Bleeding Gums and Gingivitis

Healthy gums do not bleed when you brush or floss. Bleeding is almost always gingivitis, inflammation from plaque at the gum line, and at that stage it reverses completely with better cleaning. The common mistake is to brush the bleeding area less. The right response is to clean it more thoroughly, and to be examined if the bleeding has not stopped after two weeks.

Why gums bleed

Plaque, the soft film of bacteria that forms on teeth every day, collects along the gum line and between the teeth where a quick brush does not reach. Within days the gum reacts: it becomes red, slightly swollen, and bleeds at a touch. That is gingivitis. Remove the plaque consistently and the gum heals in a week or two. Leave it, and the plaque hardens into tartar that only a professional cleaning removes, and the inflammation moves deeper.

A few other things make gums bleed more readily:

• Blood-thinning medication, including daily aspirin.
• Pregnancy, when hormonal changes make the gums react more strongly to the same plaque.
• Some medical conditions and medications.
• A badly fitting filling or crown edge that traps plaque at one spot.
• Smoking hides bleeding rather than causing it: it narrows the small blood vessels in the gum, so smokers often have gum disease without ever seeing blood.

When it has become gum disease

Gingivitis is inflammation of the gum alone. Left long enough, the inflammation reaches the ligament and bone that hold the teeth, and that is periodontitis, or gum disease. The bone it destroys does not grow back. The signs that it has crossed that line:

• Gums that have pulled back, so teeth look longer
• Persistent bad breath
• Teeth that have loosened or drifted
• A bite that has changed
• Spaces opening between the teeth
• Pus or a bad taste from the gum

It rarely hurts at any stage, which is why so much of it is found at examinations rather than because of a complaint. Our gum disease treatment page explains what happens then.

What to do at home

For two weeks, clean properly and give the gums a chance to heal:

• Brush twice a day with a soft brush, angled at forty-five degrees toward the gum line, with small circular or vibrating strokes rather than scrubbing. Spend time where the gum meets the tooth; that is where the plaque is.
• Clean between every tooth once a day, with floss or small interdental brushes, whichever you will use. It will bleed at first. That is the inflamed spot being cleaned, and it stops as the gum heals.
• Do not avoid the bleeding areas. They are the ones that need cleaning most.
• An electric toothbrush helps most people clean the gum line more consistently.

If the bleeding has not stopped after two weeks of this, or if you have any of the gum disease signs above, book an examination.

What we do

An examination measures the gums around every tooth, checks for bleeding, recession and loose teeth, and reads the X-rays for bone loss. From that we can tell gingivitis from periodontitis and, within periodontitis, old damage from active disease. For gingivitis, a professional cleaning removes the tartar you cannot, and we show you the technique for your mouth and your hands. For periodontitis, the cleaning goes below the gum line as scaling and root planing, with a reassessment a month later and maintenance visits every three months to keep the disease controlled.

Why it matters beyond the gums

Gum disease is the main reason adults lose teeth, and it undermines everything else in dentistry: the same bacteria that cost teeth their bone attack the bone around implants, and crowns, veneers and bridges on inflamed gums do not last. Treating the gums comes before any of that work here.

Frequently asked questions

My gums bleed when I floss. Should I stop flossing?

No. Bleeding means the gum is inflamed because plaque has been sitting there, and flossing is what removes it. Floss gently every day; in most cases the bleeding stops within a week or two as the gum heals.

Is it from brushing too hard?

Rarely. Scrubbing can wear the gum back over years, but bleeding is almost always inflammation, not injury. Use a soft brush, angle it toward the gum line, and let the bristles do the work.

How long before I should see a dentist?

If two weeks of careful daily brushing and flossing have not stopped the bleeding, or if you also have receding gums, bad breath, loose teeth or swelling, book an examination. Gingivitis is easy to reverse; what it can become is not.

Can bleeding gums be a sign of something else?

Sometimes. Blood thinners make gums bleed more easily, hormonal changes in pregnancy increase inflammation, and some conditions affect the gums. Smokers often do not bleed even with gum disease, because smoking narrows the blood vessels and hides the sign.

What is the difference between gingivitis and gum disease?

Gingivitis is inflammation of the gum only, and it reverses completely. Periodontitis is inflammation that has reached the bone and ligament under the gum, and the bone it destroys does not come back. Catching it at the gingivitis stage is the whole point.

Sources

Professional guidelines and peer-reviewed reviews this page draws on.

1. Eke PI, Thornton-Evans GO, Wei L, Borgnakke WS, Dye BA, Genco RJ. Periodontitis in US adults: National Health and Nutrition Examination Survey 2009-2014. Journal of the American Dental Association. 2018;149(7):576-588. DOI
2. Smiley CJ, Tracy SL, Abt E, et al. Evidence-based clinical practice guideline on the nonsurgical treatment of chronic periodontitis by means of scaling and root planing with or without adjuncts. Journal of the American Dental Association. 2015;146(7):525-535. DOI