Causes and Treatment of Bleeding Gums
Poor oral hygiene and gingivitis are the most common causes of bleeding gums, which can be effectively treated with proper oral hygiene practices, professional dental cleaning, and antimicrobial rinses like chlorhexidine gluconate.
Common Causes of Bleeding Gums
Primary Causes
- Poor oral hygiene: Leading to plaque buildup and gingivitis
- Gingivitis: Inflammation of the gums characterized by redness, swelling, and bleeding upon probing 1
- Aggressive brushing or flossing: Using improper technique or hard-bristled toothbrushes
- Dental appliances: Ill-fitting dentures or orthodontic devices causing trauma
Systemic Causes
- Blood disorders: Including von Willebrand disease, which affects blood clotting 2
- Medications: Anticoagulants and blood thinners can increase bleeding tendency 2
- Vitamin deficiencies: Particularly vitamin C and K deficiencies
- Hormonal changes: During pregnancy, puberty, or menopause
- Systemic diseases: Including diabetes, leukemia, and thyroid disorders 3
Diagnosis
Clinical Assessment
- Evaluate bleeding pattern: Spontaneous vs. provoked bleeding
- Check for visible plaque and calculus deposits
- Assess gingival appearance: Redness, swelling, consistency
- Measure pocket depths and bleeding on probing (BOP) 4
- Look for signs of trauma from improper brushing or flossing
Medical History Considerations
- Current medications, especially anticoagulants 2
- Systemic conditions that may affect gingival health
- Family history of bleeding disorders
- Recent changes in oral hygiene routine
Treatment Approach
Non-Surgical Management
Improve oral hygiene:
- Use a small, ultra-soft-bristled toothbrush 5
- Brush twice daily with fluoride-containing, non-foaming toothpaste
- Floss daily using proper technique (waxed floss may minimize trauma)
Professional dental cleaning:
- Scaling and root planing to remove plaque and calculus
- Professional removal of stains and tartar at least every six months 1
Antimicrobial therapy:
Home care recommendations:
- Salt and baking soda rinses (1 teaspoon each in 4 cups water) 5
- Avoid alcohol-containing mouthwashes that can dry and irritate gums
- Apply cold compresses to reduce swelling if present
When to Seek Additional Care
- Bleeding that doesn't improve within 2 weeks of improved oral hygiene
- Severe or spontaneous bleeding that doesn't stop within 2 minutes
- Bleeding accompanied by significant pain or swelling
- Presence of systemic symptoms (fatigue, easy bruising elsewhere)
Special Considerations
Medication-Related Concerns
- For patients on anticoagulants, dental procedures should be planned in consultation with the prescribing physician 2
- Patients should not discontinue anticoagulants without medical supervision
- Local hemostatic measures may be needed for dental procedures
Underlying Medical Conditions
- Patients with blood disorders may require specialized management in coordination with a hematologist 6
- Diabetic patients need more frequent dental monitoring due to increased susceptibility to gingival inflammation
- Immunocompromised patients may need more aggressive treatment approaches
Prevention Strategies
- Maintain consistent oral hygiene routine
- Use proper brushing technique (45-degree angle to gumline, gentle circular motions)
- Regular dental check-ups every 6 months
- Address early signs of gingival inflammation promptly
- Balanced diet rich in vitamins C and K
- Avoid tobacco products, which significantly increase risk of gum disease 5
Common Pitfalls to Avoid
- Ignoring persistent bleeding, which may indicate underlying systemic conditions
- Self-medicating with over-the-counter products without addressing the root cause
- Discontinuing proper oral hygiene when gums bleed (should continue gentle cleaning)
- Failing to recognize medication side effects that may contribute to bleeding
- Overlooking the importance of professional dental care in managing gingival bleeding