Gum Bleeding: Symptoms, Causes and Treatment

Bleeding gums is one of the symptoms of gum inflammation and indicates that the patient has one of two inflammatory gum diseases (gingivitis or periodontitis). Gums most often bleed when brushing teeth or when chewing hard food. The appearance of this symptom indicates that the gums are maximally weakened by the inflammation that occurs in them - because they are so easily injured in response to the smallest mechanical load.

The causes of bleeding gums lie in the presence of dental plaque - it can be soft microbial plaque and / or hard calculus. Dental plaque consists of bacteria that release various toxins and pathogens, which leads to the development of an inflammatory process in the gums.

Inflammation is always most pronounced in places where the edges of the gums are in direct contact with microbial plaque or calculus.

In some cases, with bleeding gums, you may not see microbial plaque and calculus in the area of ​​your teeth. The fact is that dental deposits can be not only supragingival, but also subgingival. The presence of subgingival calculus indicates the development of periodontitis, in which case the calculus will be attached to the surface of the tooth root - in the depth of the so-called "periodontal pockets". Only a dentist can detect and remove such plaque.

When treating the gums, patients can make 2 fatal mistakes that will only lead to the progression of inflammation. For example, some patients may stop brushing their teeth altogether. Others start uncontrollably using antiseptic mouthwashes, anti-inflammatory gels for the gums, special anti-bleeding toothpastes (but all this can only lead to a temporary reduction in the symptoms of inflammation).

Why do gums bleed when brushing teeth?

Plaque and calculus bacteria release a large amount of toxins and various pathogens that trigger a chain of inflammatory reactions in the gums. First, inflammation leads to increased capillary permeability and fragility (which is why blood appears when brushing the teeth), as well as to swelling, redness or cyanosis of the gingival margin and interdental papillae.

In parallel with this, the process of desquamation of the epithelial cells of the mucous membrane of the gums intensifies. This leads to a thinning of the epithelium, which further reduces the resistance of inflamed gums to mechanical stress that occurs when brushing teeth or chewing solid food. So when we put together:

fragility and increased capillary permeability,

thinning of the epithelium and

mechanical stress, which can be quite normal for people without gum problems - we get profuse bleeding when brushing our teeth.

Pain when brushing teeth

A very common symptom that accompanies bleeding gums is pain when brushing your teeth. In this case, pain is also associated with thinning of the epithelium of the gingival mucosa. And the worst thing you can do in this situation is to stop brushing your teeth altogether.

Treatment of bleeding gums should not be limited only to suppressing bleeding symptoms. The main cause of the development of gum disease should be eliminated, i.e. removal of dental plaque.

Factors that lead to bleeding gums

A very common symptom that accompanies bleeding gums is pain when brushing your teeth. In this case, pain is also associated with thinning of the epithelium of the gingival mucosa. And the worst thing you can do in this situation is to stop brushing your teeth altogether.

Treatment of bleeding gums should not be limited only to suppressing bleeding symptoms. The main cause of the development of gum disease should be eliminated, i.e. removal of dental plaque.

When is bleeding not related to gingivitis?

Sometimes the appearance of blood when brushing your teeth is not related to plaque and gum disease. In this case, it is a local bleeding in the area of ​​1 or 2 teeth, the occurrence of which may be associated with an injury to the gums (in the presence of an overhanging edge of a filling or an artificial crown). In this case, the elimination of the overhanging edge will immediately lead to the elimination of the symptoms.

Bleeding gums during pregnancy

If your gums bleed during pregnancy, and you did not have such symptoms before, it is related to hormonal changes. According to statistics, up to 50% of pregnant women suffer from the edematous form of hypertrophic gingivitis. Its symptoms are a persistent increase in the volume of gingival papillae and gums that bleed to the touch.

Treatment

The treatment of the gums always begins with the removal of the causative factor that led to the development of inflammation, and in this case the causes are soft microbial plaque and hard tartar. Another important step is to carry out a course of anti-inflammatory therapy, which will include an antiseptic mouth rinse and application of a special gel to the gums.

Removal of dental plaque

To remove dental plaque in case of bleeding, it is optimal to use ultrasonic teeth cleaning. The situation in which the gums bleed does not allow the removal of absolutely all plaque in one visit. The purpose of the first procedure is to remove massive plaque and calculus by prescribing a course of anti-inflammatory therapy, which the patient will carry out at home.

The process of ultrasonic tooth cleaning is quite simple - only in the presence of supragingival dental deposits (with gingivitis). Patients with chronic periodontitis always have subgingival dental deposits, which are located below the level of the gums, so they are very difficult to find and remove.

Anti-inflammatory therapy

The standard course of anti-inflammatory therapy for gingivitis usually lasts 7-8 days, and for periodontitis - exactly 10 days. It is prescribed by the dentist, and the patient performs it himself at home. Usually, therapy includes antiseptic rinsing + application of gum gel, but in some cases (when the patient has purulent discharge from periodontal pockets) systemic antibiotic therapy is also prescribed.

Gum treatment is carried out twice a day - in the morning and in the evening. This should be done only after brushing your teeth, which is why you should first have breakfast and only then brush your teeth, not the other way around! Next, after oral hygiene, rinse your mouth with any mouthwash containing the antiseptic chlorhexidine 0.2-0.25%. To do this, take 10 ml of the solution in your mouth (this is about 1 sip) and, without spitting, rinse your mouth for 1 minute. After that, do not rinse your mouth with water!

