Persistent Gum Swelling: Causes and Solutions

The gums are repeatedly swollen, but there is no pain?

Hello Doctor: I have a cavity in the upper left molar that was treated between October and November.
Due to the depth of the cavity, the nerve was killed with medication, and the tooth was filled (the cavity was on the outer side, so the doctor did not recommend a crown).
Around December 20th, the outer gum of the molar began to swell slowly.
I went back to the dentist, who used instruments to clean inside the gum (similar to periodontal treatment).
After the treatment, the doctor prescribed anti-inflammatory and pain relief medications, but after several days, the swelling did not subside (there was no pain).
Later, the swelling increased, and I could feel a noticeable bulge on the surface of the gum.
I pressed on the gum, and suddenly felt something burst inside, like a blister popping, and the swelling immediately reduced by half.
Coincidentally, my father also had gum pain and went to see a dentist near his workplace after work.
The dentist prescribed him anti-inflammatory and pain relief medications (which looked completely different from mine).
My father said the medications he received were stronger and had antibacterial effects.
After taking two doses, my gum swelling completely went down.
However, today, my gum is slightly swollen again (but there is no pain).
I would like to ask the doctor if the swelling is related to this cavity, or if I might have periodontal disease, or if there could be a fracture in the tooth? Thank you.

Rita, 20~29 year old female. Ask Date: 2017/01/11

Dr. Huang Tingfang reply Dentistry

Dear Ms.
Rita,
Hello! It seems that there may be an issue with the root canal.
If there is root canal inflammation, surgical treatment may be necessary; if there is inadequate filling, retreatment may be required; and if there is a root fracture, extraction might be needed.
Diagnosis should be based on X-rays and clinical evaluation.
Please communicate more with your dentist! Thank you! Wishing you peace!
Sincerely,
Dr.
Huang Ting-Fang, Dentistry

Reply Date: 2017/01/11

More Info

Persistent gum swelling can be a concerning issue, especially following dental treatments like root canal therapy. In your case, the swelling around your upper left molar could be attributed to several factors, including residual infection, gum disease, or complications related to the previous dental work.

Firstly, it’s important to understand that after a root canal procedure, the tooth is often left vulnerable to infection if the sealing is not perfect or if there are any remaining bacteria in the surrounding tissues. The fact that your tooth had a deep cavity and required nerve treatment suggests that there may have been significant bacterial involvement. If the infection persists, it can lead to localized swelling in the gums, which may not always be painful, especially if the nerve has been treated and the pain response is diminished.

The swelling you experienced could also be indicative of a periodontal issue. Periodontal disease, which affects the supporting structures of the teeth, can cause inflammation and swelling of the gums. If plaque and tartar build up around the tooth, it can lead to gingivitis, which is the initial stage of gum disease. If left untreated, it can progress to periodontitis, which can cause more severe gum issues and even tooth loss.

Another possibility is that the swelling is related to a periapical abscess, which is an accumulation of pus at the root of the tooth due to infection. This can occur if bacteria invade the area surrounding the tooth root, leading to swelling and sometimes the formation of a fistula, which may explain the sensation of something bursting when you pressed on the swollen area.

In your case, the fact that the swelling decreased significantly after you pressed on it suggests that there may have been some fluid accumulation or a small abscess that was relieved by your action. However, it is crucial to note that while this may provide temporary relief, it does not address the underlying issue.

Regarding the medications prescribed, it’s common for dentists to prescribe anti-inflammatory and pain relief medications after dental procedures. The stronger medication your father received may have had a broader spectrum of action, potentially addressing bacterial infections more effectively. It’s essential to follow the prescribed course of antibiotics if there is an infection, as this will help clear the bacteria and reduce inflammation.

To address your concerns about whether the swelling is related to the cavity, gum disease, or a fracture, a thorough examination by a dentist is necessary. They may perform X-rays to check for any underlying issues, such as bone loss, abscess formation, or fractures in the tooth structure.
In the meantime, maintaining good oral hygiene is crucial. This includes brushing twice a day, flossing daily, and possibly using an antibacterial mouthwash to help reduce plaque buildup and inflammation. Regular dental check-ups are also essential to monitor the health of your gums and teeth, especially after significant dental work.

In summary, persistent gum swelling can arise from various causes, including residual infection from previous dental work, periodontal disease, or abscess formation. It is essential to consult with your dentist for a comprehensive evaluation and appropriate treatment to ensure the health of your gums and teeth.

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