Gum Infection

Symptoms of gum infection include pain, swelling, and bleeding. The condition may result from many distinct conditions – this article will cover issues including the signs and symptoms of gum infection, partially erupted or unerupted wisdom teeth, infections after tooth removal, periodontal disease, necrotising ulcerative gingivitis (NUG), and viral infections.

Signs & Symptoms of Gum Infection

The signs and symptoms of gum infection and gum disease are wide ranging and may appear to be linked to alternative issues, meaning the time to act may be put back by the patient.

For example, hormonal changes during adolescence, pregnancy, the menopause, or whilst taking prescribed medications (including the oral contraceptive pill) are known to have an effect on oral health that mirrors some symptoms of gum infection (e.g. bleeding gums).

For this reason, patients may choose not to act, believing the issue to be temporary. However, acting fast can help to prevent oral health issues from developing.

Signs & Symptoms of gum infection include:

  • Pain and localised swelling*
  • Redness (i.e. discolouration of the gums)
  • Unexplained bad breath or a bad taste in the mouth
  • Blood in the spit when brushing, or the taste of blood in the mouth during the day
  • Receding gums, noticeably exposing the tooth root that usually sits below the gum

* Pain in the teeth that are in close proximity to the swelling may be experienced when biting. Trismus (stiffness in opening/closing the mouth, also known as lockjaw) can also occur.

Unerupted wisdom teeth and gum infection

Wisdom teeth are also known as third molars – molars are the large flat ‘chewing’ teeth at the rear of the mouth. Wisdom teeth typically erupt during late adolescence but complications arise where there is not enough room in the mouth to accommodate the tooth. This can mean that the tooth either partially erupts or is entirely prevented from erupting.

  • Partial wisdom tooth eruption and gum infection
  • Where a wisdom tooth is blocked from erupting fully (by pressing against a second molar, for example), the partial eruption can lead to difficulties in keeping the congested area clean. This increases the likelihood of pericoronitis (an accumulation of bacteria in the affected area of the gum, heightening the risk of infection).

    A partial eruption can also lead to the development of a small flap of gum called the operculum (partly covering the new tooth). This flap of gum provides the ideal cover and breeding grounds for bacteria – which can accumulate in the area if not cleaned thoroughly on a regular basis, leading to gum infection.

  • Unerupted wisdom tooth and gum infection
  • The wisdom tooth develops within a sac inside the jaw. Where the tooth does not erupt, the sac can fill with fluid, forming a cyst. Left untreated, this cyst can damage the jawbone, surrounding teeth, gum tissue, and lead to gum infection. Under rare circumstances, a tumour can also develop as a result of an unerupted wisdom tooth.

Symptoms of a partially erupted or non-erupted wisdom tooth include swelling in the affected side of the face, spasms in the surrounding muscles, and swollen lymph nodes under the jaw. These symptoms should be treated immediately by a dentist to ensure that further complications and gum infection do not lead to more serious irreversible issues.

Infections after tooth removal and gum infection

Tooth removal may be carried out under a wide variety of circumstances, with typical factors including overcrowding and tooth decay. Where a tooth is removed, a clot must be allowed to form in the socket so as to reduce the risk of gum infection. The oral surgeon will advise the patient on methods of reducing the risk of gum infection.

Methods of reducing risk of gum infection after tooth removal include:

  • A gauze pad will be provided – bite down on the pad, changing the pad only when saturated with blood. The final pad should be left in pace for up to four hours to allow the clot to form in the socket.
  • Do not rinse the mouth out for 24 hours (this will decrease the likelihood of accidentally dislodging a clot that is not yet fully formed).
  • Avoid hard foods during the healing process – stick to soft food to allow the gum to heal.
  • Lying flat can increase the length of time that bleeding takes to stop. When sleeping, use pillows to prop the head up slightly.
  • Clean the teeth as usual, and clean the tongue – avoid brushing the removal site.

Tooth removal can result in up to 24hours of intermittent bleeding, swelling, and pain. Always make an appointment to see the dentist if severe pain persists for a period of more than four hours.

Periodontal disease and gum infection

Advanced gum disease occurs where a build-up of bacteria in the mouth leads to gum irritation and swelling, pulling the gum away from the tooth and opening pockets in which bacteria can thrive. Where the bacterial infection spreads below the gumline, periodontal disease (or periodontitis) sets in, affecting the gum, tooth, and structures supporting the tooth.

Where periodontal disease is not treated, the alveolar bone – or jaw bone – in the affected area will undergo a gradual disintegration. The dentist will remove plaque and calculus from the affected tooth, and offer advice on a regular cleaning routine that will include brushing (potentially involving the use of an interdental brush) and flossing.

Necrotising ulcerative gingivitis (NUG) and gum disease

‘Necrosis’ is a medical term used to describe the death of living tissue. Necrotising ulcerative gingivitis (NUG) is a type of periodontal disease affecting the gums. NUG is associated with gum disease and the loss of gum structure between the teeth. Patients report symptoms of pain that gets worse when chewing, and bleeding that may occur seemingly at random or when eating/brushing. NUG is also associated with fever and a bad taste in the mouth or bad breath.

Left untreated, the condition may progress to necrotising periodontitis, where the loss of gum structure leads to teeth becoming loose, and even exposed bone.

Cases of NUG must be treated by a dentist as soon as possible. Initial treatments may include pain relief, antiseptic mouth rinses, and antibiotics, followed by surgical procedures where necessary – e.g. gingivectomy (the removal of gum tissue) or gingivoplasty (reshaping the gums).

Viral infections and gum disease

Viral infections can also lead to gum disease. For example, oral herpes can lead to symptoms such as inflammation and sores on the lips, inside cheek, palate, and gums. This build-up of unfriendly bacteria can easily progress to gum disease if not treated – always seek dental assistance in cases of oral herpes (antiviral medications and creams can help to stop the spread of the virus and reduce the total time required to heal).

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