A swollen gum usually signals inflammation caused by bacterial buildup along the gumline, but it can also point to an infection, hormonal changes, a nutritional deficiency, or a medication side effect. Most cases trace back to the early stages of gum disease, which is reversible with improved oral hygiene. Some causes, though, need professional treatment.
Gum Disease: The Most Common Cause
The most likely explanation for swollen gums is gingivitis, a mild form of gum disease triggered by plaque buildup. Plaque is the sticky film of bacteria that forms on teeth throughout the day. When it isn’t removed regularly, it hardens into tarite and irritates the surrounding gum tissue, causing redness, puffiness, and bleeding when you brush or floss. Gingivitis is extremely common and, importantly, fully reversible with early treatment.
Left untreated, gingivitis can progress to periodontitis, a more serious condition where the gums begin pulling away from the teeth and forming deep pockets. Bacteria colonize those pockets and break down the tissue and bone that hold teeth in place. Over time, teeth can loosen. Nearly 46% of adults aged 45 to 64 have some form of periodontitis, and that figure climbs to about 60% in adults 65 and older, according to national survey data from the National Institute of Dental and Craniofacial Research. The takeaway: gum swelling that you ignore in your 30s can become a structural problem by your 50s.
Infections and Abscesses
A swollen gum that’s intensely painful and concentrated around a single tooth may be a dental abscess, a pocket of pus caused by a bacterial infection. Abscesses feel different from general gum irritation. The pain is typically severe, constant, and throbbing, and it can radiate into your jaw, neck, or ear. You might also notice sensitivity to hot and cold, pain when chewing, swollen lymph nodes under your jaw, a foul taste in your mouth, or a fever.
If an abscess ruptures on its own, you’ll get a sudden rush of salty, bad-tasting fluid and temporary pain relief. That doesn’t mean it’s resolved. The underlying infection still needs treatment, and without it, the infection can spread to surrounding tissues or, in rare cases, become a medical emergency.
Hormonal Shifts
Pregnancy is one of the most well-known hormonal triggers for gum swelling. Rising levels of progesterone and estrogen during pregnancy amplify the body’s inflammatory response to the bacteria already present in plaque. The result is gums that become red, swollen, tender, and prone to bleeding, sometimes called “pregnancy gingivitis.” Progesterone also creates conditions that encourage bacterial growth around the gumline, compounding the problem. Puberty, menstruation, and menopause can produce similar (though usually milder) effects for the same reason: hormonal fluctuations alter how gum tissue reacts to everyday irritants.
Medications That Cause Gum Overgrowth
Certain prescription medications cause the gums to enlarge gradually, a condition called gingival overgrowth. Three drug classes are most commonly responsible:
- Seizure medications. Phenytoin is the best-known culprit. Roughly half of the approximately 2 million people taking it develop some degree of gum overgrowth.
- Blood pressure medications (calcium channel blockers). Nifedipine causes gum enlargement in about 38% of users. Diltiazem, verapamil, and amlodipine carry lower but real risks.
- Immunosuppressants. Cyclosporine, used after organ transplants and for autoimmune conditions, causes gum overgrowth in 13% to 85% of patients depending on the study.
If you’ve recently started one of these medications and notice your gums getting puffy or growing over parts of your teeth, that’s worth bringing up with your prescriber. In many cases, switching to an alternative medication resolves the problem.
Vitamin C Deficiency
Vitamin C plays a central role in building and repairing connective tissue throughout the body, including the gums. When intake drops too low for at least three months, symptoms of scurvy can develop. Gums become swollen, bleed easily, and may turn purplish and spongy. True scurvy is uncommon in developed countries, but milder deficiencies are not, particularly in people with very restricted diets, heavy alcohol use, or conditions that impair nutrient absorption. If your gum swelling comes alongside fatigue, easy bruising, or slow wound healing, low vitamin C is worth considering.
Diabetes and Blood Sugar
Diabetes and gum disease have a two-way relationship. Elevated blood sugar impairs the body’s ability to fight infection and resolve inflammation, making gum tissue more vulnerable to bacterial damage. At the same time, the chronic inflammation from gum disease can make blood sugar harder to control. If you have diabetes and notice persistent gum swelling despite good brushing habits, tighter blood sugar management and more frequent dental cleanings can both help break the cycle.
What You Can Do at Home
For mild, recent swelling with no severe pain or fever, basic home care often makes a noticeable difference within a few days. Brush twice daily with a soft-bristled toothbrush, paying close attention to the gumline, and floss once a day. A saltwater rinse can help reduce bacteria and soothe inflamed tissue: dissolve one teaspoon of salt in eight ounces of warm water, swish for 30 seconds, and spit. The salt draws water out of bacteria through osmosis and shifts the mouth’s pH toward a more alkaline environment where bacteria struggle to thrive.
Avoid irritants like tobacco, very hot or spicy foods, and alcohol-based mouthwashes while your gums are inflamed. These can worsen swelling and slow healing.
How Long Healing Takes
If the swelling is from gingivitis and you improve your oral hygiene routine, you can expect noticeable improvement within one to two weeks. After a professional deep cleaning, which involves removing hardened plaque and bacteria from below the gumline, you might experience some discomfort for a day or two. Gum sensitivity can linger for about a week, and full healing of the tissue typically takes four to six weeks.
Periodontitis requires ongoing management. While treatment can stop the disease from progressing, bone and tissue that have already been lost don’t grow back on their own.
Signs That Need Professional Attention
Swelling that lasts longer than two weeks, gets progressively worse, or doesn’t respond to improved brushing and flossing warrants a dental visit. A visible bump on the gum, severe or throbbing pain, loose teeth, persistent bad breath, or gums that are actively receding are all signals that something beyond simple irritation is going on. Facial swelling, fever, or difficulty swallowing alongside gum symptoms suggests an infection that needs prompt treatment.