are swollen, aggressive brushing makes things worse. Switch to a soft-bristled toothbrush and use the Bass technique: hold the brush at a 45-degree angle to your gumline so the bristles point toward the space where gum meets tooth. Make short, gentle back-and-forth vibrations or small circles, letting the bristle tips slip just slightly under the gumline. After a few seconds on each tooth, sweep the brush away from the gums to clear loosened debris.
This approach cleans the area where bacteria accumulate most without scrubbing inflamed tissue raw. Floss daily, easing the floss gently below the gumline rather than snapping it against the tissue. If standard floss is too painful, a water flosser can do the job with less irritation.
Common Causes of Swollen Gums
Gum Disease
The most frequent cause is gingivitis, the earliest stage of gum disease. Plaque builds up along the gumline, bacteria irritate the tissue, and gums become red, puffy, and prone to bleeding when you brush. At this stage, the pockets between your gums and teeth are still shallow (under 4 millimeters), there’s no bone loss, and the condition is fully reversible with better hygiene and a professional cleaning.
Left untreated, gingivitis progresses to periodontitis. Pockets deepen beyond 4 millimeters, the bone supporting your teeth starts to break down, and the damage becomes permanent. In severe cases, pockets reach 6 millimeters or deeper, and teeth can loosen. About 8% of adults over 30 have severe periodontitis, while another 34% have a milder form. The earlier you act, the better the outcome.
Hormonal Changes
Pregnancy, puberty, menstruation, and menopause all increase blood flow to gum tissue and make it more reactive to plaque. Pregnancy gingivitis is especially common in the second trimester. The swelling usually resolves after hormone levels stabilize, but keeping up with oral hygiene during these periods prevents it from turning into something more serious.
Medications
Certain prescription drugs cause the gums to grow over the teeth, a side effect called gingival overgrowth. Three drug categories are the main culprits: seizure medications (especially phenytoin), blood pressure drugs known as calcium channel blockers (particularly nifedipine), and the immune-suppressing drug cyclosporine. Roughly 40 to 50% of people taking any of these develop some degree of gum overgrowth. If you take one of these medications and notice your gums thickening or swelling over your teeth, bring it up with your prescribing doctor. Switching to an alternative medication often helps, though meticulous oral hygiene can reduce the severity in the meantime.
Infection or Abscess
A localized infection at the root of a tooth or in the gum pocket can cause sudden, painful swelling, often on one side. This is different from the gradual, widespread puffiness of gum disease. An abscess won’t resolve on its own and needs professional drainage and treatment.
When Swelling Needs Urgent Attention
Most gum swelling isn’t an emergency, but certain symptoms signal that an infection may be spreading. Get to a dentist quickly, or go to an emergency room if your dentist isn’t available, if you notice any of the following: fever alongside facial swelling, swelling that extends into your cheek, jaw, or neck, tender or swollen lymph nodes under your jaw, or any difficulty breathing or swallowing. These signs suggest the infection has moved beyond the gum tissue and needs immediate treatment.
What Happens at a Professional Cleaning
If home care alone isn’t resolving the swelling, your dentist will likely recommend scaling and root planing, often called a “deep cleaning.” This goes further than a standard cleaning. Your gums are numbed with a local anesthetic, and your dentist or hygienist uses specialized instruments to scrape plaque and hardite tartar from above and below the gumline. They then smooth the root surfaces of your teeth, which helps gums reattach more tightly and makes it harder for bacteria to re-colonize.
The whole process takes one to two hours. Some dentists do both sides of the mouth in one visit, while others split it into two appointments. Recovery is straightforward: most people go back to their normal routine the same day. Your gums may feel sore for a couple of days, manageable with over-the-counter pain relievers, and you can eat and drink normally as long as nothing hurts. No stitches or incisions are involved. In some cases, your dentist will also place antibiotics directly around the tooth roots or prescribe a short course of oral antibiotics.
For gum swelling caused by gingivitis, a single deep cleaning combined with improved daily care is often enough to resolve the problem completely. Periodontitis requires ongoing maintenance, typically more frequent dental visits every three to four months to keep the disease from progressing.
Daily Habits That Prevent Recurrence
Swollen gums tend to come back if the habits that caused them don’t change. Brush twice a day using the 45-degree angle technique described above, and floss once daily. An antimicrobial mouthwash can help reduce bacterial load, but it’s a supplement to mechanical cleaning, not a replacement. Smoking is one of the strongest risk factors for gum disease and also masks early warning signs by reducing blood flow to the gums, so swelling and bleeding may not appear until the disease is more advanced.
Staying consistent with dental cleanings, typically every six months for healthy gums or every three to four months if you’ve been treated for periodontitis, catches problems before they cause noticeable swelling again. Gum tissue that’s been well maintained can stay healthy for life, even after a bout of gingivitis.