There are far more things that can make your gums hurt than you may realize. What you should do about it would depend on the cause. Therefore it is of utmost importance to correctly diagnose the source of the pain in order to maximize the pain relief.
As a rule of thumb, we can categorize gum pain as either generalized pain, localized pain, or sore gums. Each specific condition would require a different treatment.
Infrequent flossing
Recent teeth cleaning
TMJ problems
Generalized pain in your gums
Generalized gum pain is when your gums hurt but you can't pinpoint a specific spot that its coming from. Instead, it just feels like your entire mouth hurts all over.
These are some common symptoms:
Gums look red
Swollen and puffy looking
Bleeds easily
May feel worse when eating
Tender when touched
There are a lot of conditions which may cause this generalized pain in your gums with some of them being dental related while others are not.
Gum disease
The most common cause for your gums to be hurting is from gum disease. Plaque and tartar that is left untreated will cause gum inflammation. This is when the gums swell up and bleed very easily.
Gingivitis
Once this happens you're in the first stage of gum disease called gingivitis. The inflammation is limited to just the gums. Since this is the early stage of gum disease, it can be easily treated by your dentist with a teeth cleaning.
Periodontitis
If you leave gingivitis untreated, it can progress to periodontitis where the gum inflammation spreads to the bone and causes bone inflammation. The bone inflammation can cause irreversible damage by inducing bone loss. If you lose enough bone around your teeth, they will get loose and eventually fall out. Treatment for periodontitis involves at a minimum, a deep teeth cleaning but could also require gum surgery if it is severe enough.
Aftercare
After you have the gum disease treated by your dentist, you still need to maintain good oral hygiene in order to prevent it from reoccurring. This means you need to brush for at least 2 minutes, twice a day. Floss before you go to bed and use a mouthwash to help reduce bacteria.
Hormonal changes
You may be surprised but abrupt changes in your hormones can cause gum pain! To be more precise, the hormones itself don't cause your gums to hurt but rather your body overreacts to the presence of plaque and tartar. This means that the threshold for tolerating gum inflammation decreases.
For example, under normal hormonal conditions your gums may not start bleeding until there is 50% plaque present in your mouth. However under abnormal hormonal conditions, your gums may start bleeding with only 25% of plaque present around your teeth.
Here are some common situations where your hormones may be going through abrupt changes:
Puberty. When you're going through that growth spurt, a lot of hormones are going haywired.
Menstruation. In additional to your uterus bleeding, your gums may hurt and bleed more.
Pregnancy. Hormones can get out of control during pregnancy where the gums can swell up into an abscess-like condition called a pregnancy tumor. More typically, the gums would just be bleeding more in general.
Menopause. At the opposite end of the spectrum is menopause where there is yet another abrupt change in hormones. A common symptom is hot flashes.
Treatment for these hormonal conditions are usually not required since they are a part of a normal progression through life. The hormones will eventually settle at a new normal after a sufficient amount of time has passed.
Aggressive brushing and flossing
If your gums hurt when you brush your teeth, you may be heavy handed and brushing very aggressively. You can cause permanent damage to your gums such as gum recession if you continually brush hard along with using a hard bristles. Once the gums recede, it does not grow back. The gums are very delicate so when you are aggressively brushing them, its no surprise that your gums would start hurting.
The same is also true with improper flossing. Sometimes if you pull the floss down too fast and too far down, you can injure the gums.
Treatment
Gums hurt when brushing. You need to stop brushing so hard. If you manage to do that, they should stop hurting. You should also switch to a very soft brush so it'll minimize the damage that you can inflict upon yourself. If you really can't trust yourself, you can buy an electric toothbrush that has a function which stops spinning if you apply too brush pressure.
Gums hurt after flossing. If you're flossing very aggressively, you need to stop. You have to slow down and take your time while you're flossing. Go through it slowly and gently so that you don't accidentally injure the gums.
Smoking
Once in awhile, an intense smoking session can cause irritation and burns to the soft tissue of your mouth. This includes the gums as well as the roof of your mouth. In fact, there is a named condition called nicotine stomatitis (smoker's palate) where the soft tissue on the root of the mouth is irritated and inflamed. It looks like a cluster of red dots all over the mouth.
This can be caused by very hot tobacco smoke or any type of smoke that you inhale such as cigars or hookah. This can cause generalized pain all over your mouth.
