Puffy or Swollen Gums After Braces – Should I Worry?

Shortly after you or your child receives braces, you may notice swollen gums and wonder whether you should be concerned. The good news is that irritation and soreness immediately after new braces or an adjustment is normal. However, if swollen gums arise after a lengthy period of no pain, there may be an issue in which case you should contact the orthodontist.

Why is Pain Normal After Receiving New Braces or a Regular Adjustment?

After you or your child receives new braces or a regular adjustment, you may feel some pain because your teeth and jaw are working hard to create a new smile. Bone will dissolve and new bone will form as teeth are repositioned. When this happens, you or your child will likely feel pressure, tension, and discomfort. While this pain can seem daunting, it is a good thing because it proves that your braces are working!

You should be aware that while some level of discomfort is normal, if it lasts for a few days, swollen gums over time could be a warning of an issue that is unrelated to the initial application of braces or an adjustment. Gingivitis or the buildup of plaque on the teeth, gingival enlargement or an overgrowth or increase in gum cells are two examples of issues that may cause swollen gums and have no correlation to braces or an adjustment.

In efforts to help fight against these scenarios, an electric toothbrush can help to prevent gingivitis, while gingival enlargement can be treated by adequate oral hygiene or in more serious cases, a gingivectomy. For tips on which electric toothbrush may be best, two name brands generally come to mind at first: Sonicare or Oral-B and either one are great options. The two brushes do the same job, but tend to feel a bit differently when brushing regarding the rotation of the bristles. If you are interested in an electric toothbrush Dr. Gladwell would be more than happy to discuss brusher further with you.

For more information regarding gingivitis and gingival enlargement…

“Gingivitis” is the inflammation of the gums that leads to a change in color from regular pink to red and causes swelling, bleeding, and sensitivity. Poor oral hygiene, certain medications like steroids, smoking, poor nutrition, and defective dental restorations are all risk factors for gingivitis.

The goal of gingivitis treatment is to remove irritating plaque and prevent it from returning. If you or your child has gingivitis, you will be encouraged to brush at least twice a day for at least two minutes with a special type of fluoride toothpaste and an electric toothbrush of your choice. You will also be directed to floss daily, rinse with an anti gingivitis mouthwash, and visit the dentist on a regular basis every six months for cleanings and a dental exam.

On the other hand, “gingival enlargement,” also known as “gingival hyperplasia,” is an abnormal overgrowth in the gum cells. Treatment for this condition usually involves improved oral hygiene and periodontal therapy. If a medication has caused gingival enlargement, the physician who prescribed the medication will need to be consulted so that the drug can be stopped or changed.

In some cases, surgical removal of the overgrown gums or a gingivectomy may be necessary.
The purpose of a gingivectomy is to eliminate excess gum tissue. Depending on the thickness of the gum tissue, the surgeon will use a scalpel blade or laser. Fortunately, this procedure does not typically require any stitches and any discomfort that it causes can be alleviated with over-the-counter medication like Advil or Ibuprofen. If you believe you have an overgrowth, you should visit Gladwell orthodontics immediately so that your condition can be evaluated and a proper treatment plan can be designed.

How to Find Relief

If you or your child is coping with swollen gums, these tips may help:

  • Daily flossing between each tooth
  • Try to start using an electric toothbrush. While soft bristled toothbrushes can do the job an electric toothbrush has been proven to be much more beneficial to the mouth.
  • Brush for at least two minutes until brackets are clean and clear
  • Rinse with mouthwash or water after brushing
  • Gargle with salt water for about 60 seconds and rinse well
  • Eat softer foods that may reduce irritation of the gum tissue
  • Schedule a visit with the orthodontist to find out the cause of swelling

Swollen Gums After Braces Removed

Has your son or daughter had their braces removed and you are hearing complaints about their gums? Are they swollen or hurting? When they are flossing, does the flossing process cause bleeding. If these are concerns, please contact Gladwell Orthodontics today so we can assist you in the ways to relieve the pain and concerns. Reach out to us at (919) 453-6325.

Common Causes of Swollen Gums

There are a number of reasons your child may experience swollen gums. Some of the most common reasons include:

Poor Brushing or Flossing

If your son or daughter brushes or flosses too vigorously, their gums may swell up and become sore. That’s why it is a good idea to buy them a soft bristled toothbrush that reduces the risk of gum damage. Gentle flossing between the teeth can help as well.

