Bleeding gums are one of the first reasons that most people give for not flossing. Gums can bleed at just the beginning stages of infections like gingivitis or be a signal that more serious problems are present. Thankfully, bleeding gums can be reversed fairly easily if care is taken quickly.
What Causes Bleeding Gums
Gums bleed due to the body’s immune system targeting infection or bacteria in the gumline area around the teeth. An increased blood supply in an area of trauma or infection is very common and is often paired with inflammation. Healing simply cannot occur if there is no flow of oxygenated blood to the area where infection is present. Some of the specific causes of gingival bleeding are:
Gingivitis – Initial inflammation due to irritation, plaque buildup, or poor oral hygiene results in gingivitis. The majority of bleeding from flossing or brushing comes from active gingivitis, due to bacteria depositing just under the gums and irregular or improper hygiene. As part of the healing process, bleeding helps cleanse the area and bring a fresh blood supply to the location of the infection so that healing can occur. However, this condition can progress into periodontal disease and irreversible bone loss if it is not treated. With gingivitis, bleeding will usually only occur during brushing or flossing, when the small area of infection is stimulated.
Periodontal Disease – When gingivitis goes untreated, plaque continues to work its way under the gumlines, causing the pockets (sulcus) to become much deeper. Once bacteria have made its way this far, regular oral hygiene usually cannot remove it because it’s impossible to reach. At this point, the gums detach from the surface of the tooth, and bone structure is also permanently lost. Once moderate to severe bone loss has occurred, teeth become mobile and may actually fall out. Unlike gingivitis, periodontal disease can cause bleeding from stimulants other than oral hygiene. Bleeding may occur during chewing, touching the area, or sporadically on its own.
Aggressive Tooth Brushing – Accidental trauma from aggressive brushing can cause injury to localized areas of gum tissue. Healthy gingiva should not ever bleed during proper brushing or flossing, so if generalized bleeding during brushing is a problem, it’s likely there’s an infection. Using medium to stiff bristled toothbrushes can cause enamel abrasion, tissue trauma, and occasional bleeding if the pressure is too firm.
Poor Oral Hygiene – Not removing bacterial plaque on a routine basis will cause an immune response in the body that results in swelling and bleeding. Brushing for too short of a time, and irregular or nonexistent flossing will allow bacteria to secrete byproducts that cause the immune system to target the area where plaque is present. If irregular oral hygiene occurs for several days, bleeding will typically come on fairly easily.
Symptoms of Bleeding Gums
Bleeding is an obvious symptom that is hard to miss. It can be seen as well as tasted when the gums bleed. For most people, bleeding gums occur when:
- Flossing is irregular
- There is visible plaque buildup along the margin of the gum tissue
- Brushing is incorrect or aggressive
Other symptoms that may be associated with bleeding gums can include but are not limited to:
- Gum disease
- Receding gums
- Bad breath
- Failing dental restorations
- Visible tartar and plaque buildup
Types of Bleeding
Localized areas of bleeding in one or two areas of the mouth, usually between the teeth when flossing is irregular.
More generalized bleeding throughout the mouth. Most areas bleed when flossed.
Quick evidence of bleeding when the gumlines are brushed. Bleeding is heavy and takes several minutes to stop.
It is important to note that while bleeding is a primary symptom of gingivitis and gum disease, using tobacco products like cigarettes can prevent bleeding from occurring. This can mask the presence of even severe gum disease and bone loss.
How to Treat Bleeding Gums
Depending on the severity of oral infection, bleeding may be something that can easily be reversed in as little as 2 weeks. If severe infection is the cause, then more aggressive treatments will be needed.
Proper Brushing – When gingivitis and early periodontitis is the cause of bleeding, then thorough oral hygiene should reverse all signs of bleeding within 2 weeks. A soft toothbrush that is angled toward the gums, making short back and forth strokes just 2 teeth at a time is adequate to remove marginal plaque as well as provide oxygen to the area which can help destroy anaerobic bacteria.
Brush the teeth twice a day for at least 2 minutes each time. Studies also show that electric toothbrushes will remove more bacteria from the mouth, as there are more strokes achieved per second in an electric brush than in someone using a manual toothbrush.
Change your toothbrush head out when you’ve experienced an illness, the bristles appear splayed, or at least every 3 or 4 months.
Why crowns are more likely to have to bleed around them than other restorations?
Crowns are placed subgingivally (just under the gumlines), while fillings are always above the gumlines. Subgingival edges of the crown are likely to harbor plaque when oral hygiene isn’t thorough every single day.