Bleeding gums are common—they mostly result from a lazy brushing and flossing routine or minor irritation. But in some cases, the bleeding may have a deeper meaning. This article explores the various causes of bleeding gums and the best ways to treat them.
Your gums are the foundation of a healthy mouth—they are the protective cushion that holds your teeth in place and keeps them healthy (and functional).
Although bleeding gums are common, healthy gums don't bleed.
But that doesn't necessarily mean your oral health is at risk.
In this article, we'll look at what bleeding gums mean and their potential causes.
What Are Bleeding Gums? A Quick Look
If you've ever brushed too hard or flossed with a bit too much vigor, you know exactly what bleeding gums look like.
But what exactly happens when your gums bleed?
Gums—also called gingiva—are made up of soft tissue that covers the alveolar bone, which supports your teeth. This soft tissue has a high concentration of blood vessels and serves as a protective barrier against bacteria and other harmful substances.
Your gums tightly surround the teeth, providing stability and acting as a seal to keep out bacteria and debris.
Healthy gums are firm, pink, and elastic. When irritated or inflamed, they become tender, swollen, and prone to bleeding.
This inflammation is usually a response to harmful bacteria that accumulate around your teeth, forming a sticky film (i.e., plaque).
If plaque isn't removed properly, it causes gum disease (gingivitis or periodontitis), which leads to the breakdown of the supporting structures of your teeth.
Inflammation and damage to the blood vessels in the gums are what cause them to bleed.
When brushing or flossing, the mechanical action can rupture these weakened blood vessels, which leads to bleeding.
Without treatment, this bleeding will become more frequent and severe. And it can lead to greater complications, such as tooth loss and bone degradation.
Common Causes Of Bleeding Gums
In most cases, bleeding gums are nothing serious. Usually, the culprit is poor oral hygiene, meaning you’re not brushing often or thoroughly enough.
Less commonly, they can also indicate serious medical problems that need immediate attention.
Let's take a look at the most common causes of bleeding gums:
Gingivitis
An estimated 90% of the population experiences bleeding gums, the majority of which is due to poor oral hygiene.
Even if you brush your teeth twice per day, failure to floss regularly can make your gums more sensitive to minor trauma from brushing or eating hard foods.
Plaque buildup caused by inadequate brushing and flossing can lead to gum inflammation, known as gingivitis.
If left untreated, gingivitis can progress to a more severe form of gum disease called periodontitis, which can result in tooth loss and bone damage.
Periodontitis
Periodontitis is the advanced form of gingivitis. It occurs when plaque is not removed as it accumulates, leading to infection deep within the gum tissue.
This infection causes deeper pockets to form between your teeth and gum line, making it easier for bacteria to accumulate and further damage the gums and bone.
Periodontitis causes more severe inflammation, which can lead to pain and bleeding.
But swollen gums are just the tip of the iceberg for periodontitis—untreated, it can destroy the bones and roots of your teeth.
Mouth Injury
If you have a cut on your gums or a bruise from a hard object rubbing against your gums, you may notice some bleeding.
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Accidental biting: Biting the inside of your cheek, lip, or tongue can result in a cut or bruise, causing bleeding in the affected area.
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Injury from sharp foods: Eating hard, crunchy, or sharp foods (e.g., tortilla chips) can result in cuts or bruises on the soft tissue of your gums.
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Aggressive brushing or flossing: Using excessive force when brushing or flossing can cause gum injuries and bleeding.
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Trauma from dental appliances: Braces, dentures, retainers, and other dental appliances can rub against the gums, causing irritation and bleeding.
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Sports injuries: Contact sports or accidents during physical activities can lead to mouth injuries, such as a knocked-out tooth or cuts on the gums.
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Piercings: If you get a gum piercing, you will certainly see some bleeding in the area. Your gums will also hurt for a few days after—a common side effect of any piercing.
- Oral surgery or dental procedures: Dental work, such as tooth extractions, root canals, or gum grafts, will temporarily result in gum bleeding as part of the healing process.
In the case of mouth injury, bleeding gums are nothing to worry about. All they are is a sign that the gums are healing.
