Why Do My Gums Bleed When I Brush, and When to Worry

Blood in the sink after brushing is so common that most people stop noticing it. That is the problem. Bleeding is not something healthy gums do, and in almost every case it is the earliest sign of gum disease rather than a sign that you brushed too hard. The good news is that caught at this stage it is usually reversible. Here is how we think about bleeding gums at our Burton office.

Healthy gums do not bleed

If your hands bled every time you washed them, you would not conclude that you were washing too vigorously. Gums work the same way. Firm, healthy gum tissue takes a soft brush and floss without bleeding at all.

What usually causes the bleeding is plaque sitting along the gum line. Plaque is a soft film of bacteria that starts forming within hours of brushing. Left in place, the body treats it as an infection and sends blood to the area. The tissue becomes swollen, slightly red and fragile, and it bleeds at the lightest touch. That is gingivitis, the first stage of gum disease.

Gingivitis and periodontitis are not the same thing

The distinction matters, because one is reversible and one is not.

• Gingivitis affects the gum tissue only. The bone holding your teeth in place is untouched. With a thorough cleaning and better daily habits, gums usually settle within a week or two.
• Periodontitis is what happens when gingivitis is left alone long enough for the infection to reach the bone. Bone that is lost does not grow back. Treatment can stop the damage and keep the teeth, but it cannot undo what is already gone.

That gap is the whole reason we take a small amount of bleeding seriously. Catching it as gingivitis is a cleaning and a conversation. Catching it later is a much longer road.

Reasons gums bleed that are not gum disease

Plaque is the usual answer but not the only one. A few others worth knowing about:

• Starting to floss again after a long gap. The first few days can bleed. If it is still bleeding after a week of daily flossing, that is no longer the explanation.
• Pregnancy. Hormonal changes make gum tissue react more strongly to the same amount of plaque. It usually settles after the birth, but it still needs cleaning in the meantime.
• Blood thinners, including daily aspirin. These do not cause gum disease, but they make any bleeding more obvious and slower to stop.
• Smoking, which does the opposite and hides the problem. Nicotine narrows the blood vessels in the gums, so smokers often bleed less while having more disease. Pink gums are not proof of healthy gums if you smoke.
• Diabetes, which raises the risk of gum infection and is in turn harder to control because of it. The relationship runs in both directions.

What to do this week

Most bleeding gums respond to a fairly boring routine, done consistently:

• Brush twice a day for two full minutes with a soft brush, angled slightly toward the gum line rather than straight at the tooth.
• Clean between the teeth once a day. Floss, interdental brushes or a water flosser all work. The one you will actually use is the right one.
• Keep cleaning the spot that bleeds rather than avoiding it. Avoiding it is what keeps it inflamed.
• Use an antiseptic mouthwash if you like it, but treat it as an extra rather than a replacement for cleaning.

If the bleeding has not improved after two weeks of that, or if you can see tartar, the hard deposit that a brush will not shift, book a cleaning. Tartar only comes off with instruments.

When to come in sooner

Call us rather than waiting if you notice gums pulling away from the teeth, persistent bad breath that brushing does not fix, a tooth that feels looser than it used to, pus around a tooth, or pain that keeps you awake. Those point to something past gingivitis.

What a visit for bleeding gums looks like here

We measure the gum pockets around each tooth, which tells us whether the bone is involved and gives us a number to compare against next time. We take X-rays if we need to see the bone level. Then we clean thoroughly above and below the gum line, and we show you the two or three places your brush is missing, because it is almost never the whole mouth.

If the pockets are deep we will talk about periodontal gum care rather than a standard cleaning, and we will tell you plainly which one you need and why. See our periodontal gum care page for what that involves.

Bleeding gums are worth twenty minutes of attention now and a great deal more later. Call (810) 715-3368 or request an appointment online. We are at 1024 N. Genesee Rd in Burton, with free parking at the door, and new patients from Burton, Flint, Davison, Grand Blanc and across Genesee County are welcome.

Questions patients ask us

About the author

Dr. Prabha Raju, DDS

Dr. Raju has practiced dentistry in Burton, Michigan since 1997, with advanced training in implants, sedation, laser dentistry and Invisalign.

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Tender Dental Care, 1024 N. Genesee Rd, Burton, MI 48509. Serving Flint, Grand Blanc, Davison, Flushing, Swartz Creek, Fenton and Genesee County. This article is general information, not a diagnosis; please see a dentist for advice about your own mouth.