Despite being a misnomer, a gum boil is not a gum abscess but rather a tooth abscess that looks like a pimple on the gums. The difference is that a gum abscess originates from the gums while a gum boil abscess originates from a tooth. That is an important distinction that needs to be made because it affects the type of treatment that is needed.
Since it looks like an ordinary pimple, people are often under the impression that it is a harmless condition but it is an abscess and that makes it serious. It is an urgent condition that requires attention but it is not an emergency to the extent that you need to disregard everything to get it treated right at this moment.
Get it treated as soon as you can because it's a tooth abscess which makes it a pus filled bump on the gums. It is certainly not healthy to have an active infection in your mouth.
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There is only ONE type of gum boils
Despite common misconception, there is only one type of gum boil but there are various other conditions that may share a mild similarity in appearance. These other conditions look different enough that patients wouldn't describe it as a "pimple on the gums", which is synonymous with "gum boil".
Other conditions that are misconstrued as a pimple on the gum:
Gingival abscess. In layman's terms, this is a gum abscess which causes swollen red and poofy gums rather than a gum pimple. Patients always describe it as their gums feeling swollen and raw feeling but they would never call it a simple pimple.
Periodontal abscess. This includes a gum abscess but it may also encompass an infection that is coming from a much deeper level than just the gums. It can originate from the bone that surrounds the teeth. Once again, the clinical presentation is more along the lines of swollen gums rather than a pinpoint pimple in the mouth.
The only type of abscess that a gum boil is, is a tooth abscess because that is where the source of the infection stems from. Despite the name, it is not of periodontal origins which means it is not caused by gingivitis.
Signs that you may have it
A gum boil is easily identified based on its appearance because it literally looks like a pimple near your tooth. It's distinct enough for people to call it a gum boil but its scientific name is a parulis, which is an inflamed mass of tissue found at the opening of a sinus tract. It is basically the opening or entry that leads to an abscess.
Aside from what it looks like, here are some other associated symptoms:
Painless. We would like to emphasize that it is very common to have a gum boil with no pain. That is not a typo, it can be painless but that is also why some people think it is harmless and don't seek treatment.
Pain and tenderness. There are times where it could be painful when you touch it.
Swelling. The pimple forms because the gum tissue swells up with pus. That is what gives it the appearance of a bump.
Pus. The boil is filled with pus so if you accidentally pop it, you'll see white pus start flowing out of it. The presence of pus signifies infection and abscess.
Bad breath. An active infection that is draining pus is a huge contributor to bad breath because it is filled with bacteria.
Nausea. The bad breath and taste in your mouth from the pus can certainly induce the desire to vomit.
Fever. Not very common but if the infection gets bad enough, a fever is possible.
Earache. Not very likely unless the boil progresses beyond just a simple tooth abscess.
What they look like:
They all look like a bump or pimple that is located on the gums.
Their color is a mix of red to white.
They're all located near a tooth because the source of the infection stems from the tooth.
It also doesn't matter if you've had a root canal or crown on it, you can still get it.
Here are pictures of gum boils on dental x-rays:
It typically looks like a big dark circle either at the tip of the root or near the root of the tooth.
A Gum Boil is NOT a Blister
Some people may mistakenly call the gum boil a blister but that is incorrect because a blister is NOT an abscess, while the boil is one.
Similarities:
They both look like bumps.
They're both filled with fluids.
Differences:
A blister is usually filled with a translucent fluid.
An abscess is usually filled with an opaque white to yellow pus and in this case, it is literally a bump with white pus on the gums.
Due to this distinction, it would be incorrect to classify a gum boil as a blister on the gums but you can still call it a pimple though!
What causes a gum boil?
A gum boil is an opening that leads to a tooth abscess so the cause would depend on whatever caused that dental abscess but the most common is tooth decay
Cavities. All tooth decay starts off as a small cavity but if it is left untreated, it can grow bigger and eventually reach the pulp of the tooth. Once the decay decimates the pulp, it will proceed to travel down the root of the tooth and form an abscess. This abscess can eat through the bone and form a pimple on the gums known as a gum boil.
Dead tooth. If your tooth sustains trauma such as from a sports injury or accident, it could end up dying. Sometimes a dead tooth can end up forming an abscess at the tip of the root, which also leads to a pimple on the gums.
Infected root canal. A tooth that has already been treated with a root canal can get reinfected. A tell tale sign of an infected root canal is a parulis, otherwise known as a gum boil.
Fractured tooth. If your tooth is cracked, you could end up with a pimple on the gums. That is your body's way of letting you know that something is wrong and it needs to be addressed.
Cancer. There have been case reports of Peripheral ameloblastoma causing gum boils. That is a rare but benign odontogenic tumor!
Thus, there are a variety of dental conditions, which can cause this phenomenon. Consequently, the treatment for it would also differ depending on the specific etiology.
How to treat a gum boil
The only way to get rid of a gum boil is by treating what is causing the source of the abscess. If you just try popping the pimple or draining it, you will find it reappearing a few days later. The reason is because the pimple forms from the source of the abscess. Since the source is intact, it can just reform it again. Therefore popping it is not a permanent cure to get rid of it.
The treatments listed below are not minor procedures but major dental procedures. I hope that drives home the point that this is a serious condition and it should not be taken lightly.
