One of the most common dental concerns we hear from patients is “my gums bleed when I brush.” According to the CDC, around 47% of adults over age 30 have some form of periodontal disease. Bleeding gums is often a hallmark of gum disease and is a symptom that should not be ignored. While you may be accustomed to seeing a little pink in the sink when you brush and floss, bleeding gums are a sign of inflammation. Healthy gums should not bleed!
Causes of Bleeding Gums
Poor Oral Hygiene and Periodontal Diseases
Poor oral hygiene is one of the most common causes of bleeding gums. Plaque and tartar accumulation at the gum line leads to inflammation of the gingival tissues and bleeding when brushing or flossing. Gum disease comes in two flavors, gingivitis and periodontitis. Bleeding gums is a hallmark symptom of both forms of gum disease. Gingivitis is the more mild, and often reversible, first stage of periodontal disease. In cases of gingivitis, the gum tissue is inflamed but none of the support around the tooth has been lost. If left untreated, gingivitis can lead to periodontitis which involves a loss of support around the tooth. This loss of support (both gum tissue and bone) can lead to recession, shifting of the teeth, and eventual tooth loss.
Pregnancy gingivitis is a common occurrence during pregnancy. Due to hormonal changes, blood flow increases to the gum tissue which can lead to bleeding and swollen gums. Hormonal changes can also impact the body's ability to fight infection, making you more susceptible to the bacteria in plaque during this time. As a result, inflammation in the gums increases and bleeding occurs more often than usual.
At the beginning of your dental appointments, you will most likely hear your dentist ask if there have been any changes to your medical history. There are a myriad of reasons why medical history is related to dental care, but one big one is medication side effects! Many medications can cause gingival inflammation and bleeding as a side effect. Aspirin and other blood thinning medications can lead to increased gingival bleeding due to their effect on the viscosity of your blood. Additionally, certain seizure medicines, immunosuppressants, and high blood pressure medications can cause gingival inflammation. If you notice that an increase in gingival bleeding began when you started a new medication, talk to your dentist or doctor about the medications you are taking and any potential oral side effects.
In most cases, bleeding gums are caused by the factors listed above, but certain cancers, autoimmune disorders, and other medical problems can cause bleeding gums as well. If you are concerned, it is always best to talk to your dentist or physician.
How to Control Bleeding Gums
For the most part, bleeding gums can be controlled by regular dental cleanings and home care. For most patients, dental cleanings should be performed every 6 months. In cases of periodontal disease, your dentist might recommend a deep cleaning to remove all plaque and tartar below the gum line and more frequent recalls. However, without appropriate homecare, the benefits of professional treatment will not be realized. Brushing twice a day and flossing once a day are key to reducing bleeding gums. See our previous blog posts about homecare for a refresher! Improper brushing and flossing technique can lead to bleeding gums if too much pressure is applied either with floss or your toothbrush. Additionally, when you first begin flossing regularly you may experience bleeding, but this should subside within a week. If you are concerned about bleeding gums, talk to your dentist at Metropolitan dental care about the potential cause and appropriate treatment!