Swollen Gums: Gingivitis, Gum Disease and What to Do

In short: Gingivitis — red, puffy gums that bleed on brushing — reverses completely with professional cleaning and better daily care. Periodontitis destroys the supporting bone, which does not grow back. Brushing harder makes it worse; thorough gentle cleaning along the gumline plus scaling is what works. Bleeding gums are never normal.

Swollen gums are the most-ignored symptom in dentistry, because gum disease does not hurt until it is advanced. By the time it does, the damage is often permanent. The early stage, however, reverses completely.

The two stages

Gingivitis. Gums are red, puffy and bleed when brushed. The inflammation is confined to the gum. This stage is fully reversible with professional cleaning and better daily cleaning.

Periodontitis. Inflammation has reached the bone supporting the teeth, and that bone begins to recede. Pockets form between gum and tooth, teeth can loosen and drift, gums recede. Bone loss does not grow back. Treatment stops progression rather than restoring what is gone.

The line between them is why acting on bleeding gums early matters so much.

What causes it

• Plaque left along the gumline — the primary cause. It hardens into calculus, which cannot be brushed off.
• Smoking and tobacco, which both worsen gum disease and mask the bleeding that would have warned you.
• Diabetes, which has a two-way relationship with gum disease — each makes the other harder to control.
• Hormonal changes, including pregnancy.
• Certain medications that cause gum overgrowth.
• Food trapping around an overhanging filling or crown edge.

Why brushing harder makes it worse

Bleeding gums make people brush harder, which damages the gum and wears the tooth surface without removing the deposit causing the inflammation. What removes it is thorough cleaning along the gumline with a soft brush, plus daily cleaning between the teeth. Hardened calculus needs a dentist.

What treatment involves

For gingivitis: professional scaling and polishing, plus a technique correction. Often that is all it takes.

For periodontitis: deep cleaning below the gumline, sometimes across several visits, sometimes with a periodontist involved and occasionally with surgery. It is ongoing management rather than a one-off fix.

See a dentist promptly if

• Gums bleed regularly when you brush
• You have persistent bad breath alongside
• Gums are receding or teeth look longer
• Teeth feel loose or have moved
• There is pus, or a swelling that comes and goes

Getting assessed

Every dentist on EnamDoc is verified against their dental council registration before they can take a booking. Related: bleeding gums.

General information, not a diagnosis. Gum disease is diagnosed by examination and measurement, not by symptoms alone.