“Early signs of inflammation and when it’s time for a periodontal check-up”
Gum bleeding is not normal
Noticing traces of blood on your toothbrush can be unpleasant, but more importantly, it’s a signal your gums are sending to warn that something is wrong. Although many people ignore this condition or attribute it to brushing too hard, the truth is that bleeding almost always indicates the presence of inflammatory processes that can threaten the health of the teeth and supporting tissues.
In this article, we explain the most common causes of gum bleeding, the early signs of disease, how to recognise them in time, and when it’s necessary to visit a periodontist.
What causes gum bleeding?
1. Gum inflammation (gingivitis)
Gingivitis is the mildest but also the most common form of gum disease. It occurs due to the accumulation of plaque, a soft layer of bacteria that forms along the gum line. If not removed through proper brushing and flossing, plaque causes irritation, swelling, and bleeding.
Symptoms of gingivitis include:
• Redness and swelling of the gums
• Sensitivity to touch
• Occasional bleeding during brushing or flossing
The good news is that gingivitis can be completely cured if detected early and treated with proper oral hygiene and professional dental cleaning.
2. Periodontitis – a more serious form of the disease
If gingivitis is left untreated, the inflammation spreads to deeper tissues and develops into periodontitis – a chronic disease that damages the bone and ligaments holding the tooth in the jaw. At this stage, gum bleeding can become frequent and occur even with slight contact.
Periodontitis often also causes:
• Gum recession
• Loose teeth
• Unpleasant breath
• Formation of periodontal pockets – spaces between the teeth and gums filled with bacteria and pus
3. Improper oral hygiene
Brushing too hard or using a hard-bristle toothbrush can mechanically injure the gums, causing temporary bleeding. However, this doesn’t mean you should stop cleaning your teeth – rather, adjust your technique, use a soft brush, and apply gentle circular motions.
4. Hormonal changes
Pregnancy, puberty, and menopause can cause hormonal fluctuations that increase gum sensitivity and susceptibility to inflammation. Pregnancy gingivitis is a well-known phenomenon and usually appears in the second trimester.
5. Certain medications
Some medications, such as antiepileptics, immunosuppressants, or antihypertensives, can cause hyperplasia (thickening) of the gums, which makes hygiene more difficult and increases the risk of inflammation and bleeding.
6. Nutrient deficiencies
A lack of vitamin C (known as scurvy in severe forms) and vitamin K can contribute to gum bleeding. Although rare, this is another reason why a balanced diet is important.
When is it time for a periodontal check-up?
Gum bleeding should not be considered harmless. Although many patients think it’s just “temporary irritation” or a result of stronger brushing, it’s often an early sign of an inflammatory process that requires professional evaluation. Once the gums start bleeding, it’s a clear sign that their protective function is weakening and that inflammation is present – something that cannot be eliminated by hygiene alone.
If you’ve noticed traces of blood on your toothbrush, dental floss, or in your saliva while rinsing, don’t wait for the condition to worsen. An early visit to the dentist or periodontist allows for an accurate diagnosis and prevents complications that are harder to treat later.
In addition to bleeding itself, there are other symptoms indicating the need for a detailed periodontal examination:
• Bleeding that occurs daily or spontaneously – even when you’re not brushing your teeth, especially if you notice blood while talking, eating, or pressing your tongue against the gums.
• A feeling of swelling, tightness, or pulsating discomfort – often localised in specific areas such as the lower front teeth, where plaque tends to accumulate.
• Gum recession – if your teeth suddenly look longer, your gums may have receded due to inflammation. This symptom often goes unnoticed until root sensitivity appears.
• Loose teeth or changes in tooth position – signs of advanced periodontitis and loss of supporting tissue. Some patients notice a “new gap that wasn’t there before” or feel that their teeth are no longer firm when biting.
• Presence of pus or discharge between teeth and gums – the presence of pus always indicates a serious infection that must be treated professionally, as it can spread to surrounding structures.
• Persistent bad breath and unpleasant taste – even after brushing and rinsing. These are often the first subjective symptoms patients notice, though they may not immediately associate them with periodontal disease.
It’s important to note that periodontal diseases can progress for a long time without pronounced pain. That’s why gum bleeding often goes ignored until serious changes occur, such as tooth mobility and bone loss.
