Q: Why do I have a swollen gum around one tooth and what to do to make it better?
A: A swollen gum around one tooth can be due to many reasons. Firstly, identify the cause so you can treat it specifically and also prevent it from happening in the future. Then, be sure to follow all the tips mentioned below for optimum relief from that swollen, tender and bleeding gum around one tooth.
Causes Of Swollen Gum Around One Tooth
Swollen, tender and bleeding gums around one tooth are usually a sign of early gum disease and infection that needs to be addressed immediately in order to prevent progressing into an advanced stage that can leave catastrophic results.
Gum disease or periodontal disease (peri = around, odont = teeth) has two known stages; an early gingivitis stage and a later periodontitis stage. If the disease is not stopped at these stages, the inflammation can worsen and the infection can spread to the whole body through the blood stream. Pericoronitis is another infection of the gums that can occur at the time of wisdom tooth eruption.
There are other localized causes of swollen gums around tooth that need to be addressed separately. These include:
1. Swollen Gum due to Gingival Abscess:
There are three kinds of dental abscesses; gingival, periodontal and periapical abscess that can cause swollen gum around one tooth. Gingival abscess is caused by a bacterial infection that enters the gum after injury due to aggressive brushing, toothpick punctures, or ill fitted crowns and dentures. It can also be due to food that has been forced into the gumline and has rotted to the extent of inviting bacterial infection.
An abscess is extremely painful. You will notice a pus filled pimple on your gum. You might have fever with chills, vomiting and diarrhea. The dentist will probably drain the abscess and put you on antibiotics. Although symptomatic treatment may provide temporary relief, this is a serious condition that needs to be treated by a dentist as soon as possible.
2. Swollen Gum due to Canker Sores: 
Canker sores, mouth ulcers or aphthous ulcers develop on the inside of the mouth, on or under the tongue, inside cheeks or lips, on the soft palate or at the base of the gums. They are small, shallow lesions, round or oval with a white or yellow center and a red border. They are usually very painful and go away in a week or two. These are non-contagious compared to cold sores of Herpes virus that mostly occur on lips and are contagious.
They are more common in teens and young adults, and mostly females. Possible triggers of canker sores and thus swollen gum around one tooth include a minor injury from ill fitted dental work, overzealous brushing, sports mishap or an accidental cheek bite. Helicobacter Pylori infection and emotional stress can also contribute.
Canker sores are also a result of certain diseases like Celiac disease, ulcerative colitis, Crohn’s disease, Behçet’s disease and HIV infection.
3. Swollen Gums due to an Erupting Tooth:
Children whose permanent teeth are still erupting might experience sore gum around one tooth. Young adults whose wisdom teeth are about to erupt can also develop an infection of the gum flap (operculum) that overlies the partially erupted third molar or wisdom tooth. This infection is called Pericoronitis.
These teeth usually start erupting during late adolescence. Sometimes, there is not enough room for them, and they come in partially or not at all. This condition can lead to inflamed gum around one tooth.
Pericoronitis can be managed with antibiotics and warm salt water rinses, and the condition should go away in one week. However, if the partially erupted tooth fails to completely enter the mouth and food debris continues to accumulate under the flap of gums, pericoronitis will more likely return. If that happens, it may be necessary to have the overlying flap of gum tissue removed or in some cases, the wisdom tooth extracted.
4. Swollen Gums after Dental Fixtures and Implants:
Braces and other dental fixtures may contribute to worsening of gum disease by covering much of the tooth surface. That makes it difficult to clean the teeth and the gum line where the plaque biofilm stagnates.
For this reason, a variety of devices have been designed to help clean the teeth and gums more effectively. These include floss threaders (small probes that help get dental floss under wires), interproximal brushes (tiny brushes that can fit in the spaces between teeth), water flossers and electric toothbrushes that can effectively remove plaque from under fixed braces. Many of these devices also have built-in timers and special heads and tips that can navigate around orthodontic appliances. Sometimes, gum tissues also don’t like the proximity of the braces and react by swelling.
Peri-implantitis is a destructive inflammatory process affecting the gums and bones surrounding dental implants. It can lead to a swollen gum around one tooth. The array of pathogens found around failing implants are very similar to those found in various gum infections. There are gaps between the actual implant and the superstructure where bacteria can enter. For prevention, the interior spaces in the implants need to be sealed.
6. Swollen Gums due to Allergies:
Food allergies particularly to chocolate, coffee, strawberries, eggs, nuts, cheese, and spicy or acidic foods can cause inflamed or swollen gums around one tooth. Try to avoid foods that seem to irritate the gums or cause teeth sensitivity. These may include chips, pretzels, salty foods and acidic fruits like pineapple, grapefruit and oranges. Avoid gum irritants like tobacco, smoke, betel nut etc.