Vitamin Deficiencies
Vitamin deficiencies, particularly vitamin C and vitamin K, can contribute to bleeding gums. Vitamin C is essential for maintaining healthy gums and collagen synthesis, while vitamin K is crucial for blood clotting.
A deficiency in either of these vitamins can lead to weakened gum tissues and an increased likelihood of bleeding.
Other vitamin deficiencies that impact your oral health include:
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Vitamin B12: Vitamin B12 deficiency impacts blood flow to the gums, which leads to inflammation. When the gums are inflamed, they become more sensitive to brushing and flossing and start to bleed. In serious cases of vitamin B12 deficiency, you will also notice a purple tongue or ulcers in the mouth.
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Iron: Iron is essential for overall health, as it helps to transport oxygen and other nutrients throughout the body. Anemia, the main condition resulting from iron deficiency, weakens your gums and makes them more prone to bleeding.
- Folic acid: This vitamin is critical for DNA synthesis in new cells, including those found in your mouth. Folic acid deficiency weakens your gums, making it easier for bacteria to access the underlying tissues.
Diabetes
Diabetes and oral health have a long and complicated relationship. People with diabetes are more prone to oral health issues, including cavities, dry mouth, and gum disease.
High blood sugar damages the blood vessels in your gums, which weakens them and causes them to swell.
The result is a higher likelihood of bleeding gums, even if you brush and floss regularly.
Elevated blood sugar levels also cause decreased saliva production, which can lead to an increased risk of gum disease.
When your gums are already weakened and inflamed, brushing and flossing can cause them to bleed.
Smoking And Vaping
If you habitually smoke, there's a good chance you'll have some level of gum inflammation and bleeding.
Smoking reduces the amount of oxygen in your blood, which weakens your gums and makes it more difficult to fight off infection.
Smokers also have increased levels of plaque on their teeth, which makes it even harder for the gums to heal properly.
Plus, smoking cigars and cigarettes increases your risk of more serious gum diseases, like periodontitis and necrotizing ulcerative gingivitis.
In the worst cases, smokers notice their gums turn black.
Vaping also has serious implications for your oral health—43% of e-cigarette users have gum disease and oral infections, according to a new study.
Leukemia
Leukemia affects blood-forming tissues, including bone marrow and the lymphatic system. This cancer results in the overproduction of abnormal white blood cells, which hinders the body's ability to fight infections, clot blood, and transport oxygen.
Leukemia decreases the platelet count in your blood. When platelet levels are low, a condition known as thrombocytopenia, even minor injuries to the gums, such as those from brushing or flossing, can lead to bleeding.
The reduced ability of blood to clot can cause the bleeding to be more severe and persistent than it would be in a healthy individual.
Leukemia also weakens the immune system, making it more difficult for the body to fight off infections, including those affecting the gums. Patients with leukemia are more susceptible to gum infections and inflammation, which can further contribute to bleeding gums.
Chemotherapy and radiation treatments, which are commonly administered to leukemia patients, can also cause side effects like dry mouth or mucositis, making the oral cavity more vulnerable to infections and gum bleeding.
Thrombocytopenia
Thrombocytopenia describes a low platelet count in the blood.
Platelets—also known as thrombocytes—are small, colorless blood cells that play a vital role in blood clotting and wound healing. When platelet levels are insufficient, the body's ability to form clots and stop bleeding becomes compromised, leading to an increased risk of bruising and bleeding, including bleeding gums.
Several factors can contribute to the development of thrombocytopenia, including:
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Autoimmune disorders: Conditions such as immune thrombocytopenia (ITP) or systemic lupus erythematosus (SLE) can cause the immune system to mistakenly attack and destroy platelets.
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Bone marrow disorders: Certain diseases, like leukemia, myelodysplastic syndrome, or aplastic anemia, can affect the bone marrow's ability to produce platelets, leading to thrombocytopenia.
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Infections: Viral infections, such as hepatitis C, HIV, or Epstein-Barr virus, can cause temporary or chronic thrombocytopenia.
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Medications: Some medications, like heparin, quinine, or certain antibiotics, can cause drug-induced thrombocytopenia by affecting platelet production or function.
