What are the treatment options for gum swelling after biting a chip?

Treatment of Gum Swelling After Biting a Chip

For gum swelling caused by mechanical trauma from a chip, immediately rinse the mouth with warm saline solution (1 teaspoon salt and 1 teaspoon baking soda in 4 cups water) at least 4 times daily, and remove any visible foreign material lodged in the gingival tissue. 1, 2

Immediate Management

Initial Examination and Foreign Body Removal

• Perform immediate visual inspection of the entire oral cavity after cleansing with water or saline to identify any embedded chip fragments. 1
• Manually remove any visible foreign material from the gingival crevice using gentle technique—avoid blind finger sweeps that could push fragments deeper into tissue. 1
• If fragments are embedded in gingival tissue and visible, a periodontal curette may be needed for removal, which requires dental referral. 3

First-Line Symptomatic Treatment

• Rinse vigorously with bland saline solution (1 teaspoon salt, 1 teaspoon baking soda in 4 cups water) at least 4 times daily to reduce inflammation and promote healing. 2
• Use alcohol-free antimicrobial mouthwash (0.2% chlorhexidine) to reduce bacterial load and prevent secondary infection. 1, 2
• Avoid commercial mouthwashes containing alcohol, as they cause additional pain, irritation, and impair healing. 2

Pain Management

• Provide over-the-counter oral acetaminophen or NSAIDs (such as ibuprofen 400mg) for residual discomfort. 1
• Topical benzocaine may be used for localized pain relief, but should not be used for more than 7 days. 4

Oral Hygiene During Healing

• Continue brushing teeth twice daily using a small, ultra-soft-headed, rounded-end bristle toothbrush, being gentle around the affected area. 2
• Maintain the saline rinse regimen to keep the area clean and promote healing. 2

Red Flags Requiring Dental Referral

Immediate Referral (Same Day)

• Extensive gingival or facial swelling develops. 5
• Foreign body sensation persists despite negative visual examination and saline rinses. 1
• Inability to remove visible embedded fragments. 3

Urgent Referral (Within Days)

• Gingival swelling does not improve within 7 days. 4
• Development of a parulis (gingival abscess or "gum boil") adjacent to the affected area. 5
• Persistent pain or redness that worsens despite treatment. 4
• Fever, rash, or signs of spreading infection develop. 4

Critical Pitfalls to Avoid

• Do not perform blind instrumentation or finger sweeps in the gingival sulcus, as this can push foreign material deeper or cause additional mucosal injury. 1
• Do not use petroleum-based lip products on affected areas, as they promote mucosal dehydration and create an occlusive environment that increases secondary infection risk. 2
• Avoid relying solely on visual examination if symptoms persist—embedded radiolucent chip fragments may not be visible and could require imaging. 1
• Do not continue topical anesthetics like benzocaine beyond 7 days without dental evaluation. 4

Expected Timeline

• Minor gingival trauma from chips typically improves within 7 days with proper saline rinses and oral hygiene. 4
• If no improvement occurs after 1-2 weeks of treatment, reevaluation by a dentist is necessary to rule out retained foreign material or secondary infection. 2