What are the possible causes of swelling in the gums?

Question

Hi doctor,

I have had issues with my gums swelling. I have lost weight in a relatively short time. Three weeks ago, after my last dental visit, my gum swelling worsened to the point where my speech pattern changed, and I could not bite into anything because my front teeth felt loose. I went to urgent care, and they put me on Amoxicillin for ten days and Prednisone for five days. I wear clear, correct aligners that have been scalloped so they do not touch my gums but they still dig into the swelling behind my front teeth. I am still trying to figure out what to do because I have tried several different kinds of toothpaste, mouth rinses, and saltwater rinses. Please help.

Thanks.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern.

As you are using clear aligners, they might have caused impingement and trauma to the gingiva of teeth bearing in the said region due to ill-fitting trays, which may have caused loose teeth—clinical review for proper fit of these clear aligners to be done. Another reason, if not from the trauma of clear aligners, could be gingivitis and periodontitis of investing tissue supporting teeth in this region. Infection from Actinobacillus actinomycetemcomitans has to be ruled out as it affects around this age group, including molar teeth called localized aggressive periodontitis.

The provisional diagnosis is trauma from the impingement of ill-fitting clear aligners. Differential diagnosis is localized aggressive periodontitis due to actinobacillus infection. Diagnostic tests include culture tests for actinobacillus infection. My treatment advice is the removal of the causative factor. The prognosis is fair.

I hope this information will help.

Thank you.