Bleeding gums: why it happens and what to do

In short: gums bleeding when you brush is not normal, even though it happens to many people. It is almost always gingivitis, an inflammation caused by built-up plaque that is reversible if you act early. The worst thing you can do is stop brushing that area: you have to clean it well and take the step of having a check-up.

Why do my gums bleed?

The most common cause, by far, is plaque built up at the edge of the gum. When that plaque stays there for days, the gum becomes inflamed in response, turning red and swollen and bleeding at the slightest touch: brushing, using floss or sometimes on its own. That is gingivitis.

There are other factors that trigger or worsen it: hormonal changes (pregnancy, menstruation), certain medications, tobacco (which masks it, beware), stress or a lack of certain vitamins. But in the vast majority of cases, behind the bleeding there is plaque that is not being removed properly.

Gingivitis or periodontitis? They are not the same

This is the key difference, because it changes the whole prognosis:

• Gingivitis: the inflammation affects only the gum. It is reversible. You remove the plaque and tartar, improve hygiene, and the gum recovers.
• Periodontitis: if gingivitis is ignored, the inflammation goes deeper and starts to destroy the bone that holds the tooth. Pockets appear, the teeth can loosen and, over time, be lost. The damage to the bone can no longer be recovered, only halted.

The good news is that the jump from one to the other is not instant: there is room to act. The bad news is that periodontitis usually advances without pain, so many people do not notice until the tooth moves. That is why bleeding is an alarm worth not silencing. (This is general guidance; the exact diagnosis is given by a professional examining your mouth.)

What do I do if my gums are bleeding right now?

A sensible plan, step by step:

1. Do not stop brushing that area. It bleeds from lack of cleaning, not from excess. Brush gently but thoroughly, twice a day, including the edge of the gum.
2. Use floss or interdental brushes daily. That is where the most plaque stays and where the brush does not reach. The first few days it may bleed a little more; within a week or two it usually eases off.
3. A soft brush and good technique, without scrubbing like crazy. Rubbing hard does not clean better, it only damages the gum.
4. Book a check-up. If after a couple of weeks of good hygiene it is still bleeding, or if it bleeds a lot, it needs to be looked at.

When do I absolutely have to go to the dentist?

Do not wait if the bleeding is heavy, if the gums are very swollen or receding (the teeth look “longer”), if you notice a tooth moving, if you have persistent bad breath or if you have already been warned about gum problems. In those cases a periodontics assessment is in order, that being the part of dentistry that deals with the gums and bone.

The basic treatment for bleeding gums almost always starts with a professional dental cleaning to remove the tartar that is inflaming it. If things are more advanced, a deeper clean below the gum may be needed. The sooner it is caught, the less needs to be done.

Can it be prevented?

To a large extent, yes, and it is fairly simple: brushing twice a day, cleaning between the teeth daily and regular check-ups to remove the tartar that forms anyway. You do not need anything strange or expensive; what almost always fails is consistency, not knowledge.

If you live in Bilbao and have been seeing blood in the sink when brushing for a while, do not let it slide: the sooner it is looked at, the easier it is. The first check-up is free, so book an appointment and we will take a look at your gums with no obligation.