An early periodontal examination enables an individual analysis of gum and tooth support health. With X-ray diagnostics, measuring periodontal pocket depth, and professional cleaning, it’s possible to stabilise the condition and preserve teeth that would otherwise be lost without therapy.
Remember: early diagnosis and intervention allow for simpler and more effective treatment, with less risk of permanent consequences. If you’re unsure whether bleeding is a reason for concern, that alone is reason enough for a consultation.
A special case: Gum bleeding in children
Gum bleeding in children can be distressing for parents, but in most cases it’s not a reason for panic. However, it should not be ignored because childhood is when lifelong oral hygiene habits are formed. The most common cause of bleeding in children is insufficient or improper oral hygiene. Children often skip brushing at night, use the wrong technique, or brush too briefly and superficially. As a result, plaque remains along the gum line, causing irritation, redness, and inflammation.
Besides poor hygiene habits, other factors can contribute to bleeding in children:
• Eruption of new teeth – During the transition from baby to permanent teeth, the surrounding gums can become sensitive and prone to bleeding. This is usually temporary but still requires careful cleaning.
• Orthodontic braces – Fixed braces make cleaning teeth and gums more difficult. If a child doesn’t use interdental brushes and doesn’t brush carefully enough, inflammation and bleeding can quickly occur.
• Diet high in sugar and acids – Frequent consumption of sweets, fizzy drinks, and snacks promotes bacterial growth that causes cavities and gum inflammation.
• Mouth breathing – The habit of breathing through the mouth (especially at night) dries the oral mucosa, reduces saliva’s natural protective function, and increases the risk of irritation and inflammation. This problem is common among children with enlarged adenoids or allergies.
Parents play a key role in recognising and preventing problems. If a child frequently has redness, swollen gums, or traces of blood while brushing, it’s advisable to visit a pediatric dentist. Early intervention can prevent the development of more serious periodontal problems later in life.
It’s important for children to learn proper brushing techniques from an early age, including using dental floss when possible (depending on age) and choosing a toothbrush suited to mouth size. Regular professional check-ups every six months are recommended, especially during active growth and orthodontic treatment.
With education, motivation, and parental support, children can quickly adopt habits that will help them maintain healthy teeth and gums throughout their lives.
How to treat gum bleeding?
Treatment depends on the cause and stage of inflammation. In mild cases of gingivitis, professional dental cleaning (removal of plaque and tartar) combined with improved home hygiene may be sufficient. In more severe forms of periodontitis, therapy includes:
1. Professional cleaning and scaling
Plaque and tartar are removed above and below the gum line, periodontal pockets are cleaned, and in some cases, antiseptic solutions or antibiotics are used.
2. Periodontal surgery
If pockets are deep and inflammation is advanced, surgical treatment may be necessary to remove infected tissue and clean root surfaces.
3. Home care instructions
Your dentist will recommend:
• Soft toothbrushes and proper brushing technique
• Daily use of dental floss or interdental brushes
• Antiseptic mouthwashes (e.g., containing chlorhexidine, for limited use)
• Dietary changes and possible vitamin supplementation
How to prevent bleeding in the future?
Prevention starts at home. Here are some key tips:
• Brush your teeth at least twice a day using a soft brush and proper technique
• Use dental floss or interdental brushes every day
• Limit sugar and acidic drinks
• Replace your toothbrush every 3 months or after illness
• Visit your dentist at least once a year – more often if you’re prone to periodontal disease
Gum health is just as important as tooth health. Without healthy gums, teeth have no stable support, which can jeopardise the entire dental arch in the long run.
What if bleeding continues after treatment?
In that case, it’s important to check for hidden risk factors – such as poorly fitted fillings, tartar in hard-to-reach areas, or systemic diseases (e.g., diabetes, anaemia, hormonal disorders). In some cases, your dentist may refer you for additional laboratory tests or consultations with other specialists.
Don’t ignore what your gums are trying to tell you
Blood on your toothbrush is not “normal” and should not be ignored. It’s a clear signal that your gums are warning of a problem that could become serious if left untreated.
If you’re experiencing frequent bleeding, swelling, or sensitivity, it’s best to schedule an appointment with your dentist or periodontist as soon as possible. A professional diagnosis, personalised treatment, and proper hygiene can fully restore your gum health.
The Esthea Clinic team is at your disposal for preventive check-ups, consultations, and all types of periodontal therapy.
Timely action makes all the difference.