Toothpaste or Mouthwash

Some toothpastes or mouthwashes may make your child’s gums swollen. This is particularly true if they have particularly sensitive teeth and gums. The good news is that switching to another product can solve the problem.


Gingivitis is gum disease in its earliest stage. It’s usually the result of poor brushing and flossing habits that create a buildup of plaque on the teeth. Plaque is a sticky material made of bacteria and debris that can harden and turn into tartar. Plaque and tartar can irritate the gums and lead to serious swelling, redness, and even bleeding. When the tartar sticks to the teeth it is really only removed with a professional teeth cleaning. Gingivitis can be reversed through improved oral hygiene and routine professional teeth cleanings.

Periodontal Disease

Periodontal disease occurs when gingivitis is left untreated. It causes the gums to recede making it much more likely for teeth to fall out. A common symptom for periodontal diseases include puffy gums that are susceptible to bleeding, as well as loose teeth that eventually fall out. While periodontal disease can be difficult to reverse, it can be prevented with excellent oral hygiene and regular trips to the dentist and orthodontist.

Crooked Teeth

If your child has crooked teeth, they may develop swollen gums. Crooked teeth can almost always be resolved by traditional metal braces or Invisalign clear aligners. If your child needs their teeth straightened, Dr. Gladwell in an invaluable resource.


Believe it or not, swollen gums can also be a sign of allergies. Both seasonal and chronic allergies can negatively impact your child’s gums. It would be important to speak with a medical doctor or allergy specialist to test for specific allergies if this is the case.

Frequently Asked Questions (FAQ) About Gum Health

Is it normal for gums to bleed after flossing?
Gums are very durable and can withstand normal brushing and flossing when they are in good shape. Typically, when gums are bleeding after flossing this means you aren’t flossing quite enough! Think of the gums as muscles, the more you exercise and “work out” your muscles the less sore you become afterwards. This is exactly what happens to the gums, the more you floss the stronger the gums will become and they won’t bleed! If you or your child have bleeding gums, they may be a sign of gum disease and you should talk to your dentist and orthodontist on how to go about reversing these symptoms.

What are the most common signs of gum disease?
The most common signs of gum disease include pain in the mouth, bleeding gums during brushing or eating hard foods, spaces between the teeth, swollen or tender gums, and persistent bad breath. Mouth sores, pus between the teeth and gums, and bite changes may also indicate gum disease.

What are pockets?
Your gum tissue and bones should fit tightly around your mouth. If gum disease exist, you may notice pockets around your teeth, which become deeper over time and create a large space for bacteria to live. This bacteria can lead to tissue and bone loss, requiring the need for a tooth extraction.

What causes gum disease?
There are a variety of reasons gum disease may develop. It may be the result of poor oral hygiene, smoking, crooked teeth, old fillings, certain medications, or pregnancy.

Can gum disease be resolved?
Gum disease can only be resolved in its early stages. Once it enters the advanced stage, it won’t completely go away but can be managed with certain procedures. This is mainly because advanced gum disease causes you to lose your bones and other important structure that helps to support your teeth.

What is the difference between gingivitis and periodontitis?
While gingivitis is an early stage of gum disease, periodontitis is the advanced stage of this condition. Gingivitis can typically be treated whereas periodontitis can lead to permanent tooth loss and even facial disfigurement without proper dental care. Our Wilmington NC Dental friends at Downtown Wilmington Dental are consistently asked this question and have to answer it every single week.

Does gum disease affect the heart?
Since gum disease can cause swelling or inflammation, it can harden the arteries and increase the risk of a heart attack. Therefore, taking great care of your gums is good for your overall health, not just your oral health.

Contact Gladwell Orthodontics Today

In 2020, we are hopeful to reduce the likeliness of swollen gums by advocating heavily on routine oral hygiene! You too can be a part of reversing gingivitis just by easily routinely visiting with the dentist and orthodontist regularly!

If you or your child have experienced swollen gums, you should reach out to Gladwell Orthodontics at (919) 453-6325 to schedule an appointment. After asking a few questions and taking a look in the mouth, Dr. Jason Gladwell can let you or your child know whether the swelling is typical or there is a certain dental issue that needs to be treated.