Understand the Cause of Bleeding Gums and How to Prevent It

Edited by Debbie, Eng, Anonymous, Marian Raquel F. Roncesvalles and 5 others

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We all know how important it is to take care of our teeth. Did you know that even if you don't have any cavities, you could still lose your teeth? Gum disease is the main reason why people lose their teeth. So if you want to keep your teeth a little longer, it's important to take care of your gums. Many people don't even know they have gum problems. How do you know if you do? Gingivitis is a mild gum disease. The symptoms include red, swollen, gums that bleed when you brush your teeth. The bad breath is the result of bacteria growth and plaque build up.

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If plaque is left untreated your teeth, it can cause more serious problems, like Periodontitis, which is when the gums loosen and pull away from the teeth. The gums become so loose that food and bacteria get underneath them, and they can become infected. Bone loss eventually occurs, and as the teeth loosen and fall out. Although bleeding gums are mostly linked to specific gum diseases, there are actually a lot of factors that can trigger this condition. It is best not to make any assumptions and get a diagnosis as soon as you notice any problems with you gums. Even red gums need to be assessed, as it signifies some kind of underlying problem. Understanding the causes and risk factors that could precipitate bleeding gums will help you deal with it successfully, or prevent it from happening at all.

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A Closer Look on the Function of Gums

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Gums, clinically referred to as "gingiva" are the mucosal layers of the mouth which line and seals up the teeth, serving as a protective covering for the underlying tissues and bones that hold the teeth securely in place. The typical healthy color of the gums is coral pink, although the color of gums depends on one's complexion and skin pigmentation. For instance; if you have a darker skin then your gums would also appear darker than usual. Also, people with excessive melanin production or pigmentation gives the gums a brownish appearance. The gingiva, or gums, is part of a vital oral structure called the periodontal tissue. The external structures of the teeth consist of the "crown" or the white enamel, visible to the eye, and the "root", buried within the gums. The alveolar bone contains the pockets your teeth sit in. It provides the connection of the periodontal tissue or the internal structures of the teeth. The main structures of the teeth include:

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  • Gums - The soft yet tough layer of surrounding tissues that protects the jawbone and periodontal structures enclosed within the alveolar bone.
  • Periodontium - This is a combination of hard and soft layers of tissue that provide the main framework of the tooth, and supports the tooth and help to attach it to surrounding tissues. It is also what gives the teeth the sensations of touch and pressure.
  • Periodontal Ligament (PDL) - The tooth is directly attached to these elastic fibrous tissues found between the alveolar bone and cementum. This is the tough structure that attaches the tooth to the jawbone. In addition, this also cushions the jawbone from direct impact especially with rigorous biting and chewing motions associated with eating.
  • Alveolar Bone �" The alveolar bone is the part of the jawbone that holds both the teeth, and the alveoli, what the teeth are suspended in.

Although the internal structures of the teeth are generally the same in individuals, the external structures of the teeth differ from one person to another such as the number of teeth as well as the shape, color and size of the teeth, and the strength of their roots.

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Most Common Causes of Bleeding Gums

That tinge of blood that appears when you brush your teeth or gargle with a mouthwash may have more explanations than one. Gum bleeding can range from a minimal drop to profuse bleeding accompanied by pain, tenderness, redness, and inflammation of the affected area. Bleeding gums are immediately linked to certain gum diseases; but the fact is, there are a number of other factors that might be purely hygienic, or lifestyle, environmental or disease-related, that can trigger spontaneous or frequent gum bleeding.