- Pregnancy: Gestational thrombocytopenia can occur in some pregnant women, usually during the third trimester, and typically resolves after delivery.
Individuals with thrombocytopenia may experience symptoms such as easy bruising, prolonged bleeding from cuts, spontaneous nosebleeds, or petechiae (small, flat, red or purple spots on the skin).
Hemophilia Or Von Willebrand Disease
Hemophilia is classified into two main types: Hemophilia A, caused by a deficiency of clotting factor VIII, and Hemophilia B, due to a lack of clotting factor IX.
Hemophilia primarily affects males. Those with hemophilia may experience spontaneous bleeding into joints and muscles, prolonged bleeding after injuries or surgery, and easy bruising.
Von Willebrand disease (VWD), on the other hand, is caused by a deficiency or dysfunction of von Willebrand factor (VWF)—a protein that helps platelets adhere to the blood vessel walls and carries clotting factor VIII.
Unlike hemophilia, von Willebrand disease affects both males and females.
Individuals with hemophilia or von Willebrand disease who experience bleeding gums face challenges in maintaining proper oral hygiene due to the increased risk of bleeding during brushing and flossing.
Treatment for hemophilia and von Willebrand disease typically involves replacing the missing or deficient clotting factors through intravenous infusions, either as needed (on-demand) or as a preventive measure (prophylaxis).
Scurvy
Scurvy is far less common than it used to be, but it still occurs in certain individuals due to inadequate dietary intake of vitamin C.
Vitamin C is essential for the body’s production of collagen—a major structural protein found in skin, bones, tendons, and other connective tissues.
A lack of vitamin C leads to poor collagen synthesis and weakened blood vessels, which can cause gum bleeding.
Still unsure what's causing your bleeding gums? If you've ruled out all the above causes, here are a few other potential causes.
Bleeding Gums During Pregnancy
Pregnancy is a time of significant hormonal changes, which can have various effects on the body, including oral health. Many pregnant women experience bleeding gums, a condition referred to as pregnancy gingivitis. This occurs due to an increased sensitivity to plaque and bacteria caused by hormonal fluctuations, particularly an increase in progesterone levels.
Some factors contributing to bleeding gums during pregnancy include:
- Increased blood flow to the gums, which makes them more prone to inflammation and bleeding.
- Hormonal changes, especially an increase in progesterone, can cause an exaggerated response to plaque and bacteria, leading to gum inflammation and bleeding.
- A weakened immune system makes it harder for the body to fight off gum infections.
- Frequent vomiting due to morning sickness can expose the teeth and gums to stomach acids, leading to enamel erosion and gum irritation.
To maintain good oral health during pregnancy and minimize the risk of bleeding gums, pregnant women should:
- Brush their teeth at least twice a day with a soft-bristle toothbrush and fluoride toothpaste
- Floss daily to remove plaque and food particles from between the teeth
- Rinse with an alcohol-free antibacterial mouthwash to help control bacteria and inflammation
- Maintain a balanced diet, rich in vitamins and minerals to support oral health
- Schedule regular dental checkups and inform the dentist about the pregnancy
Bleeding Gums When Brushing
If you spit out your toothpaste and you see a few red streaks, you might be alarmed. But this is actually more normal than you think.
There are several reasons your gums might bleed while brushing your teeth:
- Introducing a new toothbrush, especially a stiffer one
- Switching from a manual to an electric toothbrush
- Brushing too hard or too vigorously
- Burning your gums from teeth whitening (toothpaste, kits, or in-office procedures)
In these cases, your bleeding is typically minor and should go away on its own.
If you notice your gums start to bleed without any change in your brushing behavior, you may have an underlying oral health issue such as gum disease or gingivitis.
It's important to see your dentist if the bleeding persists, so they can properly diagnose and treat the underlying issue.
They may recommend more frequent visits for professional cleaning, an antibacterial mouthwash, and other treatments such as periodontal scaling and root planing (deep cleaning).
Bleeding Gums When Flossing
If your dentist has ever asked you whether or not you floss at home, they already know the answer.
