Painful Gums – Causes of Gum Pain, Tenderness

Painful gums may be caused by local gum or mouth disease, injury, or a manifestation of other more generalized conditions. Although gum disease is a very common cause of gum pain, it is often a late symptom of gingivitis. Bleeding and/or swollen gums are more likely to precede gum pain. For this reason, even transient or mild gum pain should be investigated as soon as possible so that the cause can be rectified without delay.

Causes of Gum Pain

Gum Causes

  • Gum disease such as gingivitis and periodontitis produce swelling and gum bleeding in the initial stages. Pain in the gums is usually a late feature
  • Trench mouth. Sore, painful gums develop fairly early in this condition. It is a rapidly progressive gingivitis which needs immediate attention
  • Vigorous brushing or flossing may result in gum pain, especially if the gums are diseased
  • Mouth sores or aphthous ulcers
  • Gum boil

Tooth Causes

  • Teething in babies, and later in children, can cause sore painful gums due to the teeth trying to break in through the gums
  • Impacted tooth is when the tooth erupts at a wrong angle
  • Pericoronitis is caused by impacted or a not fully erupted wisdom tooth
  • Dental caries (tooth cavity)
  • Tooth abscess
  • Tooth root sensitivity
  • Immediately following a tooth extraction
  • Dry socket – painful gums develop 2 to 4 days after a tooth extraction (usually of the lower jaw). The tissue around the socket may become extremely tender.
  • Biting on a cracked tooth can produce severe pain
  • Malocclusion of teeth or bite problem
  • Bruxism or habitual grinding or clenching of teeth

Injury to Gums

  • Trauma – blow, fall or other accidents
  • By ill-fitting dentures, braces or other mouth appliances
  • Impacted food particles, sharp-edged foods, or other foreign objects
  • During dental or orthodontic procedures
  • Hot foods can cause burns on roof of the mouth and gums
  • Aspirin burns caused by rubbing aspirin tablets directly on the gums in an effort to reduce pain


  • HIV
  • Fungal infection like oral candidiasis
  • Viral infection like acute herpetic gingivostomatitis

Nutritional Causes

  • Severe nutritional deficiencies
  • Scurvy – vitamin C deficiency
  • Vitamin B12 deficiency


  • Oral cancer
  • Leukemia
  • Chemotherapy for cancer treatment

Other Causes

  • Zimmerman-Laband syndrome is a rare inherited condition characterized by fibrosis of gums and abnormalities of ear, nose, nail and finger
  • Hand, foot and mouth disease
  • Medication such as phenytoin and cyclosporine
  • Pregnancy gingivitis
  • Pregnancy tumor
  • Lichen planus (a skin condition) sometimes causes white streaks and sores in the gums, which may be painful in rare cases. Lichen planus in the mouth is sometimes due to an allergy to mercury fillings in the teeth
  • Systemic lupus erythematosus (SLE)

Pain Originating Elsewhere

  • Temporomandibular joint disorders may cause pain that may simulate gum pain
  • Sinusitis (usually of the maxillary sinus) can cause dull pain of the upper back teeth and gums
  • A heart attack or angina pain is sometimes referred to the jaw, gum or tooth
  • Ear infection
  • Facial pain – trigeminal neuralgia

Related Articles

  1. Swollen Gums
  2. Bleeding Gums
  3. Mouth Pain

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