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  1. 1
    Poor Oral or Dental Hygiene.
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    Practicing a regular oral hygiene regime is very important to keep your teeth and gums healthy. You need to brush your teeth after every meal (including snacks) to keep plaque from accumulating. In addition to brushing, regular flossing and regular use of mouthwash is highly recommended to inhibit inflammation and other dental problems. Routine checkups with your dentist are also advised (every six months to a year). Failure to keep up your oral regimen is how you end up with tartar. Plaque is a film consisting of food particles, saliva and bacteria. If not removed from your teeth every day, it hardens into tartar, making it very difficult to remove without a dentist appointment. Tartar lifts the gums away from your teeth making it easy for bacteria to take up residence.
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  2. 2
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    Lack of consistency in oral hygiene, which must be done daily can result to a dental condition called gingivitis (the inflammation of the "gingiva" or gums), characterized by frequent gum bleeding, swelling, and redness. The gums are very tender and easily irritated by the slightest provocation, such as brushing of teeth. At this point, the teeth are still held intact in the sockets and no further complications such as irreversible bone damage or tissue loss is apparent. Follow the Dentist's advice, strictly, to avoid further complications that may warrant more intense, and expensive treatments.
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  3. 3
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    This is a common dental disease, usually precipitated by gingivitis, caused by periodontal bacteria allowed to let thrive in the mouth. There are over 700 known bacteria in the mouth that coexist peacefully with its host, until plaque buildup triggers an imbalance which allows dangerous bacteria to multiply. Poor oral hygiene remains to be the main culprit of periodontal disease, as this otherwise dormant bacterium becomes active, and its numbers dramatically increase, as the oral cavities become a suitable breeding ground for harmful bacteria to flourish. The slow progression of this disease eventually compromises the body's natural immune system. The symptoms are similar to gingivitis, but more extreme; increased gum bleeding, receding gums (which appears as lengthening of the teeth), pain, changes in the position of the teeth, loose teeth, halitosis (bad breath), inflammation, bad taste in the mouth, abscess, pus formation, and redness. Quite a high price to pay for not taking care of your teeth. There are certainly more risks involved with the development of Periodontitis as the disease eats up the alveolar, which can result in loosening, then detachment of teeth. Further complications of this disease can result in an increased risk of cardiovascular diseases and stroke. This is a serious dental disease that can be treated successfully when detected in its early stages.
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  4. 4
    Crooked or Irregularly Shaped Teeth.
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    Crooked teeth can interfere with regular brushing and can cause undue friction of the teeth and gums, which can then result in bleeding gums. Also, irregularly shaped teeth can also cause food debris to accumulate in between the teeth, which can cause inflamed and bleeding gums or progress to more serious dental complications.
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  5. 5
    Family Medical History of Dental Diseases.
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    A number of diseases involving the teeth and gums can be linked genetically. If other people in your family have issues with gum disease, it's a sign you should be extra cautious with yours.
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  6. 6
    Bruxism, or grinding your teeth during sleep, can cause a myriad of problems, from headaches and migraines, sinus issues, TMJ, and receding gums and tooth loss. The tremendous amount of pressure put on your teeth and gums while you are sleeping (40 times normal), is the culprit.
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  7. 7
    Vitamin C and K Deficiencies.
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    Certain vitamin deficiencies such as vitamin C, can lead to a medical condition called scurvy, which results in gum inflammation, pain, and bleeding. This can be attributed to the lack of adequate servings of fresh fruits and vegetables in your diet. Also, a vitamin K deficiency can lead to bleeding in any site of the body such as the gums. If you have been on antibiotics for a long time, this could destroy the intestinal microflora, which is the body's main source of vitamin K. This vitamin is responsible for the body's blood clotting mechanism, which inhibits bleeding. It's a good idea to either eat a lot of natural yogurt, or take acidophilus after taking antibiotics, to replace the flora in the intestines.
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  8. 8
    Gum Trauma.
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    If you accidentally poke your gums with a sharp or abrasive object, this could lead to bleeding of the gums, and leave you vulnerable to infections. Old toothbrushes tend to be hard-bristled, and can potentially scrape the gum area and cause gum bleeding. You should replace your toothbrush every 3 months to avoid dental mishaps from happening.
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  9. 9
    Where you store your toothbrush.
    It's important to know that if your toothbrush is within six feet from the toilet, there is a good chance it inadvertently gets sprayed with particles of fecal matter. Ew! You'd be brushing your teeth with some pretty deadly germs. Suffice it to say, best to store your brush in a container, or as far from the toilet as possible.
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  10. 10
    Reaction or Side-Effects of Medications.
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    Certain medications such as clopidogrel and aspirin can trigger gum bleeding or inflammation.
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  11. 11
    Hormonal Changes.
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    Most women experience teeth and gum problems such as noticeable tenderness or bleeding of the gums when they reach puberty, during menstruation, pregnancy, or up to menopause. Taking birth control pills (BCPs) can also precipitate gum bleeding. Erratic hormonal changes can intensify blood flow to the gingiva which can result to highly sensitive, inflamed, and bleeding gums. Post-menopausal women tend to have dry oral cavities, which results in gum bleeding and tenderness.
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  12. 12
    Chemotherapy Treatment.
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    Undergoing chemotherapy for the treatment of cancer can lead to a number of side-effects which include stomatitis or development of cankers all over the mouth and gums, accompanied by bleeding and inflammation.
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  13. 13
    Habitual Smoking and Drinking.
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    People drink alcohol and smoke cigarettes regularly, are more prone to developing a wide range of teeth and gum diseases that can provoke gum bleeding. Nicotine prevents the surrounding gum tissues to repair itself.
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  14. 14
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    Certain cancers like multiple myeloma (cancer of the bone) or leukemia (cancer of the blood cells- myeloid and lymphoid) can interfere with the body's blood clotting mechanism. Both cancer types can cause profuse or spontaneous bleeding to different organs of the body, including the gums, due to the lowered response of the immune system, and increase of white blood cells (WBC), or abnormal leukemia cells that can interfere or dampen the normal functioning of the red blood cells and platelets.
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  15. 15
    Bleeding Disorders.
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    Known bleeding disorders such as hemophilia A and B, which are genetically linked bleeding disorders that affect blood clotting and trigger abnormal and profuse bleeding in varied parts of the body like in the gums. This is also referred to as the "Royal Disease" because Queen Victoria of England passed this genetic disorder to her daughters, who became carriers of the mutated gene and passed it on to different royal families. Idiopathic thrombocytopenic purpura (ITP) is another bleeding disorder that can trigger gum bleeding. This is an autoimmune disease characterized by a decreased production in the number of thrombocytes or platelets produced in the bone marrow, which are responsible for blood clotting. ITP is known to cause purpura or the purplish streaks in the skin which signify bleeding in the blood vessels, hematoma or large pools or blood clots beneath the skin, heavier than usual menstrual bleeding, nose bleeds, and in rare cases - cranial or bleeding in the brain.
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  16. 16
    Type 1 and Type 2 Diabetes Mellitus.
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    Diabetic patients are prone to gum bleeding and inflammation due to chronic diabetes mellitus which is characterized by peaks or high glucose levels in the blood (high blood sugar). The blood clotting mechanism essential for healing wounds and easing inflammation is affected by diabetes, and in extreme cases, serious wound in the extremities that won't heal could lead to gangrene and amputation.
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  17. 17
    Anticoagulants or Blood Thinners.
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    Anticoagulants or medications that minimize or prevent blood clotting are commonly used for the treatment of a variety of diseases when the dangers of excessive blood clotting can be fatal, such as myocardial infarction (MI), atrial fibrillation, deep vein thrombosis (DVT), pulmonary embolism, and stroke. Some of the more common anticoagulants are; coumarin, warfarin, and heparin, which reduce the body's capacity to form unnecessary blood clot formation. Use of such blood thinning agents can cause some form of bleeding in other areas like the gums. Excessive use of such in unsupervised amounts could lead to hemorrhage.
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Top Preventive Measures for Gum Bleeding

