Bleeding Gums

Bleeding gums (gingival bleeding) means the gums bleed when you brush, floss, eat hard food or during a dental check. In most people it is a sign of gingivitis: inflammation of the gum margin caused by plaque, the bacterial film that builds up along the gum line when it is not removed thoroughly every day.

Why It Matters

Healthy gums do not bleed with normal brushing. Bleeding is an early warning that the gums are inflamed. At the gingivitis stage the damage is reversible. If plaque and tartar stay in place, inflammation can spread deeper and become periodontal disease (periodontitis), in which the bone and fibres holding the teeth are gradually lost. That damage cannot be fully reversed and can lead to receding gums, bad breath and loose teeth.

Clinical Details

• Most common cause: Plaque and hardened tartar (calculus) at and below the gum line.
• Other contributing factors: Smoking (which can hide bleeding while gum disease progresses), diabetes, pregnancy and other hormonal changes, some medications including blood thinners, brushing too hard, and poorly fitting dentures or restorations.
• Less common causes: Vitamin C or vitamin K deficiency and blood clotting disorders. These are rare compared with plaque-related gingivitis and usually come with other symptoms such as easy bruising.
• Examination: The dentist or hygienist checks where the gums bleed, measures the depth of the space between gum and tooth (periodontal pockets) and may take X-rays to see whether bone has been lost.
• Treatment of gingivitis: A professional scale and polish plus improved daily cleaning, including between the teeth.
• Treatment of periodontitis: Deep cleaning below the gum line (scaling and root planing), followed by regular maintenance. Advanced cases may need periodontal surgery.

FAQ

Why are my gums bleeding when I brush?

The most common reason is gingivitis caused by plaque along the gum line. It is a sign that the gums are inflamed, not that you should brush less. Brushing too hard can also make gums bleed.

Should I stop brushing or flossing if my gums bleed?

No. Keep brushing gently twice a day and cleaning between your teeth. As plaque is removed and inflammation settles, bleeding usually reduces. If it does not improve within a couple of weeks, see a dentist.

What deficiency causes bleeding gums?

Severe vitamin C deficiency (scurvy) and vitamin K deficiency can cause gum bleeding, but they are uncommon. Plaque-related gum inflammation is a far more likely cause, so a dental check comes first.

When are bleeding gums a sign of something serious?

See a dentist promptly if your gums are very swollen or painful, teeth feel loose, or bleeding happens without brushing. Bleeding gums together with unexplained bruising, nosebleeds or tiredness should also be checked by a doctor.