If you don't floss regularly, your gums won't be used to the sensation (or force) of flossing. As soon as you start flossing, your gums may become irritated and begin to bleed.
This does not mean you should stop flossing—it just means your gums haven't been flossed enough and need to get used to it.
To reduce the risk of bleeding gums caused by flossing, you should:
- Start slowly and gently while getting used to flossing
- Floss at least once a day, preferably after brushing your teeth
- Use waxed floss or an interdental brush if it's easier for you
- Replace your floss regularly to ensure it's not fraying or too rough on your gums
As you introduce flossing into your daily oral hygiene routine, you'll notice that the bleeding will eventually stop. If it doesn't, you may have an underlying gum issue and should see your dentist.
Gums Bleeding At Night
If your gums bleed in your sleep, it can be concerning and disruptive. Several factors can contribute to this issue, including:
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Bruxism: Clenching or grinding your teeth, also known as bruxism, typically occurs during sleep. This habit can cause excessive pressure on your teeth and gums, leading to irritation and bleeding.
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Mouth breathing: Breathing through your mouth while sleeping can dry out your gums and make them more prone to inflammation and bleeding.
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Gum disease: If you have gingivitis or periodontitis, your gums may be more sensitive and susceptible to bleeding, especially during the night when saliva production decreases, and bacteria can flourish.
- Aggressive oral hygiene routine before bed: Brushing or flossing too hard before bedtime can cause gum irritation and bleeding during the night.
To address and prevent bleeding gums at night, consider the following tips:
- If you suspect bruxism, talk to your dentist about a custom-made night guard to protect your teeth and gums from the pressure caused by clenching and grinding.
- Stay hydrated to reduce the risk of dry mouth, which can contribute to gum irritation and bleeding.
- Use a humidifier in your bedroom to keep the air moist, preventing dry mouth and supporting gum health.
Bleeding Gums With Braces
Pain in your gums is extremely common when wearing braces. And in the days following an orthodontist appointment, it's normal to experience a small amount of bleeding.
The brackets and wires can rub against your gums and cheeks, causing irritation and inflammation.
As your mouth gets used to the new appliance, the bleeding should eventually stop.
To help reduce gum irritation and bleeding while wearing braces:
- Rinse with saline solution (or warm salt water) after each orthodontic appointment and after meals.
- Keep your mouth clean with routine brushing and flossing, using special floss threaders designed for braces if necessary.
- Avoid hard or sticky foods that could move the brackets, causing further irritation.
What Deficiency Causes Bleeding Gums?
Bleeding gums can be a sign of various nutrient deficiencies that affect oral health.
Common deficiencies that lead to bleeding gums include:
- Vitamin C
- Vitamin K
- Vitamin D
- Calcium
- Folate
The best way to address these deficiencies is to watch what you eat. Here are some of the best foods to eat to ensure proper intake of the above nutrients:
- Vitamin C: citrus fruits, strawberries, and bell peppers
- Vitamin K: leafy greens, broccoli, and cabbage
- Vitamin D: fatty fish, mushrooms, and egg yolks
- Calcium: dairy products, tofu, and leafy greens
- Folate: beans, spinach, and asparagus.
How To Stop Gum Bleeding Immediately
The good news about bleeding gums: The bleeding won't last too long.
Within a few hours, the bleeding spot in your mouth will turn into a white spot on your gums and begin to heal.
To stop the bleeding immediately, you can rinse your mouth with a warm saltwater solution.
This will help to reduce inflammation and prevent infection from occurring.
You can also use a gauze pad or cotton swab to apply pressure on the bleeding area for 15 minutes until it stops.
Want to learn more? These are the questions our customers ask us the most.
What Do Bleeding Gums Indicate?
Depending on the context, bleeding gums might indicate several different problems. Most often, they result from neglecting a regular oral hygiene routine—particularly flossing. They can also be a sign of gum disease, mouth trauma, dry mouth, or nutrient deficiencies. In serious cases, bleeding gums are a sign of leukemia, but other side effects usually accompany these conditions.
When Should I Be Worried About Bleeding Bums?
