Swelling of the gums (gingival swelling) is a common occurrence and is quite frequently accompanied by gum bleeding and/or pain and tenderness of the gums (refer to Bleeding Gums). Identifying the cause of swelling is essential for the proper treatment. If left untreated, it can progress to more severe conditions.
Normal healthy looking gums are pink, relatively firm structures that fit comfortably around the teeth. Soft and edematous (swollen) gums, along with pain or bleeding, is a sign of gum disease.
Hyperplasia of the gums (gingival hyperplasia) is a condition where there is overgrowth of gum tissue. The triangular-shaped portions of the gums between adjacent teeth, known as papillae, may become swollen, enlarged and protrude abnormally. In extreme cases, excessive swelling of the gums may overlap the teeth and cover it completely.
Gum swelling may involve only one or two papillae or there may be generalized swelling of the gums. It may develop gradually or may have an acute onset. The history often points to the cause of gum swelling.
Causes of Gum Swelling
Trauma (injury) to the gums is a common cause of swelling and may be due to causes like vigorous brushing. The swelling should resolve once the inflammation settles.
Mouth and Gum
- Gum disease is the most frequent cause of swollen gums. The inflammation produced in case of gingivitis and periodontitis results in swelling of the gums.
- Acute necrotizing ulcerative gingivitis (ANUG) may cause an acute, generalized, and rapidly progressive gum swelling.
- Mouth ulcers.
- Poor oral hygiene.
- Viral or fungal infection.
- Pericoronitis – inflammation of the gum tissue surrounding an impacted or partially erupted wisdom tooth.
- Gum swelling localized near one or two teeth may be caused by a tooth abscess.
- Impacted food particles between gums and the teeth.
Drugs and Toxins
- Gingival hyperplasia may be caused by medication such as phenytoin (for seizures) and nifedipine (antihypertensive).
- Mercury, lead or arsenic poisoning.
- Fetal valproate syndrome is a rare congenital disorder caused by exposure of the fetus to valproic acid (used to control seizures in the treatment of epilepsy) during the first 3 months of pregnancy. Amongst other features such as spina bifida, distinctive facial appearance and mental retardation, gum hypertrophy may be an additional feature.
Dental Appliances and Products
- Poorly-fitting dentures and other mouth appliances can cause gum swelling due to constant friction with the gums, and also due to trapped food particles within them which encourages bacterial growth and infection.
- Sensitivity to toothpaste or mouthwash.
- Hormonal changes occurring during pregnancy and puberty.
- Immuno-compromised individuals – those suffering from AIDS or cancer.
- People undergoing chemotherapy or radiotherapy.
- Involvement of gum tissue, causing swelling and other features, is a very common finding in leukemia.
- Oral cancer.
- Pyogenic granulomas or pregnancy tumors are benign vascular lesions in the mouth, often seen in the gum area during pregnancy.
Diet and Lifestyle
- Severe malnutrition.
- Prolonged and severe vitamin C deficiency (scurvy).
- Excessive smoking or tobacco chewing.
Serious systemic illnesses may result in swollen gums. This could be due to :
- Blood disorders
- Genetic conditions
- Infections like HIV
- Metabolic disorders
Sometimes, gingival hyperplasia may be idiopathic, meaning no cause can be identified.