Pain in the gums

introduction

Gum pain can have several causes. In general, a distinction is made between diseases of the gums, including the gums, and dental diseases that only radiate to the gums.

If there is slight pain in the gum area, optimizing oral hygiene can in many cases be sufficient to achieve freedom from symptoms.

However, patients who frequently experience pain in the gums or who notice additional symptoms such as swelling, discoloration or bleeding should consult a dentist as soon as possible. Pain in the gums is one of the most common complaints that lead to a visit to the dentist, and it is often caused by inflammation of the gums. The so-called gingivitis

The most important risk factors for such diseases include smoking, frequent consumption of alcohol and poor oral hygiene. Genetic factors also play a decisive role in the development of pain in the gum area

Read more on the topic: Inflammation of the gums - Recognizing and treating

causes

There can be a variety of causes for the occurrence of pain in the gum area. Some of the conditions that cause gum discomfort are relatively harmless and easy to treat. Other causes, however, are more serious and require extensive therapy. The causes include:

• Caries
• Inflammation of the gums
• Exposed tooth necks
• Periodontitis (inflammation of the teeth supporting structures)
• Bad oral hygiene
• Incorrect toothbrushing technique
• Toothbrush with bristles that are too hard

Inflammation of the gums

Inflammation of the gums (gingivitis) can be a possible cause of pain in the gums. The reason for this is mostly in poor oral hygiene. The inflammation then occurs due to toxins produced by bacteria in the mouth. These in turn come from so-called plaques, and attack the gums.

Inflammation of the gums often manifests itself as occasional bleeding when brushing your teeth, as well as redness and swelling. In the early stages, pain rarely occurs. A distinction can be made between acute and advanced chronic gingivitis. If left untreated, the latter harbors the risk of turning into periodontitis, an inflammation of the teeth supporting structure, which in the worst case can lead to tooth loss.

In addition to poor oral hygiene, stress, mechanical damage, e.g. Toothbrushes that are too hard, metabolic diseases or changes in the hormonal balance are the causes of gum inflammation. In many cases, the gingivitis can regress and heal through improved and better oral hygiene. The pain usually subsides after a few days.

Read more on the topic: Pain associated with inflammation of the gums

Periodontal disease

Periodontitis (often incorrectly called "parodontosis") is an inflammatory disease of the periodontium. In addition to the usual inflammation of the gums, periodontitis is one of the most common diseases of the oral cavity. Approximately every second person suffers at least once in the course of their life from inflammatory processes in the area of ​​the tooth support system.

In general, a distinction must be made between two forms of this disease. While so-called apical periodontitis starts from the tip of the tooth root, marginal periodontitis develops from the gumline. However, both forms lead to roughly the same symptoms (including pain in the gum area).

The most common cause of the development of periodontitis starting at the tip of the tooth root with pain in the gums is the transfer of bacterial pathogens or inflammatory mediators from a market-dead tooth to the individual structures of the periodontium.

So-called marginal periodontitis with pain in the gums is caused in most cases by the penetration of dental plaque under the gum line. Gum pockets arise.

In contrast to the usual inflammation of the gums, periodontitis is a more serious disease that urgently requires dental treatment.However, the risks of these two causes of gum pain development are similar. Inadequate or inadequately performed oral hygiene also plays a decisive role in periodontitis. Other risk factors include tobacco consumption, frequent mouth breathing, and untreated carious defects. In addition, inflammatory processes of the tooth supporting structure with pain in the gums can be caused by strong mechanical stress.

Read more on the subject; Periodontal disease

Exposed tooth neck

If the neck of the tooth is exposed, this means that the gums have retreated. It no longer provides any protection for the underlying dentine. In the dentine there are millions of dentinal tubules that are in direct contact with the tooth nerves (pulp). For this reason, the affected tooth reacts very sensitively to cold, hot, spicy or sour, as the stimuli reach the nerve directly. The pain often manifests itself on touch and can radiate into the surrounding gums.

Read more on the topic:

• Tooth neck is exposed - what to do?
• Receding gums

Wisdom tooth

The wisdom teeth are the last teeth to erupt in human dentition. For this reason, they often have too little space in the jaw and can cause pain, swelling or inflammation of the mucous membrane when they break through. Wisdom teeth that have not erupted can cause inflammation of the gums, which in the worst case can spread to the periodontal structures and consequently lead to periodontitis.

It can lead to severe swelling and pain around the tooth crown. In some cases, deep pockets of the mucous membrane form in which the bacteria can settle. It is often better to work with the treating dentist to consider pulling the wisdom tooth that is causing the discomfort.

Read more on the topic: Inflammation of the wisdom tooth

pregnancy

Gum pain often occurs during pregnancy. The pain is usually associated with swollen, reddened and sometimes bleeding gums when brushing your teeth. Due to increased and changed hormone levels during pregnancy, the oral mucosa is supplied with more blood. The gums become softer and the bacteria can penetrate the tissue more easily and cause local inflammation.

