Is it normal and what should you do?
Bleeding gums when brushing or flossing your teeth is not normal!
Let’s get straight to the point here…
At no point should you be content with finding that your gums are bleeding, you need to do something about it and you should not ignore it.
However, don’t panic.
In many cases the condition of bleeding gums can be dealt with at home, without the need to see a dentist.
It is a process of elimination normally in trying to work out what it is that is causing your gums to bleed and taking action to treat it.
Common causes of bleeding gums
The following is a list of known factors that cause bleeding gums.
- Improper plaque removal – the early stage of gingivitis
- Brushing too hard/too often
- Incorrect toothbrush/brushing routine
- Improper flossing/new flossing routine
- Ill-fitting dentures or other dental appliances such as braces
- Hormonal changes particularly during pregnancy
- Any bleeding disorder
- Infection, which can be either in a tooth or the gum
- Leukemia, a type of blood cancer
- Vitamin C or K deficiency
- Use of blood thinners
- Family history
Treating bleeding gums
The following are a list of common approaches and techniques for treating bleeding gums.
- Brushing regularly
- Brushing with the correct technique
- Flossing & interdental cleaning
- Using the right toothbrush and tools
- Healthy diet
- Drinking water
- Regular dental visits
- Considering your medicine
- Quitting smoking
- Reducing stress
Stopping the gums bleeding – a process of elimination
The cause for one person may well be different to another. In some instances, a multitude of causes may well be contributing to the bleeding.
Sadly, there is no one quick fix that applies to us all when it comes to bleeding gums.
It can be a process of elimination of working out possible causes, applying certain treatments and seeing if the bleeding stops.
Having seen the list of causes above, you may already be aware or know why your gums are bleeding in the way they are.
If you are not sure why, let me explain in more detail what the most common causes are and what you can do to try and stop the bleeding.
Please note. If you are suffering from consistent or heavy bleeding contact your dentist for their advice. If you are suffering from small amounts of bleeding does not improve or stop after a couple of weeks of trying common treatments, you should too consult your dentist.
Improper plaque removal – the early stage of gingivitis
In ideal circumstances your gums should be a nice healthy looking Pink colour.
If you take a close up look at your gums, they should wrap around the top of your tooth in roughly a ‘C’ shape.
Where your gum meets the tooth, it creates what is known as a Gingival crevice. This is essentially a small pocket in which the food particles and plaque get caught.
Plaque is a sticky substance that contains bacteria. Some bacteria in plaque are harmless, but some are harmful to your gum health
Over time, if the teeth and gums are not properly cleaned, the plaque is not removed. This builds up and irritates your gums. This can lead to redness with bleeding, swelling and tenderness.
This is the early stages of a condition called gingivitis, or as it might more commonly known, gum disease.
According to Medline Plus and a large number of other resources I have consulted, this buildup of plaque along the gumline is the main cause of bleeding gums.
The NHS say that most adults have gum disease to some degree, with most experiencing it at least once.
In many cases, gum disease is treatable and can be easily managed.
Failing to treat this, will cause the plaque to harden into something referred to as tartar. This will lead to even more bleeding and a more advanced form of gum disease known as periodontitis.
Thankfully in many cases, at this early stage, the process to treat the condition is relatively simple, cheap and straightforward.
It has been widely reported how people do not brush for the right amount of time or frequently enough. You don’t want to be associated with these statistics.
You need to ensure your are brushing twice a day for 2 minutes, with a soft bristled toothbrush, using the correct technique and flossing once a day too.
Within a matter of days, you will likely see visible improvement and within a couple of weeks you should stop the bleeding altogether.
As the most likely cause to your bleeding gums, you could, if you are not already use an electric toothbrush. An electric toothbrush has many benefits, but most importantly, it can be more effective in the clean it offers your teeth and remove more plaque, speeding up your recovery.
You should consider reading over the following articles to better understand how you can improve your brushing.
Brushing too hard/too often
Your gums are made up of different layers of membranes and tissues but whilst they may appear relatively firm they are a soft tissue that is susceptible to damage.
If you apply a lot of pressure to your teeth and gums when brushing, you are brushing too hard. The bristles of a toothbrush need only skim the surface of the teeth to sweep away plaque, debris and bacteria.
