Gums are pink and spongy structures that are essential for holding and protecting the teeth. The gums adhere to the teeth very closely to prevent the entry or spreading of an infection in the roots of the teeth or jaw bone. Due to aging or disease, gums weaken and recede, paving the way for teeth falling out, so in all this process of receding, the teeth seem to be elongated, sensitive and feel shaky with bleeding.
Bleeding from the gums is mainly due to injury, infection, or inflammation of the gums. Such infected or inflamed gums are medically called gingivitis [1]. Gingivitis can be seen as a red line of blood in the gum line. If bleeding persists, then it should be taken seriously, as it is a possible indication of illnesses like leukemia or bleeding disorders. One should be aware that some people are hemophiliacs. The blood of people with hemophilia does not clot as usual, [2] and the resulting inability to stop bleeding can even result in bleeding to death, so bleeding gums can be a serious condition.
Causes Of Bleeding Gums
Bacterial, viral or fungal infections that arise in the gums and teeth produce acids and toxins that usually erode and cause inflammation of the gums. The inflammation makes gums swollen, red and spongy and that increases the tendency to bleed and simultaneously weakens the stability of the teeth as a result of gum recession.
Bleeding gums are more commonly seen in adults than in the case of children, and it is mostly due to injury due to improper brushing when it occurs in children. In the case of adults or the aged, bleeding gums are often found to be related to a disease. Females have higher incidences of bleeding gums than males. Marginal gingivitis is most common as bleeding from gums usually occurs near the base of the teeth.
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Injury or trauma, which may be caused by a blow, insertion of foreign substances, being too vigorous with a toothpick, dentures, improper brushing, or flossing. The gum may also become injured from irritation of chemicals and acids in foods, drinks, mouth fresheners, tooth whiteners, and medicines.
Disease can also cause bleeding gums. For example, there could be gum problems or an infection of the gums, retracted or receded gums, or weak and spongy gums. Bleeding gums are also a common result of dental problems such as caries, excessive tartar or plaque formation, or periodontitis.
Mouth sores can also spread the infection to the gums to cause bleeding.
Blood disorders, bleeding and clotting disorders, deficiency of coagulation factors, Thrombocytopenic purpura, hemophilia, and leukemia can cause bleeding as well.
Systemic diseases, such as liver disorders, kidney disorders, arterial or capillary diseases, diabetes, or a heart disorder can also manifest as bleeding gums.
Nutritional and physiological factors, such as vitamin C and K deficiency will lead to bleeding disorders.
Pregnancy and hormonal changes can also cause gums to bleed occasionally, as well as poor oral hygiene, infection and weakness.
Medications could also cause bleeding gums, because continuous usage of blood thinners, such as Aspirin, heparin therapy, painkillers and treatment procedures like chemotherapy, radiation therapy, can also cause bleeding from gums.
Hot food and chemicals can end up burning the gums, further resulting in bleeding. For example, some people still follow the practice of placing pain relieving tablets on the gum adjacent to the painful tooth, which invariably causes burns. Certain rapidly spreading infections can damage the blood vessels of the gums, resulting in bleeding as well.
Symptoms Of Bleeding Gums
- Bleeding after even the slightest injury or even touch
- Red, tender or swollen gums
- Blood and a bloody taste in mouth
- Sometimes, due to bleeding gums, pus can be squeezed from the gums
- Bad breath
- Recession of gums from the teeth
- Sensitive teeth
- Loose and shaky teeth
- Difficulty and discomfort in mastication and food intake occasionally due to pain and sensitivity [3]
Diagnosing Bleeding Gums
For persistent bleeding gums, there are some essential tests [3]:
- Oral examination of the teeth and gums
- X-rays of teeth and jaw
- Blood analysis
- Tc, Dc, Esr, Hb%, sugar, calcium, urea, and creatinine
- Coagulation factors and serum prothrombin time
- Bleeding and clotting time
Bleeding Gums Prevention
Everyone who wants to prevent bleeding gums should avoid hard and fast brushing, hard diets and snacks which can cause injuries such as chips, sour foods or drinks, hot drinks, carbonated acid drinks, sticky chocolates, pain-killers, blood thinners and unnecessary medication.
Oral hygiene and dental health are very important as well. Take care of plaque deposits by properly cleaning your teeth and visiting your dentist regularly. Use soft bristle toothbrushes to brush gently and use vitamin supplements in case of deficiency. Eat a well-balanced nutritious diet, employ proper mastication, and brush away the food particles in the mouth after every meal. Try to gargle with salty warm water after every meal.
