The phrase “hole in my gum” describes several distinct oral health issues, ranging from chronic tissue loss to an acute, infection-related problem. Understanding the physical appearance of the abnormality is the first step toward determining the underlying cause, such as slowly progressing gum disease or a draining abscess.
Categorizing What You Are Seeing
The visual characteristics of the abnormality help categorize the issue into three main types. The first is a wide gap where gum tissue has pulled away from the tooth surface, making the tooth look longer. This structural change is typically a sign of gum recession or a periodontal pocket.
Another manifestation is a small, pimple-like bump on the gum that may look white or red and sometimes oozes fluid or pus. This localized spot is often a fistula, which is a drainage tract for an underlying infection.
A third, less serious type is a general sore or ulcer, which is usually temporary and appears as a flat or slightly depressed red or white lesion.
Chronic Gaps: Recession and Periodontal Pockets
Gaps between the tooth and gum line are often caused by chronic gum recession or periodontal pockets. Gum recession occurs when the gum tissue pulls back, exposing the root surface below the crown of the tooth. This process is generally slow and may go unnoticed until increased sensitivity or visible tooth lengthening occurs.
Periodontal pockets result from untreated periodontitis, an advanced stage of gum disease. Periodontitis begins when bacterial plaque and tartar build up, causing the gum tissue to detach from the tooth root. This detachment creates a deepening space where bacteria thrive and destroy supporting bone and tissue structures.
These chronic issues are driven by a long-term inflammatory response to bacterial infection. Other symptoms accompanying these gaps include gums that bleed easily and a persistent bad taste or odor. If left unmanaged, the destruction of bone and tissue can eventually lead to tooth mobility and tooth loss.
Urgent Spots: The Abscess Drainage Hole (Fistula)
A small, raised spot resembling a pimple on the gum surface is frequently a dental fistula, also known as a sinus tract. A fistula forms as an outlet for an underlying dental abscess, which is a collection of pus caused by a bacterial infection deep within the tooth root or gum tissue.
The body creates this channel to relieve the pressure built up from the trapped infection. Because the infection is actively draining into the mouth, the area may not feel intensely painful, and the severe throbbing pain often subsides. This release of pressure can lead to a false sense that the problem has resolved itself.
However, the underlying source of the infection, often a dead or infected tooth pulp, remains. This drainage spot confirms an active infection that has progressed to involve the surrounding bone or root structure. If the source is not eliminated, bacteria can continue to spread to the jawbone and potentially other areas of the body.
Treatment, Prevention, and When to See a Dentist
Any perceived hole or persistent spot on the gums warrants a prompt dental examination, as home remedies cannot resolve the underlying cause. Immediate care is necessary if the abnormality is accompanied by severe swelling of the face, high fever, or difficulty swallowing, signaling a rapidly spreading infection.
For chronic issues like periodontal pockets and recession, treatment often begins with scaling and root planing, a deep cleaning procedure. If pockets are too deep, a periodontist may recommend pocket reduction surgery, where gum tissue is folded back for thorough cleaning and smoothing of damaged bone. For severe recession, soft tissue grafting may be performed, involving the surgical placement of tissue over the exposed root surface.
Treating a fistula requires eliminating the source of the infection, not just draining the pus. If the abscess relates to the tooth’s nerve, root canal therapy is typically performed to remove the infected pulp and seal the tooth. If the tooth is too damaged to save, extraction may be the only option to remove the infection entirely.
Prevention centers on meticulous daily oral hygiene and regular professional check-ups. This involves:
- Brushing twice a day with a soft-bristled brush.
- Flossing daily to disrupt bacterial colonies between teeth.
- Consistently attending dental cleanings.
Regular visits allow a dentist to measure pocket depths and identify early signs of tissue loss or infection before they progress.