Bleeding gums are cause for concern in the following instances:
- Persistent bleeding after brushing or flossing
- Bleeding that lasts for more than a few hours
- Recurrent bleeding after eating acidic foods or beverages
- Swelling, redness, and pain in your gums
- Additional side effects that accompany the bleeding (e.g., fever, weight loss, etc.)
If your bleeding gums persist beyond a few days and don’t respond to home care, it’s best to visit your dentist.
Are Bleeding Gums Serious?
Most of the time, bleeding gums are not serious. They usually indicate a concern with your oral hygiene habits. However, bleeding in your gums is a contextual symptom, so it could also mean something more serious. In the worst cases, they might be a sign of leukemia, blood circulation issues, or other serious problems. If you experience bleeding gums that don’t respond to home care and last more than a few days, you should visit your dentist.
Are Bleeding Gums Leukemia?
Bleeding gums can be a symptom of leukemia, a cancer of the blood-forming tissues, affecting the body's ability to clot blood properly. If you have persistent bleeding gums and other symptoms (e.g., fatigue, unexplained weight loss, frequent infections, or easy bruising), consult your healthcare provider for a proper evaluation.
What Illness Can Cause Bleeding Gums?
Depending on your accompanying symptoms, bleeding gums can indicate several health issues. These include:
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Diabetes: High blood sugar can damage blood vessels in the gums, leading to inflammation and bleeding.
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Liver disease: Poor liver function can cause clotting disorders that result in easy bleeding, including from the gums.
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Malnutrition: Deficiencies of vitamins and minerals such as vitamin C, folate, and calcium can lead to swollen and bleeding gums.
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Blood clotting disorders: Bleeding disorders such as hemophilia can prevent blood from clotting properly, causing gum bleeding.
- Temporal arteritis: An inflammation of the arteries, temporal arteritis can cause bleeding gums and jaw pain.
Can Your Gums Bleed From Stress?
Stress and oral health go hand-in-hand. When stress weakens your immune system, it can increase your risk of developing gum disease and other oral problems. It may also result in a neglect of your oral hygiene routine, which can eventually result in weakened and increasingly sensitive gum tissue.
Do Bleeding Gums Mean Infection?
Bleeding gums don't usually indicate infection, but they can be a sign of gum disease. Gum disease is an infection that occurs when plaque builds up between the teeth and gums and causes them to become inflamed. If you have gum disease, you will likely notice other symptoms, such as swollen gums, persistent bad breath, and receding gum lines.
Do Bleeding Gums Heal?
Bleeding gums almost always heal on their own when given the proper care. The most important thing you can do is to maintain a regular oral hygiene routine, including brushing and flossing twice daily, using an antimicrobial mouthwash, and visiting your dentist for regular check-ups. If your condition is the result of gum disease, you may have to fix your loose teeth or get a root canal to restore function and stop the bleeding.
Should I Brush Bleeding Gums?
You should continue brushing your teeth at least twice per day, even if your gums are bleeding. Avoiding your regular oral hygiene routine will only make your gum sensitivity worse in the long run. Make sure to use a soft-bristled toothbrush and be gentle when brushing or flossing.
When brushing bleeding gums, it's essential to use a soft-bristled toothbrush and be gentle when brushing or flossing. Here are some tips for brushing your teeth when you have bleeding gums:
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Use a soft-bristled toothbrush. Soft bristles are gentler on your gums, reducing the risk of irritation and further bleeding.
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Brush gently. Apply gentle pressure and use circular motions to clean the teeth and gum line effectively without causing harm to your gums.
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Brush at a 45-degree angle. Positioning the toothbrush at a 45-degree angle against the gum line helps to remove plaque and bacteria more efficiently.
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Floss with minimal pressure. When flossing, slide it up and down against the tooth surface, curving it around the base of each tooth.
- Rinse with an alcohol-free mouthwash. Using an alcohol-free, antibacterial mouthwash can help control bacteria and inflammation without causing further irritation to your gums.
Is Salt Water Good For Bleeding Gums?
