Why Do You Have a Hole in Your Gums?

Wisdom teeth removal

It is not uncommon for the occasional pain or inflammation of the gums to flare up, but a hole in the gums? That is a little less common and could be a sign of something serious lingering below the gum tissue.

There are many reasons why you may have a hole in your gums, and we are here to provide you with the answers. Read on to discover the potential causes of a hole in gums, the treatment methods needed for each of these causes, as well as tips for preventative care.

What Does a Hole in your Gums Look Like?

The area of your gum tissue that develops into a ‘hole’ can appear different depending on the cause. However, a hole in your gums generally has different textures and appearances from the surrounding tissue.

The gum can appear cratered, indented or pocketed when compared to the smoothness of the healthy tissue around it. There may also be signs of irritation, redness, swelling and bleeding when aggravated.

Causes of a Hole in the Gums

If you have noticed signs of a hole in your gums, you may be wondering what the cause of this degradation of your gum tissues is. There are, in fact, several potential causes, often beginning with a bacterial infection or a virus making its way under the gum line.

  • Open Tooth Socket
  • Infections
  • Periodontitis
  • Necrotising Periodontal Disease

However, any instances of increased sensitivity, pain or bleeding should be met with an appointment with your dentist as soon as possible.

Open Tooth Socket

While an open tooth socket is caused by a tooth extraction rather than gum disease or bacterial infection, the site still needs to be monitored.

After tooth extraction, the open tooth socket takes about 8 weeks to fill up with bone. However, it is important to keep the area clean during this healing period, even as you try not to disturb it too much.

Failing to protect the area can lead to a dry socket, where the nerve and bone of the healing socket are exposed. This will delay the healing process and can cause an infection in the socket that can spread to the jaw bone.


When some bacteria or viruses enter the body, the infections they cause can create a hole in the gum line. The infections can also cause lesions to develop in the mouth and gums, which can lead to a cratered or concave appearance. Painful ulcers may also form.

In some severe cases, a bacterial infection of the mouth and jaw can eat away at the supportive bone tissue and leave a hole.


An advanced form of gum disease, periodontitis is commonly caused by plaque buildup. The plaque is formed by the bacteria that eat the sugars from our foods, leaving behind waste products. Too much of this waste can cause your gums to become irritated and inflamed.

At this stage of inflammation and minor bleeding, the gum disease is known as gingivitis. However, as gingivitis progresses further into the gum tissue to affect the bone, it becomes a severe periodontal disease.

Without treatment, periodontal disease can cause tissue and bone loss. This loss causes receding gums, forming pockets and holes between the teeth and gums.

Necrotising Periodontal Disease

In some rare cases, gum disease develops to the point that tissue death begins to appear. It is more commonly seen in those with a weakened immune system.

As the soft tissues of the gums begin to die, holes will appear, making the tissue look cratered or punched out. These affected areas can occasionally develop a sort-of membrane across them, making the infected sites more obvious. Painful ulcers may also appear alongside these gum holes.

Symptoms Indicating a Hole in the Gums

What signs indicate that the damage to your gums is not just minor, but is, in fact, causing a hole to develop? Each cause has its own symptoms, but any indication of swelling or bleeding gums should be a cause of concern.

For periodontitis, symptoms include:

  • Sore and/or receding gums
  • Redness and/or swelling
  • Sensitive and/or loose teeth
  • Discomfort or pain while eating
  • Bad breath
  • Brushing or flossing causes your gums to bleed

Once a case of periodontal disease causes tissue death, then additional symptoms will appear. Beyond the afflicted sites being covered by a yellow or white membrane, additional symptoms of this type of gum disease could include:

  • Severe pain
  • Fever
  • Swollen lymph nodes
  • Spontaneous bleeding

In contrast to types of periodontitis, an infection of the gums has more widespread symptoms. These symptoms could include:

  • Lesions in the mouth
  • Fever
  • Loss of appetite
  • Fatigue
  • Irritability
  • Swollen lymph nodes
  • Red, swollen gums

Treatment for Holes in Your Gums

The exact treatment method required for gum holes depends mostly on the cause of this damage. Your dentist will advise you on what option works best for your gum’s health.

Scaling and Root Planing

Often used to treat periodontitis, scaling and root planing removes the plaque that is captured above and below your gum line. For most, this method is more commonly known as “deep cleaning”.

Treatment is normally conducted in two steps:

  1. Scaling: The plaque buildup on the teeth and in pockets around the gum line is removed.
  2. Root planing: The planing process smooths out the roots of your teeth, located deep in your gum line. By scaling these roots, they can have an easier time reattaching to your gums.

Local anaesthetic is often offered during this procedure to minimise any discomfort or pain potentially felt. In cases of chronic periodontitis, as well as aggressive periodontitis, multiple scaling and root planing appointments may be required.

Pocket Eliminating Procedure

Sometimes referred to as pocket reduction, this surgical procedure is required when large periodontal pockets have formed in the gums.

The process involves surgically folding back the gum tissue, removing the bacteria trapped within, and then reattaching the gum tissue to the teeth. It then reduces the depth of the pockets, undoes some of the damage caused by periodontal disease, and securely reattaches the gum to the bone.

Periodontal Surgery

In the instance that periodontal disease has become severe, surgery may be required to treat your gums. There are different methods used in periodontal treatments, with the main ones being:

  • Regenerative procedures: Plaque is removed when the gum tissue has been folded back. After which, a piece of material, usually made from proteins or bone, is placed at the site to help regenerate the tissue and bone loss.
  • Flap surgery: A small incision is made in the gum tissue, which is then lifted to remove the plaque hidden in the deeper surfaces of the teeth. This allows for your gums to fold back down and be fitted securely to your teeth.
  • Gum grafting: Used for receding gums, this procedure requires gum tissue to be taken from another part of your mouth and used to cover the exposed area of the tooth. This is occasionally referred to as grafting soft tissues, and often uses tissue from the roof of your mouth.

Bone Grafting

Cases of aggressive periodontitis sometimes result in bone loss, making grafting necessary to replace the missing bones. Similar to gum grafting, this process requires bone tissue from another part of the body to replace what has been lost. Once introduced to the existing healthy tissue, the grafted bone tissue should promote regeneration or new bone growth.


Your dentist may prescribe antibiotics if you have a severe enough case of periodontal disease or bacterial infection. This medication will slow the growth of bacteria at the site where a hole has formed in your gums.

How to Prevent Holes in Your Gums

Even if you have not gotten to the stage of gingivitis, never mind chronic periodontitis, there are still plenty of steps you can take to prevent gum disease and holes in your gums.

You can reduce your chances of developing gum disease by:

  • Brushing and flossing your teeth twice a day
  • Brushing gently to not aggravate the gums
  • Ensuring to limit sugary foods eaten daily
  • Quitting smoking

However, the recommended method for preventing gum disease and any gum issues is regularly seeing a dentist for a checkup. Appointments for deep cleaning should be made every 6 months to guarantee the shine of your smile and the health of your gums.

Seek Gum Treatment at Putney Dental Care

It is vital to your smile that you maintain healthy gums, which means dealing with potential holes as soon as you notice any signs of gum disease setting in. Professional care is the only way to ensure your gums remain healthy and whole after gum disease has set in, and Putney Dental Care offers the best services for your smile in Sydney.

You can visit our general dentistry services page to learn how we can care for your dental health. Otherwise, contact our dental specialists online or over the phone at (02) 9808 2588 to book a checkup on your gums today. 

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