Taking Care Of Bleeding Gums
Apply gentle pressure for compression, but if bleeding persists apply ice or drink ice-cold drinks or juices to stop bleeding. Do not brush the teeth; instead, you can rinse with salty warm water. Keep away from all new medication and visit your physician or dentist at the earliest opportunity to find the cause of your bleeding gums. It is important to visit the dentist at least once every six months for plaque removal. Follow your dentist’s home care instructions, because the dentist may recommend rinsing with salt water or hydrogen peroxide and water. Try to avoid using commercial, alcohol-containing mouthwashes, which aggravate the problem of bleeding gums [5].
Floss your teeth twice a day to keep plaque from building up on your teeth. Eliminate snacks between meals and reduce carbohydrate intake to help prevent plaque build-up on teeth. Use an oral irrigation device (Waterpik) on the low setting to massage the gums, and maintain a balanced, healthy diet.
You should also be familiar with some additional tips that could be helpful for bleeding gums. First, you should avoid the use of tobacco and alcohol, which aggravates bleeding gums. Secondly, have poorly fitting dentures adjusted and realigned by your dentist if they are causing sore spots in your gums, leading to bleeding gums. Thirdly, try to avoid Aspirin unless your healthcare provider has recommended that you take it. [6]
Control bleeding gums by applying pressure directly on the gums with a gauze pad soaked in ice water. And if you have been diagnosed with a vitamin deficiency, take recommended vitamin supplements. If side effects of medication are irritating, you could ask your doctor to adjust or substitute another medication. It is also important to know you should never change your medication without consulting your doctor.
When to contact a medical professional?
You must consult your health care provider if your gums continue to bleed even after treatment, or if the bleeding is severe or chronic. Other unexplained symptoms are associated with the bleeding so your dentist should examine your teeth and gums, and ask questions such as [3]:
- Whether the gums are bleeding profusely,
- Did the bleeding begin recently,
- Do the gums bleed frequently or only occasionally,
- And have you had gum problems before?
The doctor could also ask the following questions to get an appropriate diagnosis.
- How often you brush and floss
- Do you use a soft or hard bristled toothbrush?
- How vigorously do you brush your teeth?
- When was the last time you had your teeth cleaned at the dentist?
- Have you changed your diet?
- Do you eat adequate amounts of fruits and vegetables?
- Do you take supplemental vitamins?
- Do you have a high carbohydrate diet?
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The doctor should also ask what medications you take, do you take anticonvulsants, anticoagulants or Aspirin, or maybe you are pregnant. In some cases mouthwash or toothpaste could provoke the gums to bleed, so your doctor should know if you changed some of these recently. Your doctor must be familiar with other possible symptoms you might have, for example, a sore throat.
It is always best to brush away the problem in the initial period itself. Otherwise, complications like constant bleeding, swelling and pain in gums, periodontal disease, jaw bone disease, and finally tooth loss can occur.
General Treatment Of Bleeding gums
To keep healthy and smiling teeth, it is essential to keep the gums healthy. The first and best treatment is maintaining oral and dental hygiene: this includes proper brushing techniques and regular visits to the dentist. Your doctor may also request you to change certain behaviors, such as smoking or alcohol consumption, as a way to improve treatment outcome.
Due to a wide range of potential problems occurring in the gums and teeth, most patients are prescribed antibiotics and varieties of pasts to control infection [3].
The homeopathic approach, according to symptoms, similarity, and cause of the complaint, is prescribed to cure the case. Medicines which are prescribed homeopathically could control infection immediately and arrest bleeding [7]. For a complete cure, treatment should be started at the early stage; otherwise, the gums may recede or shrink, paving the way for infection to enter the base of the teeth to loosen them. Once gums get retracted and receded, gaining normalcy is tough, but even though we make gums healthy through treatment, they will not adhere to the teeth as tightly as before. In that case, the cementum of the teeth will be exposed and this will cause sensitive teeth.
Usually, pain is always preferable to numbness, where some people opt for benumbing the gum with gum gel for pain relief and arresting the bleeding. This approach will work only temporarily and in this case, the disease often advances further, causing more and more pain and more and more complications, since this type of temporary pain alleviation allows the disease to continue developing with a temporary hurdle.
Therefore, treatment of bleeding gums locally with this type of gum gel will not help in the long run. Aloe vera is often helpful [8], but a patient and a doctor should aim at treating the cause and symptoms internally with medicines for a complete cure.
- Prescription antimicrobial mouth rinse
- Antiseptic chip
- Antibiotic gel
- Antibiotic microspheres
- Enzyme suppressant
- Oral antibiotics
However, depending on how far the disease has progressed, your dentist may still suggest surgical treatment [3]:
- Flap surgery
- Bone and tissue grafts