The best treatment for this would be to permanently quit smoking. If that is not possible the next best would be to decrease the amount of smoking. Also to help the healing process along, you should rinse with salt water since it is the most gentle mouth rinse. If you use listerine or hydrogen peroxide, it may burn the already irritated spots.
Gum allergy
An often forgotten cause of gum pain is if you're allergic to a product that you're using or a food that you've ate. As a natural process of an allergic reaction, the gums may swell up, feel itchy, and feel painful.
Dental hygiene product. You could be allergic to the toothpaste that you're using. If you are you should try figuring out what ingredient it is so that you can switch to a different brand without it. Worse case scenario, you can always just brush your teeth with baking soda and water. That is the simplest toothpaste ever.
Foods. If you ate something that you're allergic to, not only would your gums hurt but your whole mouth could be in pain. The entire oral cavity will feel itchy. You should avoid consuming foods and drinks that you're allergic to.
Vitamin Deficiency
A common oral condition that use to afflict sailors was Scurvy, which is a vitamin C deficiency. When sailors were at sea for long durations of time, access to fresh fruits were difficult to come by. If you get Scurvy, all of the gums in your mouth will swell up to a beet red color. They will bleed very easily and profusely just from a light touch. As you can tell, the condition is very painful for your gums and they will hurt.
Treatment for this would be to get vitamin C, meaning you should attempt to eat plenty of fruits. After you eat a lot of fruits, the condition should slowly start to subside.
Medications
Certain medications can cause the gums to swell and enlarge. This increase in gum size consequently increases the chances for plaque and tartar to accumulate. That can lead to gum bleeding and gum pain.
Here are some common medications that may cause it:
Calcium channel blockers
Blood pressure medications
Immunosuppressants
Treatment for this would be to discontinue the offending medication but in most cases, we are unable to since they are being used to treat a different medical condition. Therefore the only thing you can do is to prevent the plaque and tartar from building up as much as possible.
Visit your dentist regularly every 6 months for a dental cleaning.
Brush and floss twice a day.
Use a mouthwash to disrupt the bacteria in your mouth from forming plaque.
Nerve dysfunction
Certain dysfunctions with the cranial nerves, which controls sensation to the mouth, teeth, and gums can make you THINK that your gums hurt. This type of pain may be shooting, sporadic, and sharp.
One such condition is called Trigeminal Neuralgia, with its main symptom being generalized facial pain. Typically it only affects one side of your face but in very rare cases, it can affect both.
Treatment for nerve dysfunctions should be treated by an orofacial pain specialist and not by your general dentist. Therefore, you should seek out a referral from your dentist but if you can't, some hospitals may have one on staff.
Viral, Bacterial, or Fungal infections
Generalized gum pain can be a result of an infection by viruses, bacteria, or fungi. These infections will typically affect the entire mouth rather than a small spot in your mouth. Here are some common infections:
Herpes. This is a viral infection where outbreaks can result in cold sores. These sores can appear on your gums, lips, cheeks, and anywhere in the oral cavity. If it happens to be on the gums, the gums can hurt pretty badly. There is an anti-viral which can treat it but otherwise it should go away on its own after about a few weeks. In the meantime you should rinse with salt water to keep the lesions clean.
Shingles. This is when chicken pox returns as an adult, either when your immunity level wanes or you get reinfected. There is a vaccine that can treat this condition.
Thrush. This is a fungal infection and what it looks like is white splotches all over your mouth. It can cover the gums, cheeks, and throat. It'll typically feel very painful but the good thing is that there are anti-fungals, which can be used to treat it.
Gums hurt in a localized area
Localized gum pain is when your gums hurt in one spot or a couple of spots but not the entire mouth. You can usually pinpoint the source of the pain and where it is coming from.
Here are some signs and symptoms:
Gums hurt but localized to one region
Gums bleed easily
Red and poofy looking gums that are swollen
Pain can be mild or severe depending on the cause
There are a variety of conditions which can cause gum pain in just one small spot but the most common one that people think of is a dental abscess.
Foreign Body Impaction
It is very common for small hard foods to get lodged into your gums, thus causing gum pain along with bleeding and swelling. The reason is because your body is unable to dislodge it on its own. Instead, it will make the area swell up as a signal to you that something is wrong and that you should do something about it.
