Bleeding Gums When Brushing: A Red Flag for Your Dental Health
The state of your gums often reveal a lot about your oral health. A common issue that I see in my clinical practice is people who have noticed that their gums are bleeding right after, or during brushing.
Many of the people, alarmingly, say that they have been avoiding brushing the problematic areas for months, believing it was the right thing to do!
*Spoiler, if your gums are bleeding you need to brush that area more, not less!
Understanding Gum Health
Gums, medically referred to as gingiva, play a vital role in our oral ecosystem. They not only anchor our teeth firmly but also act as a protective barrier against bacterial invasion.
Why Do Gums Bleed when brushing?
Healthy gums should not bleed when brushed. If there is plaque bacteria or food debris building up around your teeth, your gums will become inflamed (your body’s response to a foreign invasion) and your gums will become swollen, red, tender and fragile. When you irritate inflamed gums with your brush, they will bleed.
Bleeding gums are a sign of gum disease:
Gingivitis: This is the initial stage of gum disease and literally means ‘inflamed gums’. Triggered by plaque bacteria that thrive and multiply around the teeth, gingivitis, if untreated, can progress to more severe stages of gum disease.
Periodontitis: This is the advanced stage where prolonged inflammation causes a breakdown of the bone and supporting structures around the teeth. Over several years, this can lead to severe complications like pain, abscess formation, and even tooth loss.
Recent statistics in the UK indicate that a significant portion of adults show signs of gum disease. It's clear that this is an issue that many face, yet few fully understand.
Brushing: The First Line of Defense
One of the primary defenses against gum disease is regular and effective brushing. However, brushing isn't just about frequency—it's also about technique and the tools used.
The best way to brush your teeth and gums are to use a rechargeable electric toothbrush and interdental brushes.
Research consistently shows that electric toothbrushes are superior in plaque removal. Their oscillating/sonic heads can reach areas that are often missed by manual brushing. Moreover, they're user-friendly, making the brushing routine less tedious and more effective.
A common fallacy is to avoid brushing areas where your gums are bleeding areas. In reality, these areas require more thorough cleaning to get rid of the bacteria that is causing the bleeding. When you have gingivitis or periodontitis and you suddenly start to improve your brushing technique you will notice that your gums bleed more, however you need to persist through this and as your gums get healthier they will bleed less.
Interdental Cleaning: The Underrated Guardian
Beyond brushing, there's another crucial step in oral hygiene that's often neglected: interdental cleaning with interdental brushes (like TePe brushes).
Why use interdental brushes?
Their design allows them to clean areas often missed by toothbrushes, especially beneath the gum line. This is where harmful bacteria often reside, leading to gum inflammation and bleeding.
Choosing the correct size of interdental brush
Just as shoes are more comfortable when they fit well, Tepe brushes are most effective when they're the right size. A visit to the hygienist can provide guidance, but as a general guideline, the brush should fit snugly between the teeth, offering resistance but not discomfort. Use the largest brush that you can comfortable pass through the gap. You may need 2 or 3 different sizes off bruises to cover your whole mouth.
Quick tutorial on how to use interdental brushes
Begin by gently inserting the interdental brush between two teeth. A gentle back-and-forth motion will help dislodge trapped food particles and bacteria.
It's essential to clean the brush between spaces to prevent cross-contamination.
Other Causes of Bleeding Gums
While gum disease is the primary reason people experience bleeding gums when brushing, there are several other factors that can cause or exacerbate gum bleeding such as:
Medical Conditions: Conditions like diabetes and leukemia have been linked to gum issues.
Medications: Blood thinners like Aspirin and Warfarin, for instance, can increase bleeding.
Dietary Deficiencies: A lack of vitamins C and K can lead to gum problems.
Lifestyle Factors: Such as smoking and tobacco use
Pregnancy: Due to hormonal changes in your body your gums may become more swollen and fragile
Defective dental restorations: If you have a crown or filling that is too deep or overhanging, then this can cause your gums to be irritated and bleed, your dentist may need to adjust or replace any resrtorations to make them easier to clean.
It’s important to note that although most of the above conditions increase your risk of gum bleeding, you still need to have plaque bacteria around your teeth to trigger the inflammation so really good home oral hygiene routines will almost always be enough to combat bleeding gums.
When to see a dentist if your gums are bleeding
Bleeding gums should not be ignored. If you have followed the above advice and your gums are still bleeding then see your dentist or hygienist as soon as possible.
Your dental professional will:
Carry out a detailed examination of your teeth and gums to decide exactly why your gums are bleeding
Correct any dental work that could be causing the problem
Scale away any hardened plaque that you can’t remove at home
Show you exactly how to use your toothbrush and interdental brushes
Monitor your healing and provide further treatment if necessary
If you have active periodontist (gum disease), it’s likely that you will require more invasive cleanings under local anaesthetics to clear away all the bacteria from underneath your gum. This will need treatment by a dental professional.
Taking Action: The Path Forward
The key takeaway about bleeding gums when brushing is clear: never ignore bleeding gums. View it as a vital sign from your body, signaling that something isn't right and take steps to improve the situation.
Make sure your brushing twice a day with an electric brush and proper brushing technique. invest in some interdental brushes and clean the area throughly.
If your bleeding persists, don’t hesitate to book an appointment with your dentist or dental hygienist for a full assessment.
If you ignore your bleeding gums, you may start loosing your teeth in the future!
