Pain In The Gums : Causes, Symptoms, Diagnosis & Treatment

Last Updated: 30/06/2022

Pain in the gums occurs with gingivitis, periodontitis, periodontal disease, stomatitis, developing against the background of local changes or somatic diseases. It is detected with malocclusion, mechanical damage. It can be weak, intense, permanent, short-term. Often occurs when eating, brushing teeth. The cause of the symptom is determined on the basis of complaints, dental examination data and additional studies. Treatment is carried out using general and local means: antiseptics, anesthetics, analgesics, antibiotics, anti-inflammatory drugs. According to indications, dental operations are performed.

general characteristics

Pain is caused by changes in the gums and periodontium, which occur under the influence of local factors: poor oral hygiene, the presence of tartar, functional periodontal insufficiency due to a decrease in chewing load when eating too soft food. Smoking plays a significant role. Common factors affecting the state of the tissues of the oral cavity are gastrointestinal diseases, infectious and endocrine pathologies, natural changes in hormone levels, harmful occupational exposure.

These reasons entail the formation of an environment favorable for the activity of pathogens, the development of inflammation, disruption of local blood supply and nutrition of the gums, and a change in its structure. The result is a pain syndrome. Often the periodontium is involved in the pathological process, the disease becomes chronic, leads to gross local changes and loss of teeth.

Why do gums hurt

Gingivitis

May be local or widespread. It is manifested by soreness, swelling, redness, increased local temperature, bleeding, the formation of petechial hemorrhages or ulceration areas. There is hypersalivation. The clinical picture varies somewhat depending on the type of gingivitis:

  • catarrhal. Pain is minor, occurs when in contact with food. The main symptoms are pronounced signs of inflammation, sensitivity of the gums to temperature changes. The general condition is not broken.
  • Ulcerative necrotic. Against the background of the formation of areas of necrosis and ulceration, the gums become sharply painful. Eating is difficult. Breath is offensive. There is a deterioration in the general condition: weakness, weakness, subfebrile or febrile temperature.
  • Hypertrophic. It is asymptomatic for a long time, it is discovered by chance during dental examinations. Subsequently, in the absence of treatment, pain in the gums gradually progresses due to touching, eating. Severe discomfort when brushing teeth makes patients refuse this procedure, which worsens the condition of the oral cavity.
  • Desquamative. It occurs more often in women during menopause, due to a decrease in the number of keratin-containing cells and an increase in mucosal permeability. It is manifested by soreness and bleeding of the gums even with weak influences.

periodontal disease

The disease is based on periodontal atrophy with loosening of the gums, destruction of periodontal joints, penetration of plaque into them and subsequent tissue damage. As a result, the gums begin to bleed. There is pain under the action of any stimuli. Against the background of periodontal disease, recurrent inflammatory processes develop. Pathology can be primary, but is more often diagnosed in patients with hypovitaminosis, diseases of the digestive tract, cardiovascular and endocrine systems.

Pain in the gums

 

Periodontitis

The cause of periodontal disease is plaque, which transforms into tartar. Pain in periodontitis is rare, mainly at the initial stage, with inflammation of the gums (gingivitis). In the future, redness, bleeding, edema, and local hyperthermia predominate. There is an increase in sensitivity to the action of stimuli, which some patients interpret as a slight soreness.

As in the previous case, the disease can develop primarily, but is more often detected against the background of other pathologies. Periodontitis in diabetes mellitus is especially persistent. The disease develops or progresses rapidly during pregnancy, breastfeeding and menopause, especially if there is a history of gingivitis. It is observed in endemic goiter and Itsenko-Cushing's disease.

Stomatitis

Pain in the gums is most characteristic of Vincent's stomatitis. Soreness and bleeding of the gums are the first symptoms of the disease. This is due to the fact that the pathological process begins with the gingival margin, and only then spreads to other parts of the mucosa. Subsequently, erosions and ulcers appear. There is a putrid smell from the mouth, subfebrile condition.