Root canal
If the infection is coming from a large cavity or a dead tooth, it would require a root canal because both conditions involve an unhealthy nerve. The treatment would consist of separating the unhealthy nerve from the tooth.
What to expect:
The root canal procedure is done under local anesthesia and may take 2-3 appointments depending on how bad the infection is.
After the abscess has cleared, you will need to get a dental crown to protect the tooth.
The tooth would need to be removed if it is either fractured or the decay is so large that the tooth cannot be restored. Once the tooth is extracted, it will be gone permanently so you'll have to consider replacement options.
What to expect:
The tooth will be removed under local anesthesia. You may request sedation if the idea frightens you but most people should be able to handle a single tooth removal while consciuos.
Determine what to replace the missing tooth with.
Replacement options after tooth removal:
Dental implant - An implant is a titanium screw that is placed in the bone. Afterwards you can place a implant crown on top, which is fixed and does not come on and off.
Dental bridge - this is a fixed prosthesis that consists of at least three crowns that are attached to one another. The con is that you cannot floss in between them.
Partial denture - this is a removable prosthesis where you can take it off and put it back on at will. It is the least desirable option due to association of dentures with old people. Can also be a source of mishap at social gatherings if you partial denture comes out.
Typically, a gum boil should NOT return after the tooth has been extracted.
Surgery
If you were unfortunate and the pimple on your gums was a result of a rare but benign tumor, you may need major surgery. You will most likely need to be hospitalized and be treated by a team of doctors and not just one specialist.
curretage
Adjunctive therapies
In addition to the primary treatments, there are also adjunctive procedures which may help with alleviating some of the symptoms associated with the gum boil.
Antibiotics. If the infection is pretty big, your dentist may prescribe you a course of antibiotics to help clear out the bacteria faster. Just so that you know, if you take antibiotics without first doing the primary treatment, the pills would have no effect. This is why antibiotics are merely just an adjunctive procedure.
Deep cleaning. Deep cleaning the gums around the infection will assist with gum healing because you'll be removing all of the plaque and bacteria around it. It will also involve curettage, which means scraping the inside of the gums to remove inflamed tissue.
Drainage. This is when your dentist pops the gum boil and drains the pus. They will usually do this in conjunction with a root canal or tooth extraction.
Procedures that do not help
Denture adjustments do not help in getting rid of gum boils because dentures do not cause them. Ill fitting prosthesis may cause other gum problems but they won't cause a pimple. Therefore this is a false claim and is now considered debunked.
How to get rid of it at home
Unfortunately, there is no home remedy that can get rid of a gum boil because they are unable to treat the source of the infection. However what these remedies may do is at least alleviate the pain or speed up healing after you've received treatment at the dentist.
Good oral hygiene. Brushing twice and flossing twice a day will reduce the number of bacteria in your mouth. It will also help keep the mouth clean and that definitely speeds up healing. If your teeth were covered with plaque and tartar, that pimple may just get reinfected again.
Mouth rinses. Rinsing with a solution can certainly help keep the bacterial population in check. Especially since the gum boil is a festering pool of bacteria, you don't want to be contributing to it. Some popular mouth rinses are: salt water, coconut oil, hydrogen peroxide, listerine, and chlorhexidine.
Essential oils. Many essential oils have anti-inflammatory and anti-bacterial properties to them. That is why many patients with a more holistic approach to treatment, tend to utilize them. Some popular essential oils are: tea tree, clove, oregano, peppermint, cinnamon, and etc.
Garlic juice. Some people have advocated for using garlic juice or even eating raw garlic. There are studies which have demonstrated that garlic does have antimicrobial properties but there are no direct studies for eating garlic to treat bacterial infections.
Tumeric. This is another natural anti-inflammatory remedy which may help in the gums to recover. Studies have shown that using it as a mouth rinse can be an adjunct to mechanically control plaque build up. Alternatively you can also mash up the tumeric into a paste and use it as toothpaste but we wouldn't recommend that...
Gum boils can pop on their own
You may be surprised but it can actually pop on its own without you realizing it. All of a sudden you may experience a bad taste in your mouth or when you look in the mirror you can see white pus oozing out of your gums. That is a sign that it has popped by itself.
It can definitely happen and once it does you should brush your teeth and rinse out your mouth really well to get rid of the residual pus. The next thing you should do is schedule an appointment with your dentist because the source of the infection still needs to be treated. Just because it popped, it doesn't mean that it won't come back because it WILL reappear a few days later.
Therefore, a gum boil will last for as long as you put off going to the dentist. The sooner you see the dentist, the sooner the boil will go away. The longer you put it off, it will just permanently stay there until you finally muster up the courage to get it treated.
Takeaway
A gum boil is a result of an untreated tooth abscess, which must be treated by a dentist because they're the only ones who can get rid of it. All home remedies cannot cure the source of the infection so even if you manage to pop it, it will keep on coming back.
After you do get it treated, it is important to maintain good oral hygiene because that is the only way to help prevent it from reoccurring. You should also get your dental check up and cleaning every six months so that if something small is brewing, it can be taken care of immediately.
It may be painless and it may look harmless but it is certainly something not to be ignored.
Author: Written by Dr David Chen, a dentist in long island city.
