Gum Issues: Causes and Solutions for Painful Holes

Q: Gum Issues: Causes and Solutions for Painful Holes

Hello： If there are polyps in the gums, it is advisable to seek medical examination as soon as possible. <br>Oral gels (ointments) often contain steroids, so it is recommended to use them in small amounts for a short duration. <br>Sincerely, Lin Chia-Yung, Department of Dentistry

Gingival recession with perforation?

Hello, Doctor.
This evening while brushing my teeth, I accidentally brushed too hard and caused some bleeding.
Initially, I thought it was just a small cut and that it might be due to late-night inflammation.
However, I later realized it was quite painful and discovered that there are holes on both sides where my wisdom teeth used to be (which I had removed some time ago).
The left side has a small hole, while the right side appears to have a piece of gum that has detached and can be lifted.
I was a bit startled and applied some oral gel.

I have not had any upper wisdom teeth grow in or removed (previous X-rays indicated that there were no upper wisdom teeth).
What could be the cause of this? Do I need to seek medical attention immediately, or can I wait for it to heal on its own? Since I had my wisdom teeth removed, I have frequently experienced gum issues in that area, with pain during brushing and flossing (it doesn't always result in cuts or bleeding, but it often hurts).
I have become quite reliant on oral gel, but it feels like a temporary solution.
How should I address this issue? Thank you!

Chai Chai, 20~29 year old female. Ask Date: 2021/11/27

Dr. Lin Jiayong reply Dentistry

Hello: If there are polyps in the gums, it is advisable to seek medical examination as soon as possible.
Oral gels (ointments) often contain steroids, so it is recommended to use them in small amounts for a short duration.
Sincerely, Lin Chia-Yung, Department of Dentistry, Taichung Hospital, Ministry of Health and Welfare.

Reply Date: 2021/11/27

More Info

It sounds like you are experiencing some concerning issues with your gums, particularly around the areas where your wisdom teeth were previously located. The symptoms you describe, including painful holes and bleeding after brushing, can be indicative of several dental conditions. Let’s explore the potential causes and appropriate solutions for your situation.

Possible Causes
1. Gum Recession: After the extraction of wisdom teeth, it is not uncommon for the gums to recede, especially if proper oral hygiene is not maintained. This recession can expose the roots of the teeth, leading to sensitivity and pain.

2. Periodontal Disease: This is an infection of the gums that can lead to gum recession and the formation of pockets or holes in the gum tissue. If left untreated, it can progress to more severe forms of gum disease, which can affect the bone supporting your teeth.

3. Oral Trauma: Brushing too hard, as you mentioned, can cause trauma to the gums, leading to bleeding and the formation of small holes or lesions. This can also lead to inflammation and pain.

4. Infection: If there is an infection in the gum tissue, it can cause swelling, pain, and the formation of abscesses or pockets. This is particularly concerning if you notice increased pain and bleeding.

5. Dry Socket: Although this typically occurs after tooth extraction, if the blood clot that forms in the socket is dislodged or dissolves, it can lead to severe pain and expose the bone underneath, which may feel like a hole.

Recommended Solutions
1. Immediate Dental Consultation: Given the symptoms you are experiencing, it is crucial to see a dentist as soon as possible. They can perform a thorough examination, possibly including X-rays, to determine the underlying cause of your gum issues.

2. Oral Hygiene Practices: While waiting for your dental appointment, continue to maintain good oral hygiene. Use a soft-bristled toothbrush and gentle brushing techniques to avoid further irritation. Floss carefully around the affected areas to prevent food particles from causing additional inflammation.

3. Salt Water Rinse: Rinsing your mouth with warm salt water can help reduce inflammation and promote healing. This can also help to cleanse the area of any debris.

4. Avoid Irritants: Try to avoid tobacco products and limit alcohol consumption, as these can exacerbate gum issues and slow down healing.

5. Pain Management: Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can help manage pain and inflammation. However, consult with your dentist before taking any medication, especially if you have underlying health conditions.

6. Follow-Up Care: If your dentist identifies an infection or periodontal disease, they may recommend a deep cleaning (scaling and root planing) or other treatments to address the issue. Regular dental check-ups are essential to monitor your gum health and prevent future problems.

Conclusion
In summary, the painful holes in your gums could be due to a variety of factors, including gum recession, periodontal disease, or trauma from brushing. It is essential to seek professional dental care to accurately diagnose the issue and receive appropriate treatment. While home remedies can provide temporary relief, they are not substitutes for professional care. By addressing these issues promptly, you can help ensure the health of your gums and overall oral hygiene.

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