Pain in Gums: What Causes Sore Gums

Common causes of pain in the gums

Gingivitis

Gum disease starts as gingivitis: plaque bacteria at the gumline make the gums red, puffy, tender and prone to bleeding when you brush. It is very common and fully reversible with good brushing, flossing and a professional cleaning.

Periodontitis

Untreated gingivitis can progress to periodontitis, where the infection destroys the bone and ligaments holding the teeth. Gums recede, pockets form, teeth loosen, and breath smells bad. It is often painless until an abscess forms. Smoking and diabetes are major risk factors.

Brushing and flossing injury

A hard-bristled brush, scrubbing sideways, or snapping floss into the gums causes soreness and sometimes recession. Use a soft brush, gentle circles, and guide floss in a C-shape around each tooth.

Mouth ulcers

Canker sores (aphthous stomatitis) often appear on the gums: small, round, painful ulcers with a red rim that heal in 1 to 2 weeks. A first herpes infection in young children causes widespread painful, swollen gums with fever and blisters (herpetic gingivostomatitis).

Wisdom teeth

Pericoronitis is infection of the gum flap over a partly erupted wisdom tooth. It causes pain at the back of the mouth, swelling, a bad taste, and pain swallowing or opening the mouth.

Gum pain around one tooth

Pain focused on a single tooth suggests:

• food (such as a popcorn husk) trapped under the gum
• a gum (periodontal) abscess
• a tooth abscess from a dead nerve, with pain on biting
• a cracked tooth
• a crown or filling with a rough edge

Other causes

• Braces, retainers and dentures that rub
• Hormonal changes: pregnancy gingivitis, puberty, the menstrual cycle and hormonal birth control make gums more sensitive
• Teething in babies, and new adult molars in children
• Tooth grinding, which can cause gum and jaw soreness
• Burns from hot food or drink, and irritation from tobacco, strong mouthwashes or whitening products
• Medicines that cause dry mouth or gum overgrowth (some seizure, blood pressure and immune-suppressing drugs)
• Vitamin C deficiency (scurvy): swollen, bleeding, spongy gums
• Necrotizing gingivitis: sudden painful ulceration between the teeth, with bleeding and foul breath, linked to stress, smoking, poor sleep and a weak immune system
• Blood disorders such as leukemia: swollen, bleeding gums with bruising and tiredness
• Oral cancer: a persistent ulcer, lump or red or white patch on the gum

How a dentist finds the cause

Your dentist will ask where the pain is, how long it has lasted, whether it is triggered by biting, hot or cold, and about bleeding, medicines and smoking. They will examine your gums, measure pocket depths around the teeth with a probe, test the teeth, and take X-rays to look for bone loss or infection at the root.

Home remedies for sore gums

• Warm salt-water rinse: half a teaspoon of salt in a cup of warm water, swished for 30 seconds, several times a day.
• Brush gently twice a day with a soft brush and fluoride toothpaste, and clean between teeth daily. Keep cleaning even if gums bleed: bleeding usually stops within 1 to 2 weeks as inflammation settles.
• Cold compress on the cheek for swelling.
• Over-the-counter pain relief: ibuprofen or acetaminophen (paracetamol), following the label dose. Do not put aspirin directly on the gum, which burns the tissue.
• Numbing gels with benzocaine for short-term relief of ulcers. Not for children under 2.
• Chlorhexidine mouthwash for a short period helps control plaque. It can stain teeth with long use.
• Avoid irritants: spicy and acidic foods, alcohol-based mouthwash and tobacco.

Professional treatment

• Scaling and cleaning to remove plaque and tartar, and deep cleaning (root planing) for periodontitis
• Draining an abscess, with root canal treatment or extraction
• Irrigation and sometimes antibiotics for pericoronitis, and removal of the wisdom tooth if it keeps recurring
• Adjusting braces, dentures or rough fillings
• Gum surgery for advanced periodontitis

Frequently asked questions

What causes pain in the gums?

The most common causes are gingivitis from plaque, brushing too hard, canker sores, food stuck between teeth and erupting wisdom teeth. Throbbing pain with swelling usually means an abscess. Hormones, dentures, braces and vitamin deficiencies can also cause sore gums.

Why does my gum hurt around one tooth?

Pain around one tooth often comes from trapped food, a gum abscess, an infected tooth nerve, a cracked tooth or a rough filling edge. If pain lasts more than a few days or you see swelling, see a dentist.

How can I relieve gum pain at home?

Rinse with warm salt water several times a day, brush gently with a soft brush, use a cold compress for swelling, and take ibuprofen or acetaminophen following the label. Avoid spicy foods, alcohol and tobacco. See a dentist if it does not improve within a week.

Can sore gums be a sign of something serious?

Usually not, but they can signal an abscess, advanced gum disease, vitamin deficiency or, rarely, leukemia or oral cancer. Sore gums with fever, spreading swelling, unexplained bruising, or a sore that will not heal need prompt care.

Should I stop flossing if my gums hurt?

No. Sore or bleeding gums usually mean inflammation from plaque, and gentle daily flossing helps them heal. Use a gentle technique, curving the floss around each tooth. If pain persists after 2 weeks, see your dentist.