Gum care · 6 min read
Bleeding gums are the single most common thing patients mention and the single most common thing they ignore. Seven causes a periodontist sees weekly, and what to do about each.
If your hand bled every time you washed it, you would see someone about it. Gums get a strange exemption from that logic. Patients tell me their gums have bled for years, in the same tone they would use to describe a habit.
Healthy gums do not bleed. Not when you brush hard, not when you floss, not occasionally. Bleeding always means inflammation, and inflammation always has a cause. These are the causes I see most.
The overwhelming majority of cases. Plaque that sits undisturbed at the gumline for a couple of days hardens into calculus, which is rough, porous, and impossible to remove with a toothbrush. The gum reacts to the bacteria living on it, and inflamed tissue bleeds when touched.
What to do: a professional clean removes the calculus, and a corrected brushing routine stops it reforming. Bleeding usually stops within one to two weeks.
Plenty of people brush twice a day and still have bleeding gums, because they are cleaning the middle of the tooth and skating over the edge where it meets the gum. That junction is exactly where plaque accumulates.
What to do: angle the bristles at about 45 degrees into the gumline and use small circles. It feels counterintuitive to brush the part that bleeds, but that is the part that needs it.
A toothbrush reaches roughly three of the five surfaces of each tooth. The two surfaces between teeth are where gum disease most often starts, and they are also the sites patients are most surprised to find bleeding.
What to do: interdental brushes where the gaps allow, floss where they do not. Daily, not weekly. Expect bleeding for the first week if those sites have been inflamed for a while.
Pregnancy gingivitis is common and not a sign of neglect. Hormonal changes exaggerate the gum response to the same amount of plaque, so gums that were fine before can become swollen and bleed easily.
What to do: professional cleaning during pregnancy is safe and worth doing. The second trimester is usually the most comfortable time for a longer appointment. Tell the clinic you are pregnant when you book.
The relationship runs in both directions. Poorly controlled blood sugar makes gum disease worse and slower to heal, and active gum inflammation makes blood sugar harder to control. Some medications also cause gum overgrowth, which traps plaque and bleeds.
What to do: tell your dentist about your medical history and your full medication list. It changes what we look for and how we plan treatment.
Smoking is a peculiar case. It worsens gum disease substantially, but it also constricts the blood vessels in the gum, which suppresses the bleeding that would otherwise warn you. Smokers often present with advanced disease and gums that look deceptively calm.
What to do: if you smoke, do not take the absence of bleeding as reassurance. Get charted. Quitting measurably improves how gums respond to treatment.
Sometimes bleeding is not early-stage inflammation at all. If pockets have formed and bone has been lost, no amount of better brushing will fix it, because the bacteria now live several millimetres below where your brush can reach.
What to do: this is the reason two weeks of good home care is a useful test. If bleeding persists past that, the problem is deeper than technique, and it needs charting rather than more advice.
Do not stop cleaning the area because it bleeds. It is the most natural reaction and it makes the problem worse: less cleaning means more plaque, which means more inflammation, which means more bleeding.
Clean gently but completely, every day, and give it two weeks. If the bleeding has stopped, you have your answer. If it has not, book an examination and find out what is actually going on.
Written by Dr. Niyukty Arjal, MDS Periodontist, Gums & Giggles Dental Clinic. This article is general information about dental health and is not a diagnosis. Symptoms vary between patients, so book an examination for advice specific to your own teeth and gums.
Gum care · 7 min read
Gum disease is painless for most of its course, which is why it is usually found late. Here is how it progresses, what treatment each stage needs, and where the cost rises steeply.
Read moreTreatments · 6 min read
Both straighten teeth. They differ in price, treatment time, visibility, and how much of the result depends on you remembering to wear them.
Read moreFind us
Conveniently located on Dhobidhara Marg, minutes from Lazimpat, Maharajgunj, Naxal, Baluwatar, and Thamel.
Book a consultation at our Dhobidhara Marg clinic and get an answer based on an examination, not an article.