Cigarette smoking and tobacco chewing can be extremely damaging to your gums. You will find that smoking will increase your number of gum problems, from sensitive gums that bleed to painful sores. Mouth washes and toothpastes that contain sodium lauryl sulfate have also been linked with swollen gum around one tooth.
7. Swollen Gums due to Autoimmunity/Chemotherapy:
A faulty immune system that attacks healthy cells in the mouth can also cause swollen gum around one tooth. HIV/AIDS and Lupus which suppresses the immune system or drugs and radiation therapies that decrease body immunity also cause unpleasant side effects like swollen, tender and bleeding gums around one tooth. Many people undergoing cancer treatment get stomatitis which causes the development of painful sores and ulcers on the gums and throughout the mouth.
8. Swollen Gums due to Dietary Deficiencies:
A diet lacking in vitamin C, vitamin B-12, zinc, folic acid or iron can cause sore gum around one tooth.
9. Swollen Gums of Pregnancy:
Some women develop gum problems during puberty, menstruation, pregnancy and menopause. This is because of the rise in hormones that increases blood flow to the gums making them red, swollen, and sensitive. For women with menstrual gingivitis, the gums become red and swollen, and more likely to bleed shortly before each period, typically subsiding after the period begins. The use of oral contraceptives can cause similar swollen gum around one tooth. Though uncommon in menopause, some women may find their gums become extremely dry and sore. 
Pregnancy gingivitis typically starts in the second or third month of pregnancy and continues through the eighth month causing swollen, tender and bleeding gums around one tooth. If gingivitis is left unchecked, it may lead to a more serious periodontitis which increases the risk of preterm delivery.
Make sure to at least have one oral check up with your dentist during pregnancy, brush your teeth daily especially after vomiting during morning sickness and eat a well balanced diet. Gums will return to normal after delivery.
Tips For Quick Relief From Swollen Gum Around One Tooth
1. Proper Oral Care:
Time in and time out, it has been stressed to take very good care of your mouth not only because you want to look good when you smile, but also because you don’t want to have a foul breath or lose your teeth early and have sensitive teeth and sore gums all the time that makes it difficult to enjoy your favorite food and drinks.
- Brush your teeth with a soft bristle brush using circular movements, for two minutes, twice or thrice a day.
- Use a fluoride toothpaste in order to prevent early tooth decay.
- Floss regularly either with a string floss or water flosser.
- Rinse your mouth well with an anti-microbial mouth wash. Warm salt water (1 teaspoon table salt in 1 cup of water) or 3% hydrogen peroxide does wonders too.
2. Adequate Sanitation:
- Make it a habit to wash your hands thoroughly before you eat or touch your gums and teeth.
- Use a brush cover to guard your tooth from the dirt and germs in the air, not forgetting the fecal matter that gets sprayed into the air when you flush.
- Change your toothbrush every three months or early if you’ve been sick or the bristles have frayed.
- Remember to sanitize your toothbrush in 3% hydrogen peroxide every once in a while.
3. Cold and Hot Compresses:
Cold compress constricts the blood vessels and reduces the swelling around the gums whereas hot compress relieves pain effectively. Wrap some ice cubes in a wash cloth and place over the face above affected gum. This will help reduce the swelling. If you have pain, dip a clean wash cloth in warm water and place it on the face over the affected gum. If you have both, you can do both compresses with a little break in between.
4. Gum Massage:
Clove oil has been proven very beneficial for reducing gum pain and swelling. Gently massage the gum with some clove oil or you can put a few drops of clove oil in a cup of water and swish it around your mouth. Mustard oil, castor oil, aloe vera gel and baking soda are also highly recommended for improving gum health. These not only reduce gum swelling around one tooth but also help in growing back receding gum line. 
For canker sores, using a rinse with baking soda (1 tsp) and warm water (1/2 cup) or dabbing the sore with a mixture of ½ part 3% hydrogen peroxide and ½ part water, followed by a dab of milk of magnesia has worked for many as well. Check with your doctor or dentist if you have an unusually large or painful sore that doesn’t seem to heal.
5. Take Care of Dental Work:
If you have any restorative or cosmetic work done on your teeth, whether temporary or permanent, take care of them. Use water flossers and other cleaning devices to better remove food debris and plaque build up so your gums can remain healthy.
6. Topical Ointments:
Some topical ointments are available over the counter that have local anesthetic agents like benzocaine and lidocaine or anti-inflammatory agents like salicylates.
However, they are not free of side effects and can be dangerous if swallowed. Also due to risk of Reye’s Syndrome, salicylates are not recommended for children younger than 16 years of age. Similarly, dosage is different in teething gels for infants, oral gels for children and topical ointments for adults. Caution is advised when using these over the counter ointments.
The good news is that with good oral hygiene and routine professional cleanings, there should be nothing to worry about. These simple tips will help, in case your inflamed gum around one tooth does not get better, your dentist should be able to give you further advice.
