Why Is My Gum Growing Between My Teeth?

Gum tissue growing between your teeth is almost always a sign that the interdental papilla, the small triangular wedge of gum that normally fills the gap between neighboring teeth, has become inflamed or overgrown. The most common reason is a buildup of dental plaque triggering gingivitis, but medications, hormonal shifts, benign growths, and rarer systemic conditions can all cause the same swelling. The cause matters because treatment ranges from simply improving your brushing routine to switching a prescription or having tissue surgically removed.

What That Gum Tissue Actually Is

The fleshy point of gum that sits between two teeth is called the interdental papilla. It is made of dense connective tissue covered by the same tough oral lining that protects the rest of your gums. Its shape is determined by the contact points of the teeth on either side, the width of the tooth surfaces facing each other, and the junction where enamel meets the root. Between your front teeth it looks like a small pyramid; between your back teeth it forms two peaks connected by a shallow dip called a “col.”¹ When this tissue swells, bleeds, or bulges outward, it can look and feel like extra gum is growing in a space where it doesn’t belong.

Plaque-Induced Gingivitis, the Most Likely Culprit

If your gums have been puffy, red, or bleed when you floss, the most probable explanation is garden-variety gingivitis caused by bacterial plaque. Plaque is a sticky biofilm that forms along the gum line every day, and when enough of it accumulates between teeth, the body responds with inflammation. That inflammation makes the papillae swell, and swollen papillae can look like new tissue pushing up between your teeth.

The hallmark of plaque-induced gingival inflammation is that it stays confined to the gums rather than destroying the bone underneath, and it reverses once you remove the plaque. Systemic factors like hormone levels or certain medical conditions can amplify how severely the gums react to the same amount of plaque.² In practical terms, this means two people with identical oral hygiene can have very different degrees of swelling depending on what else is going on in their bodies.

The reassuring part is that if plaque is the only driver, a few weeks of thorough brushing, daily flossing or interdental cleaning, and a professional dental cleaning will usually bring the gums back to normal. When the swelling persists despite excellent hygiene, that’s a signal to look at other causes.

Medications That Make Gums Grow

Drug-induced gingival overgrowth is one of the more striking causes of excess tissue between the teeth, and it catches many people off guard because no one expects a blood-pressure pill to change their gums. Three classes of medication are most often responsible:

• Calcium channel blockers: drugs like nifedipine and amlodipine, widely prescribed for high blood pressure and heart conditions, are well-documented triggers. Nifedipine was the first calcium channel blocker linked to gingival enlargement, and amlodipine has since been associated with the same problem.³⁴
• Anticonvulsants: phenytoin, used to control seizures, is one of the oldest known drug causes of gum overgrowth. The excess tissue is characterized by a buildup of collagen-rich connective tissue in the gums, sometimes with varying degrees of inflammation on top.⁵
• Immunosuppressants: cyclosporine, given to organ-transplant recipients and people with certain autoimmune diseases, can cause fibrous overgrowth of the gums that leads to gingivitis, periodontitis, and in severe cases even tooth loss.⁶

The overgrowth from these drugs tends to start at the interdental papillae and gradually spreads to cover more of the tooth crown. Plaque makes it worse: patients on one of these medications who have poor oral hygiene tend to develop more severe enlargement than those who keep their teeth clean. For mild cases, ramping up oral hygiene and having the teeth professionally cleaned can bring some improvement. When that isn’t enough, reducing the dose or switching to an alternative drug, in consultation with your prescribing doctor, sometimes leads to partial or complete regression of the tissue.⁷ In stubborn cases, surgical removal of the extra tissue becomes necessary.

Hormonal Changes During Pregnancy

Pregnancy is notorious for making gums more reactive. Rising estrogen and progesterone levels increase blood flow to the gums and amplify the inflammatory response to plaque, which is why many pregnant people notice their gums bleeding or swelling for the first time. In some cases this goes beyond generalized puffiness and produces a localized lump on the gum, sometimes between two teeth. These lumps are called pregnancy tumors or pyogenic granulomas, names that sound alarming but describe a benign overgrowth of tissue, not cancer.⁸

Despite the dramatic name, a pyogenic granuloma is simply an overreaction of tissue to local irritation, amplified by hormonal changes. It tends to appear during the second trimester and can grow quickly, sometimes reaching a size that interferes with eating or brushing. Pregnancy gingivitis itself, and the granulomas it can spawn, often shrink or resolve after delivery once hormone levels return to normal.⁹ If a growth is causing significant pain, bleeding, or difficulty chewing, your dentist may recommend removing it during pregnancy rather than waiting.

