Swollen gums almost always signal inflammation, and the most common cause is the early stage of gum disease called gingivitis. Over 42% of American adults age 30 and older have some form of periodontal disease, so if your gums look puffy, red, or tender, you’re far from alone. The good news: most causes of gum swelling are treatable, and gingivitis is fully reversible when caught early.
Gingivitis: The Most Likely Cause
Gingivitis is mild inflammation of the gum tissue, typically caused by plaque buildup along the gumline. When bacteria in plaque irritate the gums, they respond by swelling, turning red, and bleeding easily during brushing or flossing. You might notice your gums look puffier than usual or feel tender when you eat.
The key thing to know about gingivitis is that it’s reversible. Improved brushing, daily flossing, and a professional dental cleaning can resolve it completely. Left alone, though, gingivitis can progress to periodontitis, a more serious condition where the gum tissue and bone that hold your teeth in place start breaking down. As periodontitis advances, the gums pull away from the teeth and form pockets that trap bacteria and become infected. This can eventually loosen teeth or lead to tooth loss.
Other Common Causes of Gum Swelling
Hormonal Changes
Pregnancy, puberty, menstruation, and menopause can all trigger gum swelling. During pregnancy especially, rising levels of estrogen and progesterone make gums more sensitive, more prone to swelling, and more likely to bleed. Increased blood flow and shifts in immune function add to the effect. This is common enough to have its own name: pregnancy gingivitis. It typically improves after delivery, but good oral hygiene during pregnancy helps keep it under control.
Wisdom Teeth
If the swelling is concentrated around your back teeth, a condition called pericoronitis may be the cause. This happens when a wisdom tooth is partially trapped under the gum tissue. A flap of gum called an operculum can form over the partially erupted tooth, and food, bacteria, and debris get trapped underneath. Chronic pericoronitis causes mild achiness, bad breath, and a bad taste in your mouth. Acute pericoronitis is more intense: severe pain near the back teeth, redness, pus, difficulty swallowing, and sometimes fever or swollen lymph nodes in the neck.
Nutritional Deficiencies
A severe lack of vitamin C, sustained for at least three months, can cause scurvy. While rare in developed countries, it still occurs. Early symptoms are vague, but as scurvy progresses, the gums become swollen, bleed easily, and can turn purple and spongy. If your diet is very low in fruits and vegetables, this is worth considering.
Medications
Certain medications cause gum overgrowth as a side effect. Three drug classes are the most common culprits: seizure medications, blood pressure medications (particularly a group called calcium channel blockers), and immune-suppressing drugs used after organ transplants. Among people taking phenytoin for seizures, roughly half develop some degree of gum overgrowth. If you’ve noticed your gums growing over your teeth after starting a new medication, bring it up with your prescribing doctor. Switching to a different drug in the same class sometimes resolves the problem.
What Swollen Gums Feel Like
Healthy gums are firm, pale pink, and fit snugly around each tooth. When they’re inflamed, you’ll notice one or more of these changes: a deeper red or purplish color, a puffy or rounded appearance along the gumline, tenderness or pain when touched, bleeding when you brush or floss, and sometimes a receding look where the gums seem to be pulling away from the teeth. Swelling can affect a small section around one or two teeth, or it can be widespread across your upper or lower gums.
The pattern of swelling offers clues about the cause. Swelling localized to the back of your mouth points toward wisdom tooth problems. Swelling around a single tooth that throbs and worsens could signal an abscess. Generalized puffiness across the gumline is more typical of gingivitis, hormonal changes, or medication side effects.
What You Can Do at Home
A saltwater rinse is one of the simplest ways to reduce gum inflammation while you figure out next steps. 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, including after meals. If the rinse feels too strong, cut the salt to half a teaspoon.
Beyond that, the basics matter more than anything: brush twice a day with a soft-bristled toothbrush, floss daily, and avoid tobacco. If your gums bleed when you floss, that’s a sign of inflammation, not a reason to stop. Gentle, consistent flossing helps clear the bacteria causing the problem in the first place. An antiseptic mouthwash can also help reduce plaque between dental visits.
What Happens at the Dentist
For gingivitis, a professional cleaning is often all that’s needed. Your dentist or hygienist removes the hardened plaque (tarite) that you can’t get off with brushing alone. If the disease has progressed to periodontitis, you may need a deeper cleaning called scaling and root planing, where the dentist cleans below the gumline and smooths the root surfaces so gums can reattach. After a deep cleaning, expect some discomfort for a day or two, gum sensitivity for up to a week, and full gum healing within four to six weeks.
For pericoronitis, treatment depends on severity. Mild cases may resolve with improved hygiene and saltwater rinses. More serious infections may need antibiotics, and if the wisdom tooth keeps causing problems, extraction is usually the long-term solution.
Signs That Need Urgent Attention
Most gum swelling isn’t an emergency, but certain symptoms suggest the situation has moved beyond simple inflammation. Fever combined with facial swelling is a red flag. Swollen lymph nodes under your jaw or in your neck indicate your body is fighting a spreading infection. Difficulty breathing or swallowing means the infection may have spread deeper into the jaw, throat, or neck, and that warrants an emergency room visit if you can’t reach a dentist immediately. Pus draining from the gums, severe throbbing pain around a single tooth, or swelling that’s getting noticeably worse over hours rather than days also call for prompt care.