Some common foods that can get stuck in the gums:
Popcorn
Seeds
Nuts
Taco shells and tortillas
Basically, anything that is small and hard can get stuck in your gums. The only way to get gum pain relief is to remove the foreign body that is lodged in your gums. Here are some methods you can try to get rid of it.
Brush and floss it out.
Flush it out with a water flosser.
Have your dentist scale it out.
In order to prevent it from happening again, you should chew slowly and not rush while eating! Also make sure you brush and floss after your meal so that if something does get stuck, you get it out before your gums start hurting.
Dental abscess
As soon as people start having gum pain, one of the first things they think they have would be a dental abscess. There must be an infection and that is why their gums hurt.
That may very well be true because abscesses are certainly painful. Although there is a distinction between an abscess on the gums and one in the tooth. The symptoms are different depending on where it is located.
Gum abscess. An abscess on the gums will certainly cause throbbing gum pain because that is exactly where the infection is located. The gums will be red, swollen, and bleed very easily. In order to relieve this gum pain, you will need to see your dentist to have the abscess drained. After that you may need a deep teeth cleaning to make sure all of the infection is cleaned out.
Tooth abscess. An abscess in the tooth, may or may not cause your gums to hurt because if the infection is only within the tooth, only the tooth should hurt. However, sometimes the infection can spill out and spread to the gums and you end up with a tooth and gum abscess at the same time. Treatment for this would be a root canal to treat the tooth infection and then the same treatment for a gum abscess as well.
Basically, treatment for this would depend on the location of the abscess.
Wisdom Teeth Infection
Another common source of gum pain is gum inflammation around your impacted wisdom tooth. Due to the fact that they are impacted, a lot of food and plaque can get trapped in the partially erupted teeth. This causes the gums to get inflamed and swell up into a condition called pericoronitis, which translates to inflammation around the crown of the tooth.
The most common symptom of pericoronitis is unbearable gum pain. Sometimes the pain can even feel like it is shooting up to your ear and your temple. It is a very painful gum condition but at least it is only localized to just where the wisdom teeth area.
What most people describe it as would be gum pain in the back of the mouth, which is accurate because the wisdom teeth are literally located at the back of the mouth.
Treatment for pericoronitis would be antibiotics and an antibiotic rinse (chlorhexidine). If you take both of them for 7-14 days, the pain should subside. Although the gum pain may return in the future UNLESS you permanently extract the wisdom teeth so that it can't do it again. The antibiotics are only a temporary solution.
Dental Cavity
Cavities can cause your gums to hurt even though the lesion is usually confined to the tooth. These cavities wouldn't be the small ones but rather the large ones, which have the capability to hurt your gums.
Large tooth decay
A tooth with a very large cavity can sometimes have the gums growing into the cavity. When this happens, the gums get very inflamed and swell up thus causing you pain.
Treatment for this would be to remove the tooth decay via a dental filling but you may also need the gums to be cut as well. The excess overgrown gums will need to be trimmed down. Afterwards, you should take some pain medication and rinse with salt water to help it heal faster.
Fractures
A fractured tooth could be in the same situation as having a large cavity. The gums can grow into the fractured tooth and swell up.
Dry Socket
This is an extremely painful situation that can happen after having a tooth removed. A dry socket will occur if a blood clot fails to form and it has nothing to do with stitches nor drinking through a straw. The process is biological and not mechanical. Unfortunately researchers are still unsure of how exactly it occurs.
What this feels like is extreme gum pain around where the tooth was removed as soon as anything touches the extraction socket. The exposed bone in the socket is extremely sensitive.
Treatment for this is palliative only because there is no permanent cure. Most of the time the only thing you can do is just wait for the dry socket to heal all on its own. In the meantime you can take pain medication and keep the socket clean of food debris by brushing and rinsing really well.
Canker Sores
Canker sores can appear on your gums and make them hurt. They can either be singles or clusters of them. They will typically stay on your gums for about 2 weeks and then go away on their own.
Treatment for them simply involves rinsing with salt water just to keep the lesions clean. It is self healing so you don't have to do anything aside from that. It would also be helpful to stay away from spicy and acidic foods so that it doesn't aggravate them.
