Why do my gums bleed when I brush my teeth?
In short
The most common reason is gum inflammation, known as gingivitis, caused by plaque and tartar building up along the gumline. Inflamed gums become fragile and bleed when they come into contact with a toothbrush or floss. Less often, medicines, hormones or other health conditions play a part, and these should be assessed with your dentist.
What is happening to your gums?
When plaque stays on the edge of the gum for a long time, the bacteria release irritating substances. The gums react by becoming inflamed: they turn redder and swollen, and the tiny blood vessels become more fragile. At that point, simply brushing is enough to make them bleed.
There are also situations that make the gums more reactive or bleeding more likely:
- hormonal changes, for example during pregnancy, puberty or the menopause;
- poorly controlled diabetes;
- anticoagulant or antiplatelet medicines;
- deficiencies in certain vitamins, such as vitamin C;
- more rarely, blood disorders.
A toothbrush that is too hard, or used too forcefully, can also irritate the gums.
My gums bleed when I floss: is that normal?
It often happens to people who are just starting to floss or who do it only occasionally, but it is not a sign of healthy gums: it means there is inflammation between the teeth. Do not stop cleaning. Use floss or interdental brushes every day, gently: the bleeding often decreases as the inflammation settles. If it carries on after a couple of weeks of consistent cleaning, it is time to get it checked.
When should I worry about bleeding gums?
Bleeding that keeps coming back should always be assessed, because untreated gingivitis can progress to periodontitis (gum disease). See your dentist without delay if you notice:
- spontaneous bleeding, for example blood on your pillow when you wake up;
- bleeding that does not stop after several minutes;
- receding gums, persistent bad breath or loose teeth;
- fever, feeling unwell, swollen lymph nodes, sores or lesions in your mouth;
- heavy bleeding while you are taking anticoagulants.
In these last cases it is also a good idea to let your GP know. Never stop taking a medicine on your own initiative.
How it is treated
The first step is often a professional hygiene session to remove plaque and tartar, together with practical advice on how to clean your teeth at home. If the examination reveals gum pockets or loss of support, a course of treatment for gum disease and pyorrhoea may be considered. To find out more about the possible causes, read our article on bleeding gums.
If your gums bleed often, book an assessment visit at our clinic in Via Cesare Pavese 135, Rome EUR: Dr Pljevljak will examine your gums and teeth and recommend the most suitable course of treatment.