Salt water rinse is a popular and effective home remedy for various oral health issues, including bleeding gums. Rinsing with warm salt water can alleviate inflammation, soothe irritated gum tissue, and promote healing. The salt in the solution acts as a natural antiseptic, which can help control and reduce bacterial growth in the mouth.
Still, it's important to note that salt water rinses should not replace regular oral hygiene practices, such as brushing, flossing, and using mouthwash. And if your bleeding gums persist or worsen over time, it's essential to consult a dental professional for an evaluation and appropriate treatment.
Do Bleeding Gums Mean You Have Diabetes?
No, bleeding gums do not necessarily mean you have diabetes. However, bleeding gums can be an indicator of poor oral health, which may be associated with diabetes in some cases. People with diabetes are more prone to developing gum disease and other oral health issues due to high blood sugar levels, which can damage blood vessels in the gums and weaken their ability to fight off infections.
Are Bleeding Gums Hormonal?
Pregnancy, menopause, and other hormonal changes can make gums more sensitive and prone to bleeding. This is due to hormones fluctuating in the body and causing inflammation. Other conditions that impact your hormonal balance, such as thyroid disorders, can also increase the risk of gum bleeding.
What Foods Help Bleeding Gums?
Your diet significantly impacts your oral health, and certain foods can help to reduce inflammation and promote healing of bleeding gums. These include:
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Leafy greens: Rich in vitamin K, which aids in blood clotting and supports gum health.
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Citrus fruits: High in vitamin C, which strengthens blood vessels and connective tissue, promoting healthy gums.
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Dairy products: Contains calcium and vitamin D, which strengthen teeth and bones, supporting gum health.
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Fatty fish: Rich in omega-3 fatty acids, which have anti-inflammatory properties, helping to reduce gum inflammation.
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Green tea: Contains antioxidants called catechins that reduce inflammation and may help protect against gum disease.
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Nuts and seeds: Provide a good source of vitamin E, which has antioxidant and anti-inflammatory properties, supporting gum health.
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Crunchy vegetables: Chewing on raw, crunchy vegetables like carrots or celery helps stimulate saliva production, which can help neutralize bacteria and reduce inflammation.
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Whole grains: High in fiber and rich in B vitamins and minerals, promoting overall gum health and reducing inflammation.
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Water: Staying hydrated helps maintain saliva production, which is essential for neutralizing bacteria and keeping gums healthy.
- Sugar-free gum: Chewing sugar-free gum containing xylitol stimulates saliva production, which helps flush away bacteria and reduce gum inflammation.
How Do You Treat Bleeding Gums Naturally?
Five ways to treat bleeding gums naturally include:
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Salt water rinse: Rinsing your mouth with a warm salt water solution can help soothe inflamed gums, reduce bacteria, and promote healing. Mix half a teaspoon of salt in a glass of warm water, and swish it around your mouth for 30 seconds before spitting it out.
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Aloe vera gel: Aloe vera has natural anti-inflammatory and antimicrobial properties. Applying aloe vera gel directly to your gums can help reduce inflammation and encourage healing. Ensure you use pure, food-grade aloe vera gel.
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Oil pulling: This ancient Ayurvedic practice involves swishing a tablespoon of coconut, sesame, or sunflower oil in your mouth for 10-20 minutes, then spitting it out. Oil pulling can help reduce bacteria, plaque, and inflammation, potentially improving gum health.
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Tea tree oil: Tea tree oil has natural antimicrobial and anti-inflammatory properties. Add a few drops of tea tree oil to a glass of water and use it as a mouthwash to help reduce bacteria and inflammation in the gums. Make sure to spit it out after rinsing, as swallowing tea tree oil can be toxic.
- Using a gum stimulator: A gum stimulator is a small, rubber massage tool that helps stimulate the gums and promote healing. Use it daily to gently massage your gums and help reduce inflammation.
Can Low Estrogen Cause Bleeding Gums?
Low estrogen levels can cause a reduction in saliva production, leading to dry mouth and an increased risk of gum disease. The decreased estrogen may also result in weaker blood vessels in the gums, making them more susceptible to bleeding and inflammation. Fortunately, these problems are usually temporary—once estrogen levels return to normal, so will your gums.
