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Definition

Bleeding gums can be a sign that you have or may develop gum disease. Ongoing gum bleeding may be due to plaque buildup on the teeth. It can also be a sign of a serious medical condition.

Causes

The main cause of bleeding gums is the buildup of plaque at the gum line. This may lead to a condition called gingivitis, or inflamed gums.

Plaque that is not removed will harden into tartar. This may lead to increased bleeding and a more advanced form of gum and jaw bone disease known as periodontitis.

Other causes of bleeding gums include:

• Any bleeding disorders
• Brushing too hard
• Hormonal changes during pregnancy
• Ill-fitting dentures or other dental appliances
• Improper flossing
• Infection, which can be either in a tooth or the gum
• Leukemia, a type of blood cancer
• Scurvy, a vitamin C deficiency
• Use of blood thinners
• Vitamin K deficiency

Home Care

Visit the dentist at least once every 6 months for plaque removal. Follow your dentist's home care instructions.

Brush your teeth gently with a soft-bristle toothbrush at least twice a day. It is best if you can brush after every meal. Also, flossing teeth twice a day can prevent plaque from building up and turning into tartar.

Your dentist may tell you to rinse with salt water or hydrogen peroxide and water, or a mouth rise designed to treat gum inflammation. Some rinses contain alcohol, so consult with your dentist prior to using one of these types.

It can help to follow a balanced, healthy diet. Try to avoid snacking between meals and cut down on the carbohydrates you eat.

Other tips to help with bleeding gums:

• Have a periodontal exam.
• Do not use tobacco, since it makes bleeding gums worse. Tobacco use can also mask other problems that cause bleeding of the gums.
• Control gum bleeding by applying pressure directly on the gums with a gauze pad soaked in ice water.
• If you have been diagnosed with a vitamin deficiency, take vitamin supplements.
• Avoid aspirin unless your health care provider has recommended that you take it.
• If side effects of a medicine are causing the bleeding gums, ask your provider to prescribe a different medicine. Never change your medicines without first talking to your provider.
• Use an oral irrigation device on the low setting to massage your gums.
• See your dentist if your dentures or other dental appliances do not fit well or are causing sore spots on your gums.
• Follow your dentist's instructions on how to brush and floss so you can avoid hurting your gums.

When to Contact a Medical Professional

Consult your provider if:

• The bleeding is severe or long-term (chronic)
• Your gums continue to bleed even after treatment
• You have other unexplained symptoms with the bleeding

What to Expect at Your Office Visit

Your dentist will examine your teeth and gums and ask you about the problem. Your dentist will also ask about your oral care habits. You may also be asked about your diet and the medicines you take.

Tests that may be performed include:

• Blood studies such as a CBC (complete blood count) or blood differential
• X-rays of your teeth and jawbone

References

Chow AW. Infections of the oral cavity, neck, and head. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 64.

Hayward CPM, Ma AD. Evaluation of the patient with suspected bleeding disorders. In: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Basic Principles and Practice. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 126.

Teughels W, Feres M, Ganesan SM, Gidley MD, Hernandez-Kapila YL, Jakubovics N. Biofilm and periodontal microbiology. In: Newman MG, Klokkevold PR, Elangovan S, Hernandez-Kapila YL, eds. Newman and Carranza's Clinical Periodontology and Implantology. 14th ed. St Louis, MO: Elsevier; 2023:chap 10.

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