Cuts and injuries
If you're eating hard foods such as taco shells or hard bread, it can sometimes cut your gums. The injury will of course cause your gums to hurt but thankfully, most cuts should resolve within a few days.
You should eat slowly so that it doesn't happen again. With that said, this will happen to most people at least a couple of times every year.
Burns
If you don't wait for hot foods to cool down before eating them, you can burn your gums. Some common burns come from hot soups and hot pizza. Pizza burns will typically hurt the gums right behind the upper front teeth.
All burns are self healing when given enough time. The only thing you can do is rinse with salt water. If you want to help relieve some of the gum pain, you can try letting an ice cube melt in your mouth. The cold will help numb the burned gums and relieve some pain.
Recent dental procedure
You may have some gum pain if you've had a tooth filling recently, especially if it was a cavity that was in between the tooth. The reason is because your dentist will put a band around the tooth and also stick a wedge into your gums to hold the band in place. This can mildly traumatize the gums and it may hurt for the rest of the day.
Fortunately, it should heal very quickly and you'll barely notice it by the next day. You don't have to do anything to take care of it. Just brush and floss like you normally do. The gum tenderness is only temporary.
Sinusitis
If you have a sinus infection, you may feel like the gums around the upper back teeth may be painful. The reason is because the sinus is very close to the roots of the upper back teeth. Sometimes the body gets confused and is unsure of where the pain is coming from. This phenomenon is called referred pain.
Treatment for this wouldn't be to treat the gums because the gums aren't actually hurting. Instead, you should go see your ENT doctor to have the sinusitis treated. Fortunately your dentist is able to diagnose sinusitis via a process of elimination and would be able to driect you to your ENT as soon as he suspects it.
Ill fitting dentures
Poor fitting dentures can compress on the gums and cause you gum pain. Typically the pain will be limited to the spot where the dentures are compressing. The other areas where the denture fits will, will not hurt.
The treatment for this would be to see your dentist and have them adjust the denture. This can be simply done by shaving away the spots that are impinging upon your gums. Once they relieve it, the gums should stop hurting but it may still be tender for the next few days. It will take awhile for the bruised gums to heal.
Oral cancer
Most people are familiar with lung cancer but you can get cancer in your mouth. It can appear on your tongue, your gums, or anywhere for that matter! If it happens to be on your gums, it will make it hurt.
Treatment for this should be done at a hospital because you'll most likely need the cancer removed and chemotherapy as well. This cannot be handled at an outpatient clinic like a dental office.
Gums sore but not painful per se
There are a variety of situations where your gums can feel sore rather than painful. What it'll feel like, is soreness or tenderness around the gums. It won't necessarily feel painful where you feel the need to take pain medication.
Infrequent flossing
If you don't floss regularly, your gums may not be use to it when you do. You'll often find the gums sore and tender if you're flossing for the first time in a month.
The solution to not having sore gums is to just floss more frequently. In fact if you do it frequently, they'll stop being sore and will bleed less as well.
Recent dental cleaning
In addition to your teeth, your gums can feel sore after a teeth cleaning. The reason is because your dentist has to scrape the teeth and gums in order to get the plaque and tartar off. This can cause your gums to feel sensitive and tender afterwards.
Although if you go regularly for your cleanings every 6 months, they won't feel as sore as someone who only goes once every other year. Therefore if you stay on top of your dental check ups, you'll feel less symptoms.
The good news is that it should recover pretty quickly over the next few days. If you find the gums bleeding, you can rinse with salt water after every meal to make them heal faster.
TMJ disorder
Individuals with parafunctional habits such as teeth grinding and teeth clenching may wake up in the morning with a sore mouth. Their teeth and gums will feel a generalized sense of soreness due to all of that night time activity.
Treatment for this involves making a night guard, de-stressing, and physical therapy.
Night guard protects your teeth from the grinding.
De-stressing will help you relax and you'll clench and grind less.
Physical therapy is helpful in relieving the muscle knots in your chewing muscles.
Takeaway
Gum pain can be caused by a variety of factors so the only way to get rid of it is to figure out what exactly is causing it because the treatment will differ depending on the cause. Treatment for it will usually be a combination of visiting your dentist and practicing good oral hygiene. It never hurts to use a mouth wash frequently because that always helps to keep the gums clean and free of food debris.
Author: Written by Dr David Chen, a general dentist in long island city.
