Swollen Gums: What One Sore Spot Usually Means

Swelling in one specific place behaves very differently from gums that are puffy throughout, and the two need different responses. This page is mostly about the localised kind, because that is the one people search for at ten at night.

The short answer

Generalised puffiness across your gums is almost always plaque-driven inflammation, and that is covered fully in our guide to bleeding gums and gum disease. A single swollen area is a different question, and the likely answers are a trapped piece of food, an infection at the root of one tooth, a gum flap over a partly erupted wisdom tooth, or something physically rubbing. One of those needs seeing urgently and the others do not, so the distinguishing features are worth knowing.

One area swollen: the usual causes

• Something trapped. A popcorn husk, a fish bone, a fragment of nut or a bristle wedged below the gum will produce a tender, localised swelling within a day or two. Often resolves entirely once dislodged with careful flossing or an interdental brush.
• An abscess. A firm or fluctuant swelling next to one tooth, with throbbing pain, tenderness on biting, and often a bad taste. This is the one that needs prompt attention. See dental abscess.
• Pericoronitis. Swelling and soreness around a partly erupted wisdom tooth, where the flap of gum over it traps food and bacteria. Very common in the late teens and twenties, and it tends to recur. See wisdom teeth.
• Something rubbing. A denture edge, a sharp filling, a broken tooth or an orthodontic bracket. The swelling sits exactly where the irritation is, which usually makes the cause obvious once you look.
• A gum abscess from a deep pocket, where gum disease has produced a pocket that has become acutely infected.
• Trauma. A knock, or a burn from something too hot. Settles over days.

Gums swollen all over

If it is everywhere rather than in one place, the likeliest explanations are plaque-related inflammation, hormonal changes in pregnancy or puberty which make gums far more reactive, certain medications that cause gum overgrowth including some for blood pressure and epilepsy, or occasionally mouth breathing which dries and irritates the front gums overnight.

Rarely, generalised gum swelling that appears rapidly with feeling unwell, bleeding and ulceration needs prompt assessment rather than a routine appointment.

When to be seen urgently

Go to A&E or call 999 if swelling is spreading into your face towards the eye, or down into your neck, if you cannot swallow or breathe comfortably, if you cannot open your mouth properly, or if you have a fever and feel generally unwell with it.

Ring us the same day for facial swelling, throbbing pain not controlled by painkillers, a swelling that is visibly growing, or pus. Otherwise a routine appointment in the next week is fine.

One more, and it matters: a swelling or lump that is painless and has been there more than three weeks should be checked rather than watched. Almost always something innocent, but three weeks is the point at which you stop waiting. See mouth cancer signs.

What helps meanwhile

• Rinse with warm salty water several times a day. Genuinely useful for a sore gum, and it costs nothing.
• Keep cleaning the area, gently. Stopping because it hurts makes localised gum inflammation worse.
• Try to dislodge trapped food with floss or an interdental brush rather than a pin or cocktail stick.
• Painkillers as directed on the packet.
• Do not apply heat to a facial swelling, and never try to lance a swelling yourself.
• Do not hold aspirin against the gum, which burns the tissue.

What it costs

A new patient examination is £89 including X-rays, £60 for existing patients, and an X-ray is usually how we distinguish an abscess from a gum problem. Treatment depends on the cause: a hygiene appointment from £60, root canal treatment from £305, or an extraction from £126. NHS urgent treatment is Band 1 at £27.90. Everything is on the fees page.

Frequently asked questions

Why is only one bit of my gum swollen?

Because something specific is happening in that spot: trapped food, an infected tooth root, a gum flap over a wisdom tooth, or something rubbing. Localised swelling almost always has a localised cause, which is good news because it usually means a localised fix.

Will a swollen gum go down on its own?

If it is caused by trapped food or a knock, often yes, within a few days. If it is caused by an infection at a tooth root, no. It may ease temporarily and come back, and that pattern of coming and going is a sign to get it looked at rather than a sign of improvement.

Should I use salt water or mouthwash?

Warm salty water, several times a day. It is soothing and helps keep the area clean. Strong antiseptic mouthwash has a place short term but will not resolve an infection, and alcohol-based ones can irritate sore tissue.

Can pregnancy cause swollen gums?

Yes, very commonly. Hormonal changes make gums much more reactive to the same amount of plaque, so they swell and bleed more easily. It needs more careful cleaning rather than less, and dental care during pregnancy is safe and worth keeping up with.

If a swelling is painful, growing, or has simply not gone, ring us on 01625 574609. We keep time for urgent problems each day.

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