Updated: Oct 14, 2022
A gum boil may look like a harmless pimple on the gums but it is actually a tooth abscess. Therefore, the presence of the boil itself is indicative of an active dental infection. If the gum boil is getting bigger it means that the severity and extent of the abscess is trending towards an unfavorable outcome.
In other words, if you notice that pimple growing in size it means that your infection is getting worse. You should definitely seek professional help because there is no home remedy which can get rid of it.
With that said, our purpose here today is to inform you of all of the possibilities which may have been contributing to the increase in size of your gum boil. That way you can be thoroughly prepared for when you go in for your dental treatment. You won't be caught by surprise when your dentist gives you your diagnosis.
Situations where your gum boil may get bigger and what it means:
The first time you've gotten a gum boil on this tooth
This is your first gum boil on this tooth and you've never gotten treatment for it. You've tried a whole bunch of home remedies in trying to get rid of it but it doesn't seem to be getting smaller. In fact the boil appears to be going in the opposite direction and getting bigger instead!
The short answer is that none of the home remedies that you've been using have been working. The gum boil is increasing in size because the infection is actually growing and not getting smaller by any means.
Your body is essentially trending towards a less healthy state as time progresses. The growing pimple on your gums is testament to that fact. What you need to do is see a dentist immediately in order to get rid of that pimple.
Nonetheless, the reason why your condition is not improving despite the home remedies is because DIY treatments are unable to get rid of the source of the infection.
Source of the infection
The gum boil is not just a simple pimple on your gums because it is actually an abscess that stems from the nerve of your tooth. Therefore the source of the infection is the abscessed nerve from within the tooth.
The picture above is of an x-ray that shows an abscessed nerve in a front tooth. What the abscess looks like on the x-ray is a big dark circle at the tip of the root. Abscesses and infections look black on the x-ray so if you see that within solid objects (white) you know that it is bad news.
The boil that you see on the gums will appear once the abscess grows big enough to eat through the bone in order to form a pimple. That pimple is basically a connection from the abscess within the bone to the external oral cavity environment.
This is why when you pop the gum boil, you'll see pus (white fluid) ooze out of it. We all know that pus is filled with dead bacteria and white blood cells. It is a tell tale sign of an infection.
How to treat the infection
Now that you know the source of the infection comes from the abscessed nerve, the only way to get rid of it is by getting rid of the infected nerve. The only way to do that is by getting a root canal on your tooth, which means only a dentist can do it.
The process of removing the nerve is a physical one because you need to physically extract the nerve from the tooth.
Home remedies are unable to physically pull the nerve out of the tooth, which is why NONE of them work. You can try every method under the sun but it won't decrease in size. You need to go see a dentist if it is increasing in size.
It was treated before but it has come back
This may not have been your first gum boil because you've had it before but you had it treated with a root canal. Unfortunately, the pimple seems to have returned a few months or a few years later.
Even though the abscessed nerve was removed and the root canal was completed, it seems to have returned with a vengeance. Since it is present and it is increasing in size, it means that the infection has returned and it is getting worse.
A possible reason for this is that your tooth may have had more nerves in there than anticipated. In other words, there were extra nerves that were "missed" the first time around during treatment.
This is common for molars because they usually have 3 nerves each but there are anomalies which can have significantly more than that.
Here is an x-ray showing what a typical molar root canal looks like with 3 nerves each. Each nerve canal gets filled in with a white line. Thus, you can see three white lines in each of the molars and that signifies that it had 3 canals.
Here is an x-ray of a molar that had more than just three nerves. It actually has FIVE nerves because you can see 5 white lines filling each canal.
If your tooth happens to have extra nerves in there, your gum boil may not disappear. It could very well increase in size even with the root canal because there are still abscessed nerves that are left from within the tooth.
The only way to get rid of the boil if you have this condition is to do a root canal retreatment. The root canal specialist will have to go back into the tooth and try to find all of the extra nerves. As long as they're able to fully extract those additional infected nerves, the gum boil should subside in size after a week or so.
This gum boil has been treated more than once but it keeps on returning
The last situation which the gum boil can grow in size is if the tooth is fractured. What you'll notice is that the pimple will keep returning or simply never go away no matter what you do for it. Your dentist could've treated it and then retreated it multiple times with root canals but the infection just won't go away.
If that sounds like you, the chances are that the tooth may have cracked in half somewhere. If the tooth itself is fractured, the only treatment for it would be to do an extraction. That is the only way to get rid of the infection.
Here is an x-ray of a tooth that had a root canal done but the infection is still present. You can see a dark halo around the roots, which implies there is a residual abscess.
Aside from the pimple next to the tooth, it looks otherwise sound. The tooth is not loose and feels stable. Although if you take a 3D x-ray you'll see a completely different story.
The picture above is of a CBCT of the fractured tooth. Sometimes the regular 2D x-rays aren't able to pick up fractures since it is only two dimensional. We had to send this patient to the oral surgeon for extraction and implant!
If you have a gum boil that is getting bigger, it either means that you've an ongoing infection because it is a dental abscess that is getting larger. There are a couple of reasons as to why it could be getting worse.
You've never had a root canal on it.
You've had a root canal but it came back.
It doesn't go away no matter how many root canals you've gotten!
The short answer is that the pimple on the gums means that you've an infection. It growing in size means that the infection is getting worse. You should go see a dentist to figure out the best way to treat this abscess.