Swollen gums are most often caused by a buildup of bacterial plaque along the gumline, a condition called gingivitis. Over 42% of U.S. adults aged 30 and older have some form of gum disease, making it one of the most common reasons for puffy, tender, or bleeding gums. But plaque isn’t the only culprit. Hormonal shifts, certain medications, infections, and even nutritional gaps can all make your gums swell.
Plaque Buildup and Gum Disease
The most common explanation is gingivitis, the earliest stage of gum disease. When plaque, a sticky film of bacteria, sits on your teeth and along the gumline, it irritates the surrounding tissue. Your gums respond by becoming red, puffy, and prone to bleeding when you brush or floss. At this stage, no permanent damage has occurred, and improving your oral hygiene can reverse it completely.
Left untreated, gingivitis progresses to periodontitis. This is where the inflammation moves deeper, and you start losing bone around your teeth. That bone loss is permanent and sets off a chain of problems: receding gums, loose teeth, and eventually tooth loss. The shift from gingivitis to periodontitis doesn’t happen overnight, but it’s the reason swollen gums shouldn’t be ignored for weeks or months at a time.
Medications That Cause Gum Overgrowth
Roughly 40 to 50% of people taking certain medications develop some degree of gum overgrowth. Three drug classes are the main offenders: seizure medications (particularly phenytoin), blood pressure medications called calcium channel blockers, and the immune-suppressing drug cyclosporine. Of the approximately 2 million people taking phenytoin, about half experience gum tissue growing larger than normal.
Among blood pressure drugs, nifedipine carries the highest risk at around 38%. Others in the same class have lower but still notable rates: diltiazem at about 20%, and verapamil and amlodipine at lower percentages. If you started a new medication in the weeks or months before noticing your gums swelling, this connection is worth raising with your doctor or dentist. Switching to a different medication in the same class can sometimes resolve the problem.
Hormonal Changes
Pregnancy is one of the most well-known triggers for swollen gums. The surge in progesterone during pregnancy encourages the growth of bacteria in plaque and increases your gums’ sensitivity to that bacteria. The result is inflammation, tenderness, and bleeding that can start as early as the second month and peak in the third trimester. This is common enough to have its own name: pregnancy gingivitis.
Puberty, menstruation, and menopause can trigger similar shifts. Any time your body goes through a significant hormonal change, the blood flow to your gum tissue increases and the tissue’s response to irritation becomes exaggerated. The swelling typically improves once hormone levels stabilize, but keeping up with brushing and flossing during these periods makes a real difference.
Infection or Abscess
If the swelling is concentrated in one spot rather than spread across your gums, you may be dealing with a periodontal abscess. This is a pocket of infection that forms between the gum and the tooth, and it looks like a boil or pimple on your gum tissue. The area is usually darker than the surrounding gum and visibly swollen. Many people feel pain or tenderness at the site, though some don’t.
Other signs of an abscess include pus draining from the bump, swollen lymph nodes in your neck or jaw, and a bad taste in your mouth. Abscesses don’t resolve on their own. They need to be drained and the infection treated. If swelling around a tooth becomes severe and spreads into your face or neck, or if you develop a fever or difficulty swallowing, that’s a sign the infection is moving into deeper tissue and requires urgent care.
Vitamin C Deficiency
Severely low vitamin C levels cause a condition called scurvy, and the gums are one of the first places it shows up. Symptoms include swollen, bleeding gums that may turn purple and feel spongy. In advanced cases, teeth can loosen and fall out. Scurvy is rare in developed countries, but it does occur in people with very restricted diets, those with absorption issues, and older adults who eat very little fresh food. If your gums are swollen and your diet has been lacking in fruits and vegetables for an extended period, this is worth considering.
Dental Appliances and Mechanical Irritation
Braces, dentures, retainers, and other oral appliances can all cause localized gum swelling. With braces, plaque tends to build up around the brackets and wires, creating inflammation in the surrounding tissue. With dentures, a poor fit puts pressure on certain areas of the gum, leading to irritation and swelling. If the swelling started around the time you got a new appliance or your existing one started feeling different, the two are likely connected. An adjustment from your dentist or orthodontist typically resolves the issue.
What You Can Do at Home
A salt water rinse is the simplest first step. Mix half a teaspoon of salt into a cup of warm water, swish it around your mouth for 30 seconds, and spit it out. Salt water helps reduce bacteria and draws fluid out of swollen tissue. You can do this two or three times a day.
Beyond that, the basics matter more than anything: brush twice a day with a soft-bristled toothbrush, and floss once a day. If your gums are tender, a soft toothbrush is less likely to make the irritation worse. Avoid alcohol-based mouthwashes, which can dry out and further irritate inflamed tissue. These steps are often enough to reverse mild gingivitis within a couple of weeks.
Signs That Need Prompt Attention
Most gum swelling improves with better oral care within one to two weeks. If it doesn’t, or if it’s getting worse, a dental visit is the logical next step. Certain symptoms signal something more serious. Fever combined with facial or gum swelling suggests the infection is spreading beyond the local area. Severe swelling in the floor of your mouth, under your jaw, or in your neck can compress your airway, which is a genuine emergency. Pus, a foul taste, difficulty swallowing, or swollen lymph nodes all point to an active infection that won’t clear up with home care alone.