Read more on the topic: Bleeding gums during pregnancy

Risks

These risk factors increase the likelihood of gum pain:

• Frequent consumption of alcohol and nicotine
• Mouth breathing
• immunodeficiency
• pregnancy
• Frequent consumption of sweet and sour foods
• stress

therapy

The therapy in the presence of pain in the gum area depends primarily on the underlying disease. Depending on the cause of the complaints, the necessary treatment is more or less extensive.

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Therapy for gingivitis

Treatment of gingivitis with pain in the gums usually begins with a general prophylaxis session. During this session, the affected patient is shown with special staining procedures where oral hygiene should be optimized. This is followed by learning a suitable toothbrushing technique. This tooth-brushing technique is adapted to the special conditions within the oral cavity of the individual patient (for example, a crooked tooth).

A so-called professional tooth cleaning (PZR) can then be carried out. Professional tooth cleaning represents the actual treatment of gingivitis with pain in the gum area. During the PCR, every single tooth is scanned from all sides with special instruments (curettage). In this way, both soft plaque and hard deposits (tartar) can be removed from the tooth surface.

As an alternative to manual tooth cleaning, the plaque can be removed using a "sandblaster". The treatment of gingivitis with pain in the gums is not covered by health insurance. The cost of teeth cleaning is usually only partially covered by the statutory health insurance. For this reason, the patient has to pay at least part of the total costs himself. The price of a professional tooth cleaning is on average between 70 and 150 euros.

Read more on the topic: What helps with inflammation of the gums?

Therapy for periodontal disease

The treatment of periodontitis with pain in the gum area roughly corresponds to the treatment of a simple inflammation of the gums (gingivitis). A clear difference in the treatment of both diseases is the fact that professional teeth cleaning in the case of periodontitis must be done under the gumline. To ensure thorough cleaning of the tooth surface below the gums, two different methods can be used.

The open and the closed curettage.
The same hand instruments that are used for gingivitis treatment are used for closed curettage. To prevent excessive gum pain, the gums will be numbed locally before treatment begins.

Open periodontal therapy involves cleaning the tooth surface after opening and folding back the gums. In this way, the tooth surface lying under the gumline can be seen and impurities can be removed much more effectively.
However, open curettage is a method in which severe trauma and associated pain in the gum area can occur. In addition, there is a high risk of bleeding and infection due to the surgical opening of the gums.

Therapy for other causes

If pain in the gums is caused by a radiation emanating from a carious tooth, filling therapy should be started as soon as possible.
During this treatment, the carious defects are removed with small dental drills and the affected tooth is then provided with a filling material. In cases in which the carious defects go very deep, the medullary cavity can open during the removal of the carious defects. The result is irritation or, in the worst case, damage to the dental nerve fibers located in the medullary cavity. In these cases, nerve fibers often have to be freed from the tooth root to prevent the development of purulent processes that can lead to severe pain in the tooth and gums. In the specialist dental language one speaks of a so-called "root canal treatment"

Which cream helps?

Various ointments and creams are suitable for treating the symptoms at home. In general, it is very important to see a dentist for pain that lasts longer than a week, as in many cases this means advanced inflammation. Most creams available over the counter in pharmacies have analgesic and anti-inflammatory ingredients such as Dynexan oral ointment with the narcotic active ingredient lidocaine.

In addition, there are many other ointments that can help individually. The creams should be gently applied to the affected areas in the mouth. Ointments can provide the first relief for slight inflammation of the gums.

Read more on the topic: Ointment for inflammation of the gums

Home remedies

If inflammation of the gums is just beginning, various home remedies can help. Gargling and rinsing with chamomile tea or apple cider vinegar diluted in water or salt water can help to disinfect and relieve the symptoms. There are also various oils such as coconut oil, tea tree oil or walnut oil, some of which can be mixed with water and applied to the affected areas. Sage or myrrh are also used for gum pain. However, one of the most important home remedies is adequate oral hygiene. This includes the use of interdental brushes, a suitable toothbrush, dental floss, and tongue cleaners.

Read more on the topic: Home remedies for gum inflammation

Symptoms

Pain in the gum area is not a disease of its own. It is more a specific symptom that can indicate a variety of different diseases. In order to be able to diagnose the reason for the occurrence of pain in the gums, attention should be paid to the presence of certain accompanying symptoms.

The most common symptoms associated with gum pain include swelling, localized discoloration, and bleeding. In addition, in some cases, the presence of discomfort can be observed in other places within the oral cavity. Depending on the cause of the pain in the gum area, damage to the jawbone (for example, bone regression) can also be detected.

Pain in the gums with swelling

Gum pain can have various causes. If the gums are swollen in one or more places, the cause is usually inflammation. The typical symptoms of inflammation are swelling, redness, warmth, and pain in the affected area. As soon as any swelling is noticed on the gums, a dentist should be seen.

A swelling of the gums can be the first sign of inflammation that can easily spread to the teeth holding apparatus. This so-called periodontitis can lead to tooth loss. The dentist removes the plaque on the teeth and orders rinsing, for example with the bacteria-inhibiting solution Chlorhexamed®.

Read more on the topic: Chlorhexamed®

In addition to inflammation of the gums, stress, changes in the hormonal balance, e.g. During pregnancy, mechanical stimuli such as brushing your teeth too hard or thermal stimuli can be the cause of swelling.

