Toothache and swollen gums may be due to apical periodontitis, periodontal abscess, pulpitis and other diseases, need to take medication, surgical treatment for the cause of the disease. 1. Apical periodontitis: common symptoms include toothache and swollen gums. If there is inflammation spreading, need to follow the doctor’s instructions to apply metronidazole, ceftriaxone and other antibiotics, and ibuprofen, acetaminophen and other non-steroidal anti-inflammatory painkillers. In the acute phase, pain relief can usually be achieved by opening the pulp and draining it. Root canal therapy, pulpal hemodialysis reconstruction, and microscopic apical surgery should be considered. 2. Periodontal abscess: The main symptoms are redness, edema and pain in the gums. Patients need to follow the doctor’s instructions to use hydrogen peroxide solution, chlorhexidine solution and other rinses, as well as povidone-iodine, iodine glycerin and other anti-inflammatory astringent drugs, as well as 2% minocycline and other slow-release agents. Systemic periodontal therapy, including scaling and scraping, is also required. For chronic periodontal abscesses, flap surgery should be considered. 3. Pulpitis: Typical symptoms include tooth pain and swelling. The treatment of this disease is divided into pulp preservation and preservation of the affected tooth, the former includes direct pulp capping, indirect pulp capping, etc., and the latter includes root canal treatment. Root tip induction plasty is also required for underdeveloped teeth. To summarize, patients with toothache and gum puckering need to go to the hospital in time and cooperate with the doctor to actively treat the primary disease.