Benign Growths on the Gum

Not every lump between the teeth is plain inflammation. A peripheral ossifying fibroma is a reactive gum growth that originates from the tissue around the tooth’s root attachment. It appears as a firm, rounded mass on the gum or the interdental papilla and can be the same pink color as healthy tissue or look reddish and ulcerated. A large retrospective study found these are more common in women, tend to appear in the third and fourth decades of life, and favor the front part of the upper jaw.¹⁰ The growth is benign, but it has a notable tendency to come back after removal, so your dentist will want to follow up periodically.¹¹

Pyogenic granulomas also occur outside of pregnancy. Any chronic low-grade irritation between the teeth, from a rough filling edge, a piece of calculus, or repeated food packing, can trigger one of these red, easily bleeding lumps. Because they can look similar to other growths, your dentist will often send removed tissue to a pathologist to confirm what it is.

When Food Impaction Is the Trigger

If you constantly get food jammed between the same two teeth, the chronic irritation can cause the papilla in that spot to become inflamed and swollen. Food impaction happens when the contact point between two teeth opens up, whether from a cavity, a worn or poorly fitting restoration, tooth shifting, or a missing neighboring tooth. The trapped food acts as a constant source of plaque and mechanical irritation against the gum.¹² Fixing the root cause, such as replacing a filling that lost its contour or closing a gap orthodontically, typically resolves the gum swelling in that area once the irritation stops.

Orthodontic Braces and Gum Enlargement

People wearing fixed braces sometimes notice their gums ballooning around the brackets, especially between the front teeth. The combination of brackets, wires, and bands makes cleaning harder, so plaque builds up more easily. On top of that, orthodontic forces physically stress the gum fibers; studies have shown that collagen fibers in the gum can thicken in both tension and compression zones when force is applied to a tooth.¹³ Research on adolescents with orthodontic-related gingival enlargement has found higher plaque scores and bleeding on probing, along with shifts in the oral microbiome including elevated levels of periodontal pathogens.¹⁴

The good news is that gum enlargement during orthodontic treatment usually improves after the braces come off and oral hygiene becomes easier. In some cases, a gingivectomy (trimming the excess tissue) is performed during treatment to keep the gums manageable. A randomized controlled trial comparing scalpel gingivectomy, laser gingivectomy, and non-surgical cleaning alone in orthodontic patients found that both surgical approaches controlled gum inflammation more effectively than cleaning alone at one, three, and six months of follow-up.¹⁵

Vitamin C Deficiency

Severe vitamin C deficiency, or scurvy, is rare in developed countries but still turns up, especially in people with extremely restricted diets, certain eating disorders, or chronic alcohol dependence. One of the classic oral signs is swollen, purplish, bleeding gums, and dental professionals are sometimes the first to spot it.¹⁶ The gum changes in scurvy include swelling and hemorrhages, and they occur only in people who have teeth; edentulous individuals with scurvy don’t develop the gingival signs.¹⁷ If your gums are swollen and you also have fatigue, easy bruising, or joint pain, mention your diet to your doctor so vitamin C levels can be checked.

Rare but Serious Systemic Causes

In uncommon cases, rapidly appearing gum swelling points to something systemic. Leukemia, particularly acute forms, can cause generalized gum enlargement along with bleeding and ulceration as one of its earliest oral signs.¹⁸ This kind of enlargement tends to come on fast, involves the gums broadly rather than at just one spot, and is often accompanied by other symptoms such as fatigue, unexplained bruising, or recurrent infections. It is not something most people need to worry about, but any gum swelling that is sudden, widespread, and unresponsive to cleaning warrants prompt medical evaluation.

Hereditary Gingival Fibromatosis

Some people have gums that slowly enlarge over years with no clear trigger. Hereditary gingival fibromatosis is a rare genetic condition in which the gum tissue gradually overgrows, sometimes to the point of partially or completely burying the teeth. It usually becomes noticeable during childhood when the permanent teeth are coming in. The condition is most often inherited in an autosomal dominant pattern, meaning only one copy of the altered gene is needed, though sporadic cases with no family history occur too.¹⁹ Mutations in genes including SOS-1 and REST have been identified in affected families.²⁰

Because the enlargement is slow and painless, many families don’t seek treatment until the overgrowth interferes with chewing or is cosmetically distressing. Treatment is surgical: the excess tissue is cut away in a procedure called gingivectomy. Unfortunately, regrowth is common, and repeat surgeries over a lifetime are often needed.

