Gum pain

Nicole Wendler holds a PhD in biology in the field of oncology and immunology. As a medical editor, author and proofreader, she works for various publishers, for whom she presents complex and extensive medical issues in a simple, concise and logical manner.

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Gum pain can affect anyone, from toothless babies to old people with dentures. The pain is caused by inflammation of the gums and is often associated with bleeding gums. Read here about inflammation triggers, what you can do yourself against gum pain and when dental treatment is necessary.

Gum pain: description

The gums (gingiva) are part of the oral mucosa and, as part of the teeth holding apparatus, surrounds each individual tooth. The multilayered squamous epithelium is divided into free and attached parts:

The free gingiva sits loosely at the base of the tooth, forms a gum line about one to two millimeters thick and can be easily pushed back.
Fixed gingiva, on the other hand, is fused with the bones of the upper and lower jaw (alveolar process).

Gum pain can occur in all areas of the mouth. The affected areas usually feel sore, burn or are red and swollen (edema = accumulation of fluid in the tissue). The gums may pulsate or bleed. It is not uncommon for gum pain to be associated with bad breath (halitosis).

Other common side effects are aphthae (painful blisters in the lining of the mouth), white spots, a furry feeling and an altered sense of taste. In severe cases, gum pain can also cause a fever.

Gum pain: causes and possible diseases

If you suffer from gum pain, inflammation in the mouth is always the trigger. Either the gums have been injured by mechanical stimuli or an infection with viruses, bacteria or fungi is to blame for the inflammation. In both cases, connective tissue and blood vessels react with reddening, swelling, heat development and pain. Wounds make it easy for the pathogens to settle and multiply, which is why an injury is often followed by an infection. In rare cases, autoimmune reactions or benign and malignant neoplasms can also cause pain in the gums.

Gum injury from external mechanical stimuli

Various external causes can cause injuries to the gums, often with subsequent gum pain:

Brush teeth
Using dental floss
Braces, dentures, artificial teeth
Trauma (injuries)
hot, spicy food

Injury to the gums from internal mechanical stimuli

Internal factors can also cause injuries to the gums:

Tooth growth / eruption
Wisdom teeth (dens sapiens): Pain in the growth phase, due to inflamed gums around the tooth, after surgical removal

Infection of the gums

Gum pain is often caused by infections. Their triggers can be:

Bacteria such as streptococci, fusiform bacteria: gingivitis (in severe cases: necrotizing ulcerative gingivitis or periodontitis), syphilis
Viruses such as Herpes simplex type 1 (cause of oral rot = stomatitis aphtosa), cytomegalovirus, Eppstein-Barr virus (cause of Pfeiffer's glandular fever)
Fungi such as Candida albicans (cause of oral thrush / mouth fungus = oral candidiasis, stomatitis mycotica)

Gum pain due to disturbed oral flora

It is quite normal for our mouths to be teeming with microorganisms. The degree of acidity (pH value), enzymes and antibodies in the saliva as well as regular tooth brushing ensure that the number of germs does not get out of hand. However, the following factors and diseases can unbalance the microenvironment, promote bacterial deposits (plaques) and promote gum inflammation (with subsequent gum pain):

poor oral hygiene
hormonal changes (e.g. during pregnancy: pregnancy gingivitis)
Medication (prolonged use of antibiotics, cytostatics as part of chemotherapy)
Luxury foods: nicotine, alcohol
stress
Food: cheese, citrus fruits, pineapple
Malnutrition: vitamin deficiency (scurvy, vitamins A, B, C), iron or folic acid deficiency
genetic predisposition
Immunodeficiency (as with HIV)
Metabolic disorders (such as diabetes mellitus)
malignant diseases (cancer)
Allergies
Autoimmune diseases: pemphicus vulgaris, Sjogren's syndrome, lupus erythematosus, celiac disease
Lichen planus mucosae (presumably virus-induced autoimmune reaction)
Crohn's disease (inflammatory bowel disease)

Gum pain: when to see a doctor?

If the gum pain persists, you should see a dentist. Because there is then, for example, the risk that gingivitis will develop into parodonditis, which attacks the bone and, in the worst case, leads to tooth loss.

You should also seek medical treatment if you have prolonged bleeding from your gums, which interferes with your food intake.

It can also be dangerous if the pain in the gums is accompanied by a fever: There is a risk of sepsis (generalized bacterial infection, "blood poisoning").

Gum pain: what does the doctor do?

If an injury is the cause of the pain in the gums, your dentist will prescribe a locally numbing, pain relieving mouth rinse or ointment.

If the gum pain is caused by an infection, the germ count should first be reduced with a professional tooth cleaning (PZR). In addition, your dentist can clean gums and gingival pockets using lasers or ultrasound.

Sometimes it may be necessary to remove inflamed tissue surgically or mechanically with a sharp instrument (curettage). Nowadays this is less painful and gentler with the use of a laser. Your doctor may then prescribe medication with antibiotic, antiviral or antifungal active ingredients - that is, medication that is effective against bacteria, viruses or fungi.

For gum pain due to an erupting wisdom tooth, surgery is often the only solution.

If the gum pain is triggered by disease-related reactions (autoimmune, allergic), these can sometimes be inhibited with medication.

Gum pain: you can do it yourself

In our mouth there is a pleasant environment for fungi, bacteria and viruses. Small spaces and niches are an ideal place to live for microorganisms. It is always pleasantly warm and humid, and leftover food provides the necessary energy for growth. This is how the germs multiply and form clusters called plaques. Those who regularly and conscientiously care for their teeth can reduce these deposits and ultimately prevent subsequent gum pain. Proper oral hygiene includes:

Regular, correct brushing of teeth (children under supervision)
regular replacement of old toothbrushes
Using dental floss
Applying a mouthwash
Using a tongue brush
Proper care and cleaning of dentures and braces
Dental prophylaxis with professional teeth cleaning (once or twice a year)

If you suffer from gum pain, you must not neglect the prophylactic measures mentioned. Mouthwashes, ointments or tinctures with locally anesthetic or antibacterial agents (chlorhexidine) from the pharmacy can alleviate symptoms.

Applications from the medicine cabinet can also help: rinsing with chamomile, sage, myrrh, cloves, oak bark or ribwort have anti-inflammatory effects, for example, while salt water and black tea relieve the swelling. Important: Even if gum pain makes brushing uncomfortable, you should not neglect dental hygiene.

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