Your gums should not bleed. It’s a sign that something is wrong, but for some reason it has become accepted by many that gums bleed and there is a disconnect between how bleeding gums can indicate problems that affect not only the mouth but general health. A way to visualize this to consider that the surface area that is inflame
d and bleeds with gum disease can be as much as the palm of your hand. No one would ignore an area on their body that is inflamed and bleeding, but this is often the case when it comes to gums. This article will focus on the reasons for bleeding gums, the risks, and what can be done about it.
Three main reasons that gums bleed are gum diseaserts as gingivitis and progresses to periodontal disease. Both are infections of the gums that starts with inflammation and is reversible (gingivitis) and can progress to full blown gum disease (periodontal disease) which is chronic and includes loss of tooth supporting bone.
Several risks of gum disease include pain, loss of teeth and correlation to systemic diseases. Gum disease is progressive, meaning it gets worse over time if left untreated. It starts with inflammation of the gums that allows the gums to be slightly swollen and bleed easily, but without bone loss. At this level, the bacteria are not deeply imbedded below the gums and often are able to be treated by regular dental cleanings and excellent home care of brushing, flossing, and mouthwash.
If left untreated, gingivitis progresses as the body responds with bone loss near the inflammation and bacteria. As it continues to progress, further bone is lost, and the bacteria are seeded further and further below the gumline making it more difficult to treat. At this point of the disease process, it is chronic and will not respond to simple dental cleanings and improved home care. The next treatment is non-surgical in which a deep cleaning called scaling and root planning is performed disrupt the bacteria to slow the progress. This can work well with increased home care and regular maintenance appointments every three months. If this doesn’t work, there are surgical interventions available.
The second main cause for bleeding gums is dental work. No matter how well a filling or crown is done, there is always an interface between the tooth and restoration. Most of the time the edge between the restoration and tooth is smooth and the amount of bacteria trapped is negligible. Unfortunately, there are times where the anatomy of the tooth makes it nearly impossible for a smooth edge or the restoration has a poor shape leading to a trap for bacteria. The solution to this situation is usually a new restoration and possibly reshaping of the tooth.
The third and final main cause for bleeding gums are systemic issues. This category encompasses many different systemic issues including hormonal changes during pregnancy, thin blood from medications, blood cancers such as leukemia, and vitamin deficiencies such as Vitamin C (scurvy) and vitamin K. With these conditions, it continues to be critical to have excellent oral health to minimize the bacterial infiltration into the blood and to see a physician to address the underlying cause.
