Swollen Gums & Gum Abscess

San Antonio Dental Office

Swollen Gums are Scary!

Not only does waking up to swollen gums feel scary, it can also be painful. Swollen gums are a key symptoms of a serious gum infection. What does the swelling of a gum infection look like? The swelling may look like puffiness, a pus-filled gum abscess or hard bubble on gum surface. Swelling isn’t the beginning of the problem. It can seems like the first sign of infection, but it is NOT the first stage of infection. Swelling tells us that the infection is exploding. If you have an exploding gum infection, you need answers to these important questions: Why are my gums swollen? What are the gum abscess stages? How do I fix it before it creates a much bigger problem? If you have an abscess, you need to know more. Keep reading.

gum infections and abscess can be associated with a lot of oral pain

Why are my gums swollen?

Swelling Is the #1 Sign of a Gum Abscess.

You’ve seen swelling from infections before. We’ve all had infected cuts that start out red, begin to swell, get hot, and finally start producing pus. If your gums are swelling, you probably have had an infection brewing there and it’s finally announcing itself. With gum infection, swelling happens first sometimes. Other times, people get surprised by an abscess, pus or a bubble on their gums. Just remember, infection always causes swelling.

Can Swollen Gums Be a Sign of Other Problems Besides an Abscess?

Yes, they can – Good question. Infections may always have swelling, but not all swelling is aninfection. Here are the other things that cause gum swelling:

  • Injury – Examples Include:
    • Cuts from hard or sharp foods
    • Burns (think pizza burn)
    • Sores from Dentures or Partials putting pressure on the gums
    • Facial trauma
  • Allergic Reaction
  • Autoimmune Conditions


Gum Infections, Gum Abscess, Swollen Gums, Bubble on Gum

How to tell the difference between infection swelling and other swelling?

Firstly, you usually know if you have been cut, burned or injured. You also usually know if your denture is making you sore. Most people can also tell when they are having an allergic reaction.

The swelling most often confused with infection is the auto-immune swelling. It looks a lot like infection swelling only it doesn’t produce pus. If you’re not absolutely positive that your swelling is NOT an infection, go in and see your dentist to make sure. Gum infections are dangerous for more than just your teeth and it’s not worth the risk!

What are the Gum Abscess Stages?

Stage #1: Invisible Infection

Gum abscesses are like undercover agents. They start as bacteria sneaking quietly under the gums: invisible and painless. Once they are under the gums, they make plans to take over. So tricky! This is usually the stage when a dentist will diagnose someone with gingivitis. You may notice your teeth bleeding when you brush.


red puffy bleeding gums

Stage #2: Swelling & Spreading

Once those sneaky bacteria have set up a home base, they begin to multiply and spread. Eventually, they put so much pressure on the local tissue that it kills the surrounding gums and bone. If they aren’t stopped by a dentist, these bacteria will just continue to spread, kill and destroy. At this stage, a dentist will be able to measure the gum attachment loss when they perio chart and the bone loss will be visible on an x-ray. You may not feel any pain, but you definitely notice bleeding when you brush and floss and your gums are probably more red than pink. This is also the stage that the swollen gums start even though it isn’t usually noticable at first.


gum disease

Stage #3: Gathering Pus Storm

Eventually the spread of the bacteria becomes obvious. They’ve multiplied to the point that they can’t hide anymore and your body is fighting them with everything it’s got. This when you might see a bubble on your gum. It’s when the swelling and pus become obvious. You may feel nothing or you may feel pressure or even intense pain. What you feel depends on whether the infection finds an outlet to relieve the pressure. This is the gum abscess stage when the damage moves from local to global.

Gum Disease

Stage #4: Active Invasion

If an abscess isn’t treated, it will continue to grow and spread until it finds an outlet. When the outlet goes through the gums into the mouth, you see pus draining from a bubble on the gum. If the outlet goes through the bone horizontally, the infection will spread to neighboring teeth. If the infection pushes deeper into the bone, it will eventually reach the blood stream and from there, the rest of the body. In this stage, you are looking at three possible kinds of damage, a messy mouth, more damaged teeth or a dangerous systemic infection throughout your body.

Stage #5: Bone Craters, Tooth Loss and Brain Infections

Infection isn’t an orderly thing though. Sometimes it causes all three kinds of damage. The end result of an untreated abscess is always some degree of cratered, destroyed bone, as well as one or more loose teeth. In addition, if the infection reaches the blood stream, it can mean brain or heart infections and coma. In third world countries, dental abscesses are still one of the leading causes of adult deaths. It’s that serious. Even in America, I have met dentists who have had patients ignore an abscess and end up with a brain infection in the hospital. If you choose to ignore a dental abscess, you may or may not end up in the hospital, but you will certainly end up with a damaged mouth.

Periodontal dentistry

How Do I Get Rid of the Gum Abscess?

Hope Is NOT a Plan (and neither is garlic)

In dentistry, as in investing, hope is not a plan. If you read the section on gum abscess stages, then you know that ignoring an infection in hopes that it will go away is like ignoring termites hoping that they’ll eventually just move out. Unfortunately most natural cures fit into the hope category as well. Garlic and oils won’t fix an abscess and neither will salt water rinses or mouthwash. It’s not that they won’t have any effect at all – many natural products have antibacterial properties. The problem lies in how well those products can reach the infection. ANY antibiotic has to reach the source of the infection in order to be effective. Putting anything ON swollen gums when the infection is deep into the bone cannot fix the actual infection. Well, if home remedies and waiting won’t fix it, what will? Keep reading – infections are like termites.

Ending an Abscess Is Like Treating Termites: Kill the Bugs, Remove the Damage

How do you get rid of termites? You have to kill the bugs and get rid of all the rotten wood they are feeding off of and living in. How do you get rid of an abscess? You kill the bacteria and remove the infected and damaged tissue they’ve been eating and living in.

Killing the bacteria requires an antibiotic that will reach the infection at it’s source. Removing the dead and damaged tissue requires either an extraction of the tooth that the infection surrounds or a periodontal surgery to clean out the damaged bone and gums.

“I took the antibiotic and it took care of the bubble on my gum. That’s all I needed!”

I hear this a lot. Patients come in with badly swollen gums, an abscess or a bubble on the gum. After the initial antibiotic treatment, the swelling is gone and the pus has stopped. They think their problem is solved and don’t bother to return to get the damaged tissue removed. Problem! What did I tell you – fixing an abscess permanently means killing the bacteria AND removing their food source and home. If you don’t remove the dead and destroyed tissue, other bacteria will move in after the antibiotic wears off and the abscess comes back with a vengeance. Don’t be fooled after antibiotics alone. You’re asking for a second abscess.

What Happens If I Don’t Treat My Swollen Gums?

There Are a Number of Possibilities – Here Are the Ones I’ve Seen:

If you read up above about the five stages of a gum abscess, then you already know what happens to an untreated abscess. Here’s what I’ve seen and heard of from other doctors.

  • The abscess spreading to other teeth
  • The infection destroings bone around multiple teeth
  • Teeth getting loose and falling out on their own
  • Bone full of holes like Swiss cheese
  • The infection getting to the whole body via the blood
  • People ending up in a coma
  • Infected hearts and joint replacements
Gum Disease swollen gums gum abscess

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