By applying the extra force you are applying unnecessary pressure to the delicate tissue of the gumline which can become damaged or suffer trauma and bleed as a result.
Using a toothbrush with a built in pressure sensor can be useful as it will alert you when brushing too hard.
This bleeding will likely also occur if you are brushing your teeth frequently. It is perfectly possible to brush your teeth too much, you need only brush twice a day for 2 minutes at each time.
Relieve the pressure and decrease the frequency of brushing if this applies to you and your gums should naturally recover and bleeding should subside.
Incorrect toothbrush/brushing routine
If you did not know, there is no need to be ashamed, but the bristles on your toothbrush are rated based on how ‘stiff’ they are.
You may have noticed on packaging for a toothbrush that it may state ‘Soft’, ‘Medium’, or ‘Firm’.
This is all to do with the bristles.
The stiffer or firmer the bristles are does not mean it will clean better.
When you brush your teeth you really want and soft of medium rated brush head, unless advised otherwise by your dental professional.
This will mean as they pass over and under the gumline they are less likely to cut in or aggravate the gum and trigger bleeding.
If it is not clear as to how stiff the bristles are on your toothbrush, most leading brands will tend to opt for a medium to soft bristle.
Whether using a manual or electric toothbrush you can specifically purchase soft bristled heads. Some brands will refer to these super soft bristled heads as ‘sensitive’.
It is not well advertised or all that easy to check, but the majority of premium brands do too normally actually round off the top of each bristle. This is not noticeable to the human eye, but under a microscope, you would see that they have a rounded tip.
When bristles are cut to length they can be left with sharp and abrasive ends, which can damage the teeth and gums if not rounded off. Very cheap toothbrushes or lesser known brands may well skip this process to keep costs down.
Nylon bristles are most common and generally considered the standard, but as technology and techniques advance, we have seen the introduction of silicone and rubber bristled toothbrushes. Opinion is divided on these amongst professionals but studies have shown them to be as effective and many consider them to be softer on the teeth and gums.
With the right toothbrush and brush head you can be assured that you are on the path to reducing the bleeding, but linked to the toothbrush itself is your approach to brushing.
Are you holding the brush head at 45 degrees to the gumline? Are you brushing twice a day for 2 minutes? If the answer is no either of these two questions, you might want to address this.
The following articles may well be of interest to you.
Improper flossing/new flossing routine
Brushing your teeth only cleans 60% of the tooth surface, some 40% goes uncleaned unless you partake in interdental cleaning or as most of us know it as, flossing.
In between teeth in everyone’s mouths are gaps. Some of these gaps are larger or smaller than others and may require different flossing tools. However irrespective of the size, you need to regularly (ideally daily) clean these gaps.
Floss is best suited to small or tight gaps between the teeth, whereas interdental brushes are often preferred for the larger gaps, not to mention the added convenience they bring.
Getting in the routine of flossing is important, but it is just as important to ensure you use the correct technique otherwise you are wasting time and failing to really deal with the source of the problem.
Done correctly, the floss will actually get under the gumline and into the spaces the toothbrush does not to remove the plaque buildup.
Many people claim that flossing causes their gums to bleed, but the simple fact of the matter is, you are not doing it properly. When done right, they will not bleed.
Try following these steps when you floss next.
- Step 1: Pull out and cut off the reel of floss about 18 inches (45cm)
- Step 2: Wrap the ends around your two pointer fingers, and stretch it between them, so it is fairly taught, leaving about 6 inches between the two fingers.
- Step 3: Gently position the floss in between teeth, flex the floss slightly so it cups around the edge of one tooth in an C like shape. Move the floss up and down to get rid of plaque. Repeat this for the tooth on the other side of that same gap.
- Step 4: Repeat this for the tooth on the other side of that same gap.
- Step 5: Repeat this process for all teeth and gaps in the mouth.
- Step 6: Dispose of the floss.
Follow this routine regularly and you should see and feel the benefits.
Ill-fitting dentures or other dental appliances such as braces
Poor fitting dentures and dental work can be another common cause for your gums bleeding.
Your dentist will likely advise if some bleeding is to be expected at any point, but if you are not anticipating a bit of bleeding then you may wish to speak to your dentist for assistance.
