Gum bleeding is by far one of the most common reasons for people to seek treatment from dental professionals.
As I received more queries from dental patients regarding bleeding gums, I began to search for the causes of bleeding gums. This article compiles the causes of bleeding gums while brushing and the ways to manage it.
Essentially, gum bleeds easily when it is fragile due to gum inflammation, or gingivitis. The most common reason for gingivitis is due to dental plaque which comes from food debris. Let us understand this process more and find out how to stop gums from bleeding.
Why Gums Bleed while Brushing?
The table below summarizes the reasons of bleeding gums while brushing and what can be done to stop the bleeding gums.
| Reasons | What to do? |
|---|---|
| Gum disease | Continue brushing at least twice daily (for two minutes) with soft bristle toothbrush with proper brushing technique for two weeks. *Have a dental visit if bleeding does not resolve. |
| Aggressive brushing habit | Use soft bristle toothbrush. Brush in small motion instead of big strokes. |
| Tooth abscess/crack tooth | As the main cause is related to tooth, it should be treated by dental professional as soon as possible. |
| Blood thinner drugs | Discuss with doctor/physician who prescribed the drug. |
| Body condition: hormonal changes, lack of nutrition, blood disorders | Gum bleeding should stop when there is no disruption to hormones level. Make sure to eat a balance diet to strengthen the gums. Seek medical help if there is other sign of disease (eg easy bruising, unstoppable bleeding, extreme tiredness, frequent sickness, loss of appetite and weight). |
Reason #1: Gum disease
Bacteria is present inside our mouth all the time. When food debris is not cleaned well, the bacteria start growing more. And the gum pocket is one of the most preferred sites for bacteria to grow.
As they strive, they start building a community with the help of proteins residue in the mouth, and this forms dental plaque (think of it as bacteria building a camp). You will see the dental plaque which appears as the yellowish or whitish slimy substance that accumulates around the gum line.
Over time, the dental plaque is hardened when the minerals like calcium and phosphate accumulate in it, forming calculus (think of it as the camp is now reinforced by bricks).
Meanwhile, the body’s immune system is trying to fight against the bacteria by mounting a group of white blood cells (armies) towards the dental plaque in the pocket. This process leads to gingivitis (inflammation of the gum) which is presented as swelling, redness, bleeding, and possibly pain.
Just like any wound, irritation to the inflaming gums such as brushing can cause it to bleed because it is delicate.
What to do?
Even if the gum is bleeding, you should continue brushing the teeth and focus more on the gum pockets to remove the dental plaque. With proper brushing and flossing, the gingivitis (gum inflammation) should resolve and gums bleeding should stop in one to two weeks. Certain mouthwash could also help to reduce the inflammation and the bleeding. Read this article to find out the most suitable mouthwash for your condition and the ways to use it.
You should have a dental visit if the gum bleeding persists after two weeks of proper toothbrushing because there are other reasons for gum bleeding that need to be treated by professionals.
Reason #2: Brushing too hard
A healthy gum which is free from dental plaque will not have inflammation. If you find that your gums do not have swelling, redness, and pain, maybe the gum bleeding is caused by the aggressive brushing habit.
What to do?
A soft bristle toothbrush and small vibratory motion are more recommended than the hard bristle and strong brushing strokes. You can check out this article on How to Choose Toothbrush. You can also learn about proper toothbrushing technique using this this guide prepared by American Dental Association.
Reason #3: Tooth abscess
Tooth abscess can be caused by an infected tooth or a cracked tooth. The infected tooth usually has a decay, while a cracked tooth may cause you to have sudden sharp pain when you bite randomly.
An infected tooth or a cracked tooth may allow bacteria from the mouth to enter the tooth and spread into the surrounding gums. When bacteria get into the gums through the tooth, it may cause a small swelling or lump on the gum just beside the tooth. This is called a tooth abscess. Sometimes, pus and blood can be expelled when pressed with fingers.
What to do?
You should seek dental professional to treat an infected tooth or cracked tooth. An infected tooth can probably be saved by root canal treatment, whereas a cracked tooth has less promising outcome. It is advisable NOT to leave an infected tooth or cracked tooth in the mouth without treatment.
Reason #4: Underlying body condition
Sometimes gums bleed not because of gingivitis, but because of the inability of the body to stop the bleeding, or to form blood clots. In a normal situation, bleeding stops naturally because the body has a proper blood clotting mechanism.
However, some drugs can disturb this mechanism, such as warfarin (Coumadin) and heparin. Besides drugs, some blood disorders such a Hemophilia can also cause gum bleeding.
Hormones can also affect the gums’ health. This is especially true when the gums bleed more frequently during puberty and pregnancy because of the hormonal changes.Proper nutrition is also important for gums’ strength. Lack of vitamin C in the diet has been related to poorer gum’s health, which makes the gums bleed more easily. Click on this find out more about diet and gum health.
What to do?
If the dentist finds that the cause of bleeding gums is more than causing by the dental plaque, you may be referred to physician to carried out further examination.
If it is due to a lack of vitamins, it usually can be corrected with proper diet or supplements.
If the bleeding is related to hormones and happens periodically, no treatment is needed usually. If the blood disorder is suspected, further medical treatment would be needed to treat it.
Should I continue brushing and flossing with bleeding gums?
Since the most common reason for bleeding gums is the presence of dental plaque that houses the bacteria, it is recommended to continue brushing and flossing with proper methods. This means that the brushing technique should aim to remove the dental plaque from the gums pocket while flossing should clean in between the teeth.
With proper brushing and flossing, the gingivitis should resolve and gums bleeding should stop in one to two weeks. You can check out this article on How to Choose the Best Toothbrush.
Why are my gums still swell or bleed after brushing and flossing?
If the inflammation and bleeding of the gums continue, it may mean that the gingivitis has progressed to a more serious stage that involves deeper structure such as the bone and ligaments that give support to the teeth. This condition is called periodontitis.
When periodontitis happens, the gums and the bone that are holding the teeth are destroyed, and the teeth can become loose.
To prevent this stage from happening, it is important to seek help from the dentist or dental hygienist if gums bleeding cannot be stopped after two weeks of proper self-care.
On the other hand, excessive gum bleeding can also signify an underlying body condition that affects blood clotting. It is important to inform the dentist or dental hygienist regarding your body condition and the drugs that you are taking.
Reference
- Albandar JM, Brunelle JA, Kingman A. Destructive periodontal disease in adults 30 years of age and older in the United States, 1988–1994. J Periodontol. 1999;70(1):13–29.
- Gingival Bleeding – Systemic Causes. European Journal of Molecular & Clinical Medicine, 2020; 7(5): 1472-1476.
