What is the treatment for swollen gums?

Treatment for Swollen Gums

The primary treatment for swollen gums is mechanical removal of bacterial plaque through proper oral hygiene, not antibiotics, as gingivitis is reversible with good dental care alone. 1, 2

Immediate Management Approach

First-Line Treatment: Mechanical Plaque Control

• Use a soft toothbrush (ultra-soft-headed, rounded-end bristles) to brush teeth twice daily after meals and at bedtime using the Bass or modified Bass method 3
• Clean with mild fluoride-containing, non-foaming toothpaste to reduce bacterial load and strengthen enamel 3
• Rinse mouth with alcohol-free mouthwash at least four times daily for approximately 1 minute, then spit out (avoid eating or drinking for 30 minutes after rinsing) 3
• Replace toothbrush monthly to maintain effectiveness and prevent reinfection 3

Adjunctive Measures

• Rinse vigorously with bland saline solution (1 teaspoon salt, 1 teaspoon baking soda in 4 cups of water) several times daily to remove debris and reduce plaque accumulation 3
• Avoid alcohol-based mouthwashes as they can dry oral tissues and worsen inflammation 3
• Maintain adequate hydration by drinking ample fluids to keep the mouth moist 3

When to Escalate Care

Refer to Dentist/Periodontist If:

• Swelling persists despite 7-10 days of proper oral hygiene 3
• Signs of periodontal disease develop: deep pockets around teeth, tooth mobility, or bone loss 2, 4
• Systemic symptoms appear: fever, lymphadenopathy, malaise, or cellulitis 3, 5
• Gingival bleeding continues beyond 2 minutes after flossing 3

Antibiotic Therapy is NOT Indicated

• Do not prescribe antibiotics for uncomplicated gingivitis as they provide no benefit over mechanical debridement alone 3, 5
• Antibiotics are only appropriate when systemic involvement is present (fever, diffuse swelling, lymphadenopathy) or in medically compromised patients 3, 5

Specific Clinical Scenarios

For Chronic Periodontitis (Advanced Disease)

• Scaling and root planing is the definitive treatment performed by dental professionals 3
• Sub-antimicrobial dose doxycycline (20 mg twice daily for 3-9 months) may be used as adjunct to mechanical therapy only in established periodontitis 3
• Do not use systemic antimicrobials for routine chronic periodontitis or peri-implantitis 3

Dietary and Lifestyle Modifications

• Avoid irritating foods: tomatoes, citrus fruits, hot drinks, spicy foods, raw or crusty foods 3
• Eliminate tobacco and alcohol use as these worsen gingival inflammation 3
• Consume low-sucrose diet to reduce bacterial substrate 3

Common Pitfalls to Avoid

• Never prescribe antibiotics without surgical/mechanical intervention for dental infections, as this is ineffective and promotes antibiotic resistance 5
• Do not start interdental cleaning (flossing, interdental brushes) if the patient is not already doing so regularly, as this can break the epithelial barrier and cause bleeding 3
• Avoid petroleum-based lip products (vaseline) for chronic use, as they promote mucosal dehydration and increase infection risk 3
• Do not use glycerin or lemon-glycerin swabs as they dry the mouth rather than moisturize 3

Follow-Up

• Schedule dental evaluation within 1-2 weeks if symptoms do not improve with proper oral hygiene 3
• Maintain dental follow-ups every 6 months minimum for ongoing monitoring 3
• Monitor for progression to periodontitis: gum recession, tooth mobility, or deepening pockets around teeth 2, 4