Dentures should fit snugly to the gums, but as the jawbone and gums change over time the fitting can become loose. Whilst adhesives can help, the best course of action is to have a proper assessment from your dentist, who can then advise whether new dentures are required or alternative approaches to stop the aggravation and bleeding that occurs.
When it comes to braces depending on what type of braces you have may impact where the bleeding is coming from and the exact cause. It is possible that one of the fittings has a sharp edge or something has come loose or is not fitting correctly and causing the bleeding to take place.
Fixed braces can also cause bleeding on the inside of the cheeks.
With braces and the surface area they offer to plaque to attach too, it is important to ensure you brush and floss regularly and thoroughly to avoid the chance of any excess build up and gum disease as wearing braces makes you a little more susceptible.
In most instances the bleeding is not as a result of anything you are doing, so you should consult your dentist sooner in this instance.
If you have a medical condition that requires you to be on certain types of medication, one of the side effects can be bleeding gums.
This does not mean that just because you are on a particular drug that you will suffer with such but it is possible and a known side effect.
Thus, if you are taking one of these drugs and your gums bleed, it is to some degree normal.
2 main types of medications affect the bleeding and clotting. These are called anticoagulants and antiplatelets.
Anticoagulants thin the blood and reduce the clotting ability of blood. Commonly prescribed blood thinners include warfarin, heparin and enoxaparin.
Antiplatelets such as aspirin, ticlopidine and clopidogrel prevent blood platelets from sticking together to form blood clots.
However, it is worth speaking to your doctor or dentist about the medication prescribed and considering whether there are alternatives available if you do suffer from bleeding. Always get professional advice if you have concerns and do not take it upon yourself to stop or change your medication.
Hormonal changes particularly during pregnancy
Bleeding gums are common amongst those who are pregnant.
Increased blood flow to the gum tissue, causes them to be more sensitive. This condition is known as Pregnancy Gingivitis.
The changing hormones within the body mean the body is hindered in dealing with plaque like it normally would, and therefore when pregnant you are more susceptible to plaque buildup.
This is somewhat to be expected and normal, although close attention does still need to be paid to it.
Responsive action can and should be taken by you.
The steps to take are much the same as the most common cause of bleeding gums.
You need to make sure you brush twice a day for 2 minutes, floss once a day too.
Use a soft bristled toothbrush, eat healthily and drink plenty of water whilst ensuring you do too have regular checkups with your dentist.
My gums are bleeding consistently
If you are suffering from heavy bleeding or your gums are bleeding consistently you should seek assistance from a dental professional as soon as possible. It is quite likely that there is a simple treatment, but you should get a professional opinion on the matter.
Seeing your dentist
It is important irrespective of bleeding gums to have regular checkups with your dental professional to maintain good oral health.
If at any point you have concerns about your mouth or the bleeding you are suffering with does not improve, even if you are taking clear steps to improve your gum health, speak to a dentist for a professional assessment and opinion.
If your gums are bleeding the good news is that for many, with a little investment from yourself and maybe a bit of cash spent on the right tools, you can mange and reverse the condition of bleeding gums.
You need to ensure you are brushing twice a day for 2 minutes.
Make sure you floss and clean interdentally once a day too.
Ensure you are brushing with the correct technique and perhaps invest in an electric toothbrush or interdental brushes to help you improve your cleaning regime.
Assess your overall health, could you improve your diet? Can you drink more water? Reduce any stress you may have?
Taking such steps can further contribute to reducing and stopping bleeding gums.
If it does, continue to keep up the routine, slacking might just cause the bleeding to begin again.
This is not the answer for all. For some bleeding gums may be a regular occurrence due to medication or disease whilst for others it may be a sign of more serious dental health issues.
Should you have regular light bleeding that does not stop within a few weeks or trying to address the issue, speak to your dentist. If you have heavy or continual bleeding, speak to a dental professional. A dental professional can make an assessment and are qualified to advise on possible courses of action.
Bleeding gums are never normal and you should always consider the cause and get them checked out whilst taking steps to resolve the bleeding if possible.
For the vast majority, investing in a good oral healthcare routine is all that is needed.
With a little practice you can perfect your technique and enjoy a healthy, pain and blood free mouth.