Bleeding gums are usually a sign of gum disease but can also occur during pregnancy and more rarely as a result of serious medical conditions such as leukaemia and systemic bleeding disorders.
The content that follows concentrates on the most common cause of bleeding gums – gum disease.
Gum disease is a general term used to describe the condition of the gums when they fall short of being healthy.
Gum disease is very common. In the UK, it is estimated that half the adult population has some degree of gum disease and most people experience it at least once. It is much less common in children.
There are two main forms of gum disease: gingivitis and periodontitis:-
Gingivitis means inflammation of the gums. This is a mild form of gum disease which is completely reversible and almost always caused by inadequate oral hygiene. The most common symptom of gingivitis is gums that bleed on brushing. Correcting the Oral Hygiene results in the gingivitis clearing. Your dentist will tend not to classify this as 'Gum Disease' because that tends to be a classification reserved for Periodontitis.
Long-standing gingivitis can progress to Periodontitis (Periodontal disease) which results in irreversible damage to the gums.
In Periodontitis the attachment of the gums around the teeth breaks down resulting in periodontal pockets down the sides of the teeth which are more difficult to clean and attract more bacteria, exacerbating the problem.
As the disease gets worse the bone anchoring the teeth in the jaw can be gradually lost, making the teeth loose. If this is not treated, the teeth may eventually fall out. In fact, more teeth are lost through periodontal disease than through tooth decay.
Some of the damaging effects of Periodontitis include;
Gum disease has also been linked to a variety of other health problems, including:
Heart disease and heart attacks - People with gum disease are almost twice as likely to have coronary artery disease than people without gum disease. When people have gum disease, bacteria from the mouth can get into their bloodstream. The bacteria produce protein. This can then affect the heart by causing the platelets in the blood to stick together in the blood vessels of the heart. This can make clots more likely to form. Blood clots can reduce normal blood flow, so that the heart does not get all the nutrients and oxygen it needs. If the blood flow is badly affected this could lead to a heart attack.
Diabetes and its control - People with diabetes are more likely to have gum disease than people without it. This is probably because diabetics are more likely to get infections in general. People who do not know they have diabetes, or whose diabetes is not under control, are especially at risk.
If you do have diabetes it is important that any gum disease is diagnosed, because it can increase your blood sugar. This would put you at risk of diabetic complications.
Also, if you are diabetic, you may find that you heal more slowly. If you have a problem with your gums, or have problems after visits to your dentist, discuss this with your dentist before you have any treatment.
New research has also shown that you are more likely to develop diabetes if you have gum disease.
If you have diabetes, you have an increased risk of losing teeth.
All of this means that if you are Diabetic, ensure that it is well-controlled and that your Oral Hygiene is excellent, and that you attend the dentist and hygienist frequently.
Book your appointments at a time when the dentist is least likely you keep you waiting, such as first thing in the morning. Try to avoid lunchtime in case you have to miss a meal
Stroke - Several studies have looked at the connection between mouth infections and strokes. They have found that people who have had a stroke are more likely to have gum disease than people who have not had one. When the bacteria that cause gum disease get into the bloodstream, they produce a protein. This can cause inflammation of the blood vessels, and this can block the blood supply to the brain. This can cause a stroke.
Pregnant women who have gum disease may be over three times more likely to have a baby that is premature and so has a low birth weight. There is a one-in-four chance that a pregnant woman with gum disease will give birth before 35 weeks.
It seems that gum disease raises the levels of the chemicals that bring on labour. Research also suggests that women whose gum disease gets worse during pregnancy have an even higher risk of having a premature baby.
Having gum disease treated properly during pregnancy can reduce the risk of a premature birth. This involves implementing the appropriate Oral Hygiene measures and maintain dental and hygienist appointments.
All gum disease is caused by plaque. Plaque is a film of bacteria which forms on the surface of the teeth and gums every day. Many of the bacteria in plaque are completely harmless, but there are some that have been shown to be the main cause of gum disease. To prevent and treat gum disease, you need to make sure you remove all the plaque from your teeth every day through brushing, interdental cleaning and mouthwashing.
Plaque that is not cleaned off the teeth calcifies, hardening and becoming calculus (tartar) which can then only be cleaned off professionally (by the Hygienist). Calculus that accumulates around and under the gums is particularly damaging, hence the importance of regular Hygienist visits.
Signs of gum disease include:
If you're concerned that you may have gum disease, visit your dentist.
Visiting the dentist
Step one of treating Gum Disease is to see your dentist so that it can be diagnosed and treated early – as with all conditions, the early it can be diagnosed and treatment started, the better the outlook. If you have never had gum disease and have good oral health, you may only need to visit your dentist every year or so for a check-up, with the Hygienist visit being every 6 months or yearly.
If you have had problems with gum disease or periodontitis in the past, you will need to visit your dentist and Hygienist more regularly.
If you have an increased risk of developing gum problems - for example, if you smoke or have diabetes (a condition caused by too much glucose in the blood), you may be advised to visit your dentist more often so your teeth and gums can be closely monitored.
Good oral hygiene is essential if Gum Disease is to be treated, the condition of the gums cannot and will not improved unless oral hygiene is excellent. Further detail on oral hygiene measures can be viewed in our dedicated section on this but a brief summation is:-
Your Smilemakers' hygienist can give you expert Oral Hygiene advice aswell as a bespoke Oral Hygiene package to enable you to maintain the highest possible level of Oral Hygiene between visits.
The effects of spending a few extra minutes a day on oral hygiene measures is often underestimated and can prevent a huge number of problems further down the road!
The following dental treatments may be recommended to treat gingivitis and periodontitis:-
Scale and polish
To remove the plaque and tartar that can build up on your teeth, your dentist may suggest that you have your teeth scaled and polished. This is a 'professional clean' usually carried out at your dental surgery by a dental hygienist.
The dental hygienist will scrape away plaque and tartar from your teeth using a special instrument, then polish your teeth to remove marks or stains. If a lot of plaque or tartar has built up you may need to have more than one scale and polish.
In some cases of gum disease or periodontitis, root planing (debridement) may be required. This is a deep clean under the gums that gets rid of bacteria from the roots of your teeth.
Before having the treatment, you may need to have an anaesthetic (painkilling medication) to numb the area. You may experience some pain and discomfort for up to 48 hours after having root planing.
'If you have severe gum disease you may require further treatment such as antibiotic or surgical therapy. In some cases, it is necessary to remove the affected tooth. Your dentist will be able to tell you about the procedure needed and how it is carried out. If necessary, they will also be able to refer you to a specialist.
Stopping smokingSmoking is the most significant risk factor for gum disease and periodontitis and stopping smoking can often be the difference between the gums returning to health or not. Please see our section on smoking for further information.