Toothache with a bag on the gums may be acute periodontal abscess, pulpitis, apical periodontitis, etc., it is recommended that timely medical treatment. 1. Acute periodontal abscess: the patient is usually more sudden onset, mainly manifested as swollen gums and accompanied by severe pain, the surface is red, bright and so on. Therefore, patients with toothache and a bag on the gums may be acute periodontal abscess. 2. Pulpitis: patients with pulpitis will also have toothache, gum edema, congestion, usually due to caries, bacterial infection. 3. Periapical inflammation: If inflammation recurs over a long period of time, the inflammatory substances seep out of the apical foramen, it is easy to form periapical inflammation, which makes the root apex pus, forming pustules, which is usually accompanied by pain symptoms as well. In addition to the above factors, we can not rule out other causes of symptoms, it is recommended to go to the hospital in time for examination and treatment, so as to avoid more serious symptoms.