In other types of pathology, the presence or absence of pain in the gum area is determined by the affected area. In patients with ulcerative stomatitis, a symptom is observed when defects are located near the edge of the gums and the inflammatory process spreads to nearby tissues. Manifestations are especially pronounced in the presence of severe somatic diseases and in childhood.

Malocclusion

Pain in the gums with malocclusion develops against the background of the above dental pathologies (periodontal disease, periodontitis, etc.), which are secondary in nature and occur as a result of contact disturbances between the teeth, improper distribution of chewing load and chronic traumatization. The symptom is observed in some patients with deep and crossbite. It can occur with distal and mesial occlusion.

Mechanical damage

Gum injury can be acute or chronic. Acute injuries are the result of accidents at home (for example, a blow or fall), scratching with hard pieces of food (fish bone, the edge of a cracked nut), or medical instruments during dental procedures. Pain is local, sometimes accompanied by bleeding or hemorrhage. Disappear after a few days. Chronic injuries are associated with poor fitting dentures. The pain is not intense, persists for a long time, increases with food.

allergic reactions

Allergy to prosthetic materials is usually a type of stomatitis (contact allergic stomatitis). Along with pain when eating, it is manifested by dryness, burning and the presence of a metallic taste in the mouth. It can develop many months or even years after the installation of prostheses. It is combined with swelling of the buccal mucosa, soft palate and tongue, burning sensation in the tongue, impaired taste sensitivity.

Diagnostics

The dentist determines the cause of pain in the gums. Dental examination involves assessing oral hygiene, examining the condition of soft tissues, identifying signs of inflammation and mucosal defects, determining the presence and severity of periodontal pockets and tooth mobility. As part of an additional examination, the following procedures are prescribed:

  • Radiography. In inflammatory periodontal diseases, osteoporosis is visible in the pictures. Horizontal destruction indicates the chronic course of the pathology, vertical - the formation of abscesses. In periodontal disease, osteoporosis is combined with sclerotic changes. According to the results of radiovisiography or orthopantomography, the type and severity of malocclusion are assessed.
  • Bacteriological or bacterioscopic examination . Performed with Vincent's stomatitis, inflammatory periodontal diseases. This type of stomatitis is characterized by a large number of Borrelia Vincent. In other cases, various types of pathogenic bacteria are found, less often fungi.
  • Other laboratory tests . The inflammatory process is accompanied by leukocytosis and an increase in ESR in the general blood test. If an allergy is suspected, intradermal, scarification, skin drip, exposure and elimination allergy tests are carried out.

Dental checkup

 

Treatment

Conservative therapy

Mandatory measures for pathologies accompanied by pain in the gums are professional oral hygiene and the treatment of carious teeth. In case of allergies, mechanical injuries due to errors in the installation of prostheses, repeated prosthetics or correction of structures is necessary. Patients with malocclusion undergo orthodontic treatment. Depending on the nature of the disease, therapeutic regimens may include:

  • Gingivitis . Means for improvement of local immunity are shown. After eating, it is recommended to rinse your mouth with herbal decoctions and antiseptic solutions. With intense pain syndrome, analgesics are prescribed.
  • Periodontal disease . Periodontitis is treated with antibiotics and anti-inflammatory drugs. In periodontal disease, electrophoresis, hydro- and vacuum therapy are used to improve local blood supply. Mobile teeth are fixed with temporary splints.
  • Stomatitis Vincent . As part of local treatment, local anesthetics, sorbents, preparations with proteolytic, antimicrobial and antiprotozoal effects are applied. At the resolution stage, keratoplasty is effective, accelerating tissue repair. Common remedies include antibiotics, NSAIDs, antihistamines, antipyretics, and pain medications.

Surgery

Patients with hyperplastic gingivitis accompanied by persistent hyperplasia undergo gingivectomy. Treatment of periodontal diseases includes gingivotomy, curettage of periodontal pockets. 3-4 degree of tooth mobility is an indication for their removal with subsequent prosthetics.

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