What Drives the Tissue Overgrowth at a Cellular Level

Regardless of the trigger, most forms of gum overgrowth share a common thread at the cellular level: an excess buildup of extracellular matrix, particularly collagen, in the gum’s connective tissue. A growth factor called TGF-β1 plays a central role. It drives gum fibroblasts, the cells responsible for producing the structural scaffold of soft tissue, to ramp up collagen output and can even push them to transform into a more contractile cell type called a myofibroblast.²¹ TGF-β1 also increases the activity of enzymes like lysyl oxidase that cross-link collagen fibers, making the tissue denser and more fibrous.²² Understanding this pathway matters because it explains why drug-induced, genetic, and inflammatory forms of gum overgrowth can all look remarkably alike: they converge on the same collagen-production machinery even though the initial trigger is different.

How Dentists Figure Out the Cause

When you show up with gum tissue bulging between your teeth, your dentist will work through a mental checklist. The process starts with a detailed medical and medication history, because drugs are one of the first things to rule in or out. Next comes a clinical exam: is the swelling localized to one spot, or is it generalized across the mouth? Is the tissue soft and red (suggesting active inflammation) or firm and pink (suggesting a fibrous overgrowth)? Does it bleed easily? Forming a differential diagnosis based on these details, then narrowing it down with investigation, is the standard approach.²³

For isolated lumps, a biopsy (removing a small piece of tissue and examining it under a microscope) is often needed to distinguish a pyogenic granuloma from a peripheral ossifying fibroma or, rarely, something more concerning. For generalized enlargement, blood tests may be ordered to check for leukemia or nutritional deficiencies. X-rays help assess whether the underlying bone is intact or whether gum disease has progressed beyond inflammation into actual bone loss.

Treatment Options

Treatment depends entirely on the cause, which is why getting a proper diagnosis matters more than trying to treat the symptom in isolation.

• Improved oral hygiene: for plaque-driven gingivitis, thorough twice-daily brushing with a soft-bristled brush, daily interdental cleaning, and a professional scaling are often enough to resolve the swelling within a few weeks.
• Medication adjustment: for drug-induced overgrowth, your dentist and prescribing physician may discuss lowering the dose or switching to an alternative that is less likely to cause gum changes. This alone can lead to partial or complete resolution.⁷
• Gingivectomy: when excess tissue doesn’t resolve with conservative measures, it can be trimmed surgically. This can be done with a traditional scalpel or with a diode laser, both of which produce good results.²⁴ Laser gingivectomy tends to cause less bleeding during the procedure, though long-term outcomes are similar.
• Addressing local irritants: if a rough restoration, an open contact, or trapped food is the irritant, fixing the dental problem resolves the gum problem.
• Nutritional correction: when vitamin C deficiency is confirmed, supplementation reverses gingival symptoms relatively quickly.

When Gum Growth Comes Back

Recurrence is a real concern with several of these conditions. Drug-induced gum overgrowth tends to return if the patient stays on the same medication, even after surgical removal. Hereditary gingival fibromatosis regrows almost by definition, since the genetic driver hasn’t changed. Peripheral ossifying fibromas have a recognized tendency to recur after excision, which is why thorough removal including the tissue at the base and close follow-up are recommended.¹¹ In one documented case of idiopathic gum enlargement, recurrence happened fifteen years after the original surgery.²⁴

The best defense against recurrence, regardless of the underlying cause, is meticulous oral hygiene. Plaque amplifies every type of gum overgrowth, so keeping bacterial biofilm to a minimum makes it harder for any trigger to produce visible enlargement. Regular dental visits let your provider catch early regrowth before it becomes a problem again.

How Gum Overgrowth Affects Daily Life

Overgrown interdental papillae aren’t just a cosmetic annoyance. When tissue bulges between the teeth, it creates deep pockets that are nearly impossible to clean, setting up a cycle where plaque accumulates, inflammation worsens, and the tissue grows further. Eating can become uncomfortable, and the gums may bleed at unpredictable times. Research into the quality-of-life effects of gum disease has found that even symptoms at the milder end of the spectrum, like bleeding and swelling, can negatively affect everyday wellbeing, self-confidence, and willingness to smile.²⁵ People sometimes put off dental visits because they assume bleeding gums are normal or that surgery is the only option, when in many cases the earliest intervention, cleaning and hygiene improvement, is all that’s needed. If you’ve noticed tissue building up between your teeth, the single most useful thing you can do is get it looked at before the cycle of inflammation and overgrowth becomes self-reinforcing.