What causes pain and swelling in the upper gum above the last tooth?

Question

Hi, Doctor,

My upper gum's last tooth was swollen and painful, and there was bleeding. When I touch it in the gums, there is a small tooth-likeparticle.

Please help me.

Answer 1

Hi,

Welcome to icliniq.com.

I can understand your concern.

From your symptoms, it is evident that you have swelling of the gingiva in the region of the last tooth in the upper jaw (likely the third molar), associated with pain and occasional bleeding.

Probable causes:

Impaction of the third molar in the upper quadrant, likely causing pericoronitis or soft tissue inflammation.
The eruption sequence may be contributing to gingival swelling and bleeding.

Investigations recommended:

Intraoral periapical radiograph (IOPA) of the affected region to confirm impaction and assess root formation, angulation, and any surrounding pathology.
Clinical evaluation of occlusion, opposing dentition, and soft tissue coverage.

Probable diagnosis:

Impacted upper third molar (possibly tooth 18 or 28) with an inflamed operculum, causing localized pain, swelling, and bleeding.

Treatment plan:

Surgical extraction (exodontia) of the impacted third molar.
Operculectomy if the gingival flap persists or prevents adequate eruption.
Prescribe analgesics and antibiotics if infection is present.
Provide postoperative instructions (hygiene, diet, activity, and follow-up).
Monitor healing and review in 7 to 10 days.

Preventive measures:

Improve oral hygiene practices.
Regular dental checkups.
Consider prophylactic removal of the contralateral third molar if similarly impacted.

If you need any more clarification or help with your questions, feel free to ask.

Thank you.