Bleeding Gums

Why gums bleed is a common question that patients ask their dentist and dental hygienist.  It is a fitting question because it correctly assumes that bleeding gums are not healthy.  Bleeding is a sign that the body is trying to fight off an infection and has responded by creating an inflammatory response.  Sometimes bleeding gums are not obvious to the patient but detected by the dentist or hygienist.  They can occur for a number of reasons. The most common reasons that gums bleed are: poor oral hygiene (ineffective brushing or not flossing), crooked teeth that are hard to keep clean, mouth breathing that dries out the gums, smoking and chew tobacco, medical conditions like diabetes, medications (steroids, epilepsy drugs, cancer drugs, calcium channel blockers and oral contraceptives), vitamin deficiency, pregnancy and genetics.

The first step in diagnosing and treating bleeding gums is to determine if it is caused by a localized problem like food caught between the teeth or something more involved like a bacterial infection. Localized one-time problems can be easily solved with proper dental cleaning and good homecare, like using a soft bristle toothbrush, brushing at least twice a day and flossing once a day.  If the problem is more involved, like an infection in the gums (gingivitis), the remedy will most likely require a visit or two with the dental hygienist and a discussion about what caused the infection.  Most often the cause is poor oral hygiene but any one or a combination of the reasons listed in the previous paragraph may be the cause.  It will take a careful evaluation of the situation by the dentist and dental hygienist to determine the cause, the best treatment and ongoing care. These evaluations may include periodontal probing and x-rays of the teeth and jawbone. If gingivitis is not resolved it will progress to periodontal disease which can lead to irreversible bone loss, gum recession, loosening of teeth and possibly abscess and loss of teeth.  Periodontal disease is often unnoticed by patients because it tends to not be painful in the early stages.  Treatment may take place in a general dental office or with a specialist called a periodontist.  One or more sessions may be needed consisting of deep scaling, medications and in some cases gum surgery.

Bacterial infections of the gums; gingivitis or periodontal disease are a health risk.  Bacteria cause an inflammatory reaction; these bacteria will get into the blood stream and circulate throughout the body.  The body responds to the infection causing inflammatory cells to circulate throughout the body.  Patients with gingivitis and periodontal disease have a higher incidence of heart attacks, high blood pressure and diabetes.  The causes and effects are not fully understood but we know there is a systemic link in our bodies, when one area is under attack (infection) other areas can become adversely affected or vulnerable.

Report bleeding gums to your dentist and dental hygienist.  It may not seem important because it may not hurt but these symptoms are indications of a possibly more involved problem for the teeth and gums, but also for the health of your whole body.

Dr. Robert A. Gallegos is a Fellow in the Academy of General Dentistry, he is on the faculty of Spear Education, a member the American Academy of Cosmetic Dentistry, the American Academy of Dental Sleep Medicine and the American Dental Association.  Dr. Gallegos practices dentistry in Middleburg, VA.

Dr. Gallegos