Read more on the topic: Swollen gums

Pain in the gums between the teeth

The pale pink gums run like a garland along the tooth crowns and fill the spaces between the teeth, the so-called interdental spaces. The gums can also cause pain in these spaces. The most common reason is local inflammation of the gums. This is mostly caused by food residues left in the interdental spaces. The use of floss in daily oral hygiene is therefore very important.

To reduce the inflammation of the gums, an antibacterial mouth rinse available at the pharmacy can be used. Furthermore, caries in the interdental space, insufficient prosthetic restorations or periodontitis can be reasons for the pain between the teeth. In any case, a dentist should be consulted if the pain persists.

Pain in the gums during a cold

During a cold, the paranasal sinuses or the maxillary sinuses are usually very irritated or even inflamed. Due to the close anatomical proximity to the oral cavity, dull throbbing pains are usually perceived there when you have a cold. Often there is inflammation and, as a result, pain in the gums, as the immune system is severely weakened due to the common cold and bacteria can be fought less strongly.

Pressure sensitive gums

If the gums are very sensitive to pressure and the pain can be localized, the gums are usually inflamed. The reasons for an inflammation-related pressure sensitivity are often poor oral hygiene. Inadequate prosthetic restorations or excessive brushing of the teeth can also be the trigger. If the pressure sensitivity recurs frequently or persists over a longer period of time, a dentist must be visited to clarify the cause. If pressure sensitivity occurs, disinfectant mouthwashes can be used as a first step at home and the affected areas can be brushed gently with a soft toothbrush.

Pain in the gums with pus formation

The reason that pus forms is due to the buildup of bacteria that cause infection. The pus is initially below the gums and can escape when pressure is applied. Those affected usually feel a strong feeling of pressure locally. If pus emerges from a swelling of the gums, this can be a sign of a deep-seated inflammation in the area of ​​the roots.

Since the pus cannot drain there, the inflammation makes its way into the oral cavity. As soon as signs of a pus focus are noticed, a dentist must be visited immediately. This removes the pus focus and tries to find out the cause. Untreated gingivitis, for example, can also be associated with pus formation.

Read more on the topic: Inflammation of the gums with pus

After eating

Post-meal gum pain is common and not uncommon with sensitive gums. Cold, hot, spicy, or acidic foods can irritate the gums and cause pain. This is mainly the case when the gums are already irritated. The cause of the irritation should be found out. If the pain persists, it is advisable to consult a doctor

diagnosis

Before starting treatment for pain in the gums, the cause of this symptom should be clarified. In the course of this, extensive screening must be carried out. The screening of patients with complaints in the area of ​​the gums or the tooth support system includes both the survey of the current tooth status and the assessment of the individual components of the tooth support system.

In order to be able to make a meaningful statement about the condition of the gums, the treating dentist measures the depth of any gingival pockets that may be present. This measurement can be done in two different ways. The simpler, but much less accurate measurement method is the collection of the so-called periodontal screening index (PSI for short). With this method, representative pocket depths are recorded in each quadrant. The much more extensive but more precise measuring method is the survey of the pocket depths at six points around each individual tooth. In both procedures, the dentist pushes a narrow, scaled probe into a gap between the tooth substance and the gums. As a rule, the elevation of the pocket depths should be completely painless for the patient. In addition, the function of the gums and the tooth-supporting apparatus are not negatively affected in any way.

In patients with pronounced pain in the gums and demonstrably increased pocket depths, a special microbial test can be carried out to precisely determine the germs. In addition, an overview of the jaw (orthopanthomogram; short: OPG) should urgently be taken in these patients. The treating dentist uses the OPG as an aid in assessing the condition of the bone structures involved.

prophylaxis

Prophylaxis (prevention) of pain in the gum area involves improving oral hygiene and participating in a dental preventive program.
In general, teeth should be brushed three times a day, i.e. after every meal.

But not just the quantity but above all the quality of oral hygiene plays a decisive role in preventing pain in the gums. In particular, the interdental spaces are often neglected by most of the affected patients. To achieve effective cleaning of these interdental spaces, interdental brushes and / or dental floss should be used at least once a day. In addition, professional teeth cleaning should be carried out at regular intervals.

forecast

Diseases that lead to the occurrence of pain in the gum area need urgent treatment dental treatment. The reason for this is the fact that inflammatory processes within the oral cavity and their long-term consequences can negatively affect both facial aesthetics and chewing ability. In addition, bacterial pathogens that persist in large numbers within the oral cavity can sometimes penetrate the bloodstream and damage other organ systems.

Duration of pain in the gums

The duration of pain in the gums depends on the cause. If the pain is due to inflammation of the gums, it can subside after a few days, depending on the severity of the inflammation.However, if the inflammation can already be described as chronic, i.e. already advanced, treatment with included healing can take a longer period of time.

Since pain in the gums is mostly based on inflammation, the duration of the pain can be influenced by the extent of your own oral hygiene. If the cause of the pain is an incorrect brushing technique or an injury / irritation of the gums, with suitable countermeasures, rapid healing can occur within a few days.