What could be the reason for red and swollen gums?

Hi,

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Hope you are doing well. As per the pictures shared by you (attachment removed to protect patient's identity) and the details mentioned, a gingival abscess has most likely formed near the premolar tooth on the tongue side. From the picture, dental decay is not seen in the tooth of the concerned site. It is a positive sign that it is not painful now, but it will start aching once the infection spreads deeper. It could be due to a decayed tooth or periodontal reasons (related to gums). Rarely trauma to the gums could be the reason. It surely needs care from a dental surgeon. I would suggest you get a check-up done with radiographic like IOPA (intraoral periapical radiograph) or RVG (radiovisiography) for confirmation and followed by appropriate treatment. If no tooth involvement is seen, then abscess drainage and follow-up are sufficient. If there is tooth involvement, root canal treatment or dental restoration (depending on the extent of tooth involvement) and abscess drainage are needed, followed by a review. I would suggest you get an OPG (orthopantomogram) radiograph done to check the status of wisdom teeth and decide if it has to be removed. With the teeth alignment and jaw space, it is highly doubtful that wisdom teeth will erupt without any problem. So I would suggest you get it removed before it causes any issues. Do reach out for further information or clarifications. Have a great day. Regards.