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  1. 1
    Keep Your Teeth Plaque-Free.
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    Maintaining oral hygiene is a must for everyone. This must be taught to toddlers so that they can carry on good oral habits, and pass them on to their children. Brushing your teeth after every meal is necessary to maintain a healthy set of pearly whites. Don't forget to floss daily to get rid of food debris in hard-to-reach areas around and in between your teeth. A good mouthwash will help to kill bacteria, give you fresh breath and healthy gums and teeth. Avoid plaque and tartar buildup by creating a positive and effective oral hygiene regime. Preventive measures are simpler and a lot less expensive and painful, than undergoing numerous dental treatments.
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  2. 2
    Cut Down On Sugar.
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    Maintain a well-balanced diet consisting of fresh fruits and vegetables which are way healthier compared to those delectably sweet chocolate truffles packed with sugar and calories that are not good for your dental and overall health. This will also help reduce plaque from growing and irritating the gums that could lead to infection and increased gum bleeding. If you must eat the sweets, brush afterward.
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  3. 3
    Proper Hydration.
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    Keep yourself well hydrated by consuming at least 8 glasses of water each day. Avoid too much caffeine or alcohol. Stick to healthy and fresh fruit juices as well as green tea, which are full of antioxidants to help achieve healthy gums and teeth, while ensuring a fit mind and body.
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  4. 4
    Visit Your Dentist Regularly.
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    Routine visits to your Dentist is necessary to ensure top-of-the-line dental services for the entire family. You should go for dental checkups at least once a year (every six months is better), to make sure you are doing a good job at taking care of your gums and teeth.
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  5. 5
    Quit smoking.
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    Nothing good or beneficial is ever gained from smoking. If you want to kill time, it's best to do something productive. You can quit gradually by substituting gum or other healthy food alternatives and even activities that can keep you busy. Nicotine is very toxic to gum tissue and to the lungs which is in fact the leading cause of a number of life-threatening diseases involving the respiratory and cardiovascular systems.
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  • Take good care of your gums and teeth, they are the only ones you'll ever have!

Questions and Answers

How is gene mutation related to gum bleeding in scurvy?

Anything related to DNA damage and DNA mutation?

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I've had bleeding gums during brushing my teeth & gargling for the last 10 years.

I've had bleeding gums from grinding teeth, during brushing teeth & also gargling after 3-4 hours of inactive period for the past 10 years. I am 68 years old & staying in Mumbai India. I was under the impression that bleeding occurs due to bone loss. But while going through your article, I understand it can occur due to bacterial growth. Now, from this day, I am going to start brushing my teeth in morning, night & after meals. Now I have also started using Listerine as a mouthwash after brushing. No doctors ever told me this. Is such bleeding harmful to the heart as well? If the bleeding doesn't stop, is it necessary to remove teeth so grinding is not possible?

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How to treat gum bleeding? Why does it happen?

When I brush my teeth vigorously, my gums bleed more. On the other hand, when I brush slowly, I bleed less. There are other times, when I'm not brushing, that my gums bleed.

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Hi, I would like some advice. I suffer badly from anxiety and depression and don't go out.

My teeth are in a terrible condition, and I haven't been to a dentist in years. I'm too ashamed to go to the dentist. I have bad gums that bleed sometimes. Can you please tell me if they can bleed when you least expect them to?

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How to differentiate the site of bleeding in bleeding from oral cavity?

A patient comes to dentist with the history of bleeding from oral cavity for 30 years. I have tried: Tooth picks. I think it was caused by: Tobacco pouch in buccal vestibule might be

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