Bleeding gums usually show up as pink when you spit after brushing, or red on the floss. Usually the cause is plaque irritating the gum, and at that stage the damage can still be undone. Here is what else makes gums bleed, what to do at home, when to see a dentist and what treatment involves.
What bleeding gums usually mean
Plaque is the sticky film of bacteria that forms on teeth every day. Along the gum line it inflames the gum, which turns red, puffy and quick to bleed. This early stage is called gingivitis, and it affects the gum only. The US Centers for Disease Control and Prevention (CDC) calls it a reversible condition.
Plaque left on the teeth hardens into tartar, a rough yellow or brown deposit also called calculus. A toothbrush cannot remove it; a dentist or hygienist has to scale it off. While plaque and tartar stay, the gums stay irritated, red and swollen, which is why bleeding can carry on after your brushing improves.
If the inflammation continues for months or years, it spreads below the gum line. The gum pulls away from the tooth, leaving a gap called a pocket, and the bone that holds the tooth starts to shrink. This is periodontitis, and bone loss around the teeth is its main feature. In advanced cases the bone supporting the teeth is destroyed and teeth can loosen or shift.
Why early bleeding is the moment to act
Gingivitis can be reversed. Bone lost to periodontitis does not grow back on its own.
At the bleeding stage only the gum is inflamed, and once the plaque and tartar are gone it can return to health. After periodontitis has taken bone from around a tooth, treatment can bring the disease under control, and the support already lost stays lost.This is why dentists take bleeding gums seriously even when nothing hurts. The CDC says periodontitis cannot be reversed but can be slowed down and managed, and Cleveland Clinic calls the bone loss permanent. Acting at the bleeding stage means:
- Simpler treatment. Gingivitis can usually be cleared with a professional cleaning and better brushing at home.
- Fewer visits. Deep cleaning in sections, surgery and years of maintenance come later, if at all.
- Teeth that keep all of their bone, which holds them firm.
Other causes of bleeding gums worth knowing
- Brushing too hard. Gums can bleed if you brush too hard. A soft or extra-soft brush cleans well enough.
- Starting to floss. Gums may bleed at first as they get used to it. This usually settles in about a week.
- Pregnancy. Hormone changes make the gums react more strongly to plaque, and some women develop pregnancy gingivitis: swollen, tender gums that may bleed a little.
- Blood thinners. These medicines may cause your gums to bleed. Do not stop one on your own; tell your dentist and the doctor who prescribed it.
- Diabetes. It is a risk factor for gum disease, and unexplained bleeding gums are one reason a doctor may test for it.
- Low vitamin C or vitamin K. A shortage of either can show up as bleeding gums.
- Smoking. It can cover up a gum problem by restricting blood flow to the gums. In a US study of more than 12,000 people, smoking strongly suppressed gum bleeding, most of all in heavier smokers, yet tobacco is the most significant risk factor for gum disease.
What to do at home, and what to avoid
Keep brushing, even when you see blood. Skipping the sore areas leaves the bacteria in place and makes the inflammation worse.
- Brush twice a day with fluoride toothpaste and a soft-bristled brush.
- Clean between your teeth every day with floss or interdental brushes, as the NHS advises.
- Rinse with warm salt water if the gums feel sore.
If the bleeding has not settled within two weeks of careful cleaning, book a check-up.
When to see a dentist sooner
Gums that bleed when you brush are reason enough for a check-up, and the NHS lists it among the reasons to see a dentist. Ask for an earlier appointment if you also notice:
- very sore, swollen gums
- teeth that feel loose or have started to move
- gums that have pulled back, so the teeth look longer
- pus coming from the gum around a tooth
- bad breath or a bad taste that will not go away, which the American Dental Association (ADA) lists among the warning signs
See a doctor too if your gums bleed with no clear cause, or the bleeding is hard to stop; the ADA advises contacting a physician if it does not stop quickly. Less commonly, bleeding gums are a sign of a blood condition such as leukaemia.
Bleeding gums treatment: what to expect
A gum check
Your dentist looks for bleeding and gently measures the gap between gum and tooth with a thin probe. If the bone level needs checking, we take a LASER RVG digital X-ray, which uses lower radiation. Together they show whether it is gingivitis or periodontitis.
Cleaning for gingivitis
Scaling removes tartar above and just below the gum line, usually with an ultrasonic scaler that shakes deposits loose with a spray of water, and then the teeth are polished. With better cleaning at home, this is usually all gingivitis needs.
Deep cleaning for periodontitis
Called scaling and root planing, it cleans tartar and bacteria off the roots inside the pockets. Your dentist may numb the area with local anaesthetic first, and the mouth is often treated in sections over two or more visits.
Laser or surgery, if needed
A dental laser can disinfect pockets or trim swollen gum. The evidence that it adds much to a thorough deep cleaning is mixed, and a 2020 European guideline suggests not using lasers alongside it, so we use one only where we expect it to help your case. When pockets stay deep after cleaning, surgery may be required so the roots can be cleaned directly.
Maintenance visits
Periodontitis can return if plaque builds up again. The same guideline recommends professional maintenance visits every 3 to 12 months, depending on your risk.
What gum treatment feels like
Pain. A routine cleaning is usually done without an injection, with a numbing gel for sensitive spots. For deeper work the area can be numbed first, so what you notice is pressure. Gums can be tender and bleed slightly for a day or two afterwards.
Sensitive teeth and gaps. Teeth can feel sensitive to cold for a few days where tartar covered the root. They can also look more spaced, because swollen gum and tartar were filling gaps that were already there.
Loose teeth. Teeth loosened by inflamed gums can firm up as the inflammation settles. Where the bone support has gone, they may stay loose, and the X-ray shows which applies to you.
Gum disease treatment at our Malad West clinic
Gurukrupa is ISO 9001 certified and sits on Marve Road at Mith Chowky, Malad West. Our dentists do routine cleanings and gum checks. When the gums need more, Dr. Aanchal Sahni, a gum specialist who took a gold medal in her MDS in Periodontology and Oral Implantology at PGI Rohtak, plans deep cleaning, laser gum treatment and gum surgery. Read about all our dentists, what a routine teeth cleaning involves, our wider general dentistry care, or our guide to laser dentistry.
Cost depends on how many areas need treatment and how deep the pockets are. Visit us for a detailed quote; you get the estimate in writing before any treatment starts.
Common questions
Is it safe to have my teeth cleaned while pregnant?
Yes. The ADA, the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics all encourage dental visits during pregnancy, and some women need cleanings more often while pregnant.
Why do my gums bleed more since I stopped smoking?
Blood flow to the gums recovers, so inflammation that smoking was hiding starts to show. In a small study, gum bleeding doubled in the weeks after people quit, even though their cleaning improved.
Does diabetes affect gum disease treatment?
It can, because diabetes affects how the gums heal. The European guideline for treating periodontitis recommends diabetes control alongside gum treatment, so tell your dentist your latest results.
How often should I get my teeth cleaned?
Every six months is the usual advice. If your gums are healthy and you keep plaque down, once a year may be enough.
Have your gums checked
If your gums bleed when you brush or floss, come in for a gum check, and we will tell you what stage you are at and what it needs. We are on Marve Road at Mith Chowky, Malad West, close to Malad East, Kandivali and Goregaon.