How to Apply gum Gel on your gums?

Immediately after antiseptic rinsing, anti-inflammatory gel should be applied to the gums.

Before applying the gel to the gums, it is necessary to dry them with dry gauze, which will improve the fixation of the gel on the moist oral mucosa. The gel is squeezed out in small portions onto the tip of the index finger, from which you will already transfer it to the gingival margin around the tooth. The main focus should be on the gums from the front surface of the teeth, but it is also desirable to apply the gel from the inside.

You must first apply the gel around the lower teeth, then around the upper teeth. Do not squeeze a lot of gel onto the finger at once, trying to apply it to the entire surface at once (squeeze out small portions of the gel and treat the gums in segments). In patients with bleeding gums, it is better to apply the gel to the gingival margin without rubbing. But when the swelling and bleeding of the gums are reduced, you can first gently rub the first part of the gel in the area of ​​the gums with light massaging movements, and then simply apply the second part of the gel to the gums without massaging and leave it.

In the process of gum treatment with gel, saliva is usually always released. You don't need to save it or spit it out, just swallow it as usual. After gum gel treatment, you should not drink anything - 30-60 minutes, and also rinse your mouth or eat - 2-3 hours. In the evening, you must repeat the procedure in the same order (dinner → oral hygiene → rinsing with an antiseptic → applying gel to the gums). And so every 7-10 days, depending on the dentist's recommendation.

Toothpastes for bleeding gums

If you want to achieve an even faster effect, then in addition to rinsing and gels for the gums, you can also use special therapeutic toothpastes. Such pastes contain special antiseptic and anti-inflammatory components aimed at combating bleeding and gum inflammation.

For example, the composition may include components such as aluminum lactate or zinc lactate, which reduce bleeding very quickly (you will notice the effect after the first application). Also in the composition you can usually find - antiseptic chlorhexidine from 0.05 to 0.25%, mineral salts, allantoin, bisabolol, thymol and eugenol, phenyl salicylate, as well as extracts of medicinal plants.

Toothbrush for problems with bleeding gums

If your gums bleed when brushing your teeth or brushing your teeth causes pain and the desire to completely abandon oral hygiene - in this case it is better to use a special gentle toothbrush with soft fibers (label - Soft). But remember that it is undesirable to constantly use such a toothbrush, because the soft bristles will be less effective in removing plaque. And therefore, after the inflammation subsides, it is necessary to start again using a brush of medium hardness (label - Medium).

Oral hygiene

After removing all dental plaque, the doctor should teach you how to brush your teeth properly. Otherwise, the plaque will reappear within a few weeks and you will suffer from the same symptoms again. Remember that the best cure for bleeding gums is proper good oral hygiene, including regular flossing after every meal.

Taking vitamins

If you are on a strict diet or starving, then your body simply will not have anywhere to get the vitamins necessary for metabolism. A lack of certain vitamins can lead to poor blood clotting and capillary fragility, which together with poor hygiene can stimulate the development of bleeding symptoms. Thus, vitamin C somewhat prevents bleeding gums, and it is best to take it as part of multivitamin preparations.

Under no circumstances and never take vitamin C in a daily dose of 1 g (1000 mg) or more. In such concentrations, it leads to the opposite effects in the body. Under normal conditions, the daily requirement for men is about 90 mg, for women - 75 mg. With a cold (sudden decrease in immunity), daily consumption can be increased to no more than 500-800 mg, and only for a short period of time.

Additional therapeutic measures

If you have gingivitis, then all of the above is enough to cure this disease and forget about bleeding gums forever. However, if you have moderate or severe periodontitis, then all of the above activities are usually only basic treatment. Further, depending on the clinical picture in the oral cavity, the periodontist can prescribe inhalation procedures, prosthetics, curettage, antibiotic therapy, etc.

It should also be borne in mind that the following factors (which require mandatory elimination) have a very negative impact on the course of gum disease:

• the absence of a large number of teeth leads to overloading of the remaining ones and requires prosthetics,

• prosthetic condition

• the presence of teeth with untreated caries or rotten teeth under the crowns,

• fistulas with purulent discharge,

• mouth breathing etc.

Canker sores and Canker sores treatment

MostReferendum it goes away on its own in a week or two. If the treatment of the canker sore itself is prolonged, it may indicate a larger problem with the immune system, in which case check with a doctor or dentist if you have unusually large or painful canker sores or canker sores that do not heal.

How to make an accurate diagnosis

If you have bleeding gums, the causes and treatment will be interrelated, which means that the treatment required will largely depend on the type of gum inflammation (gingivitis or periodontitis). The final diagnosis will be made by your dentist, but in most cases differentiating these 2 forms of gum disease is quite simple. Here is a simple algorithm to help you determine your diagnosis.

In gingivitis, in addition to pain and bleeding gums when brushing teeth, there is swelling, redness or cyanosis of the gingival margin, accumulation of soft plaque and/or calculus near the teeth. What cannot be with gingivitis is tooth mobility, periodontal pockets (their presence can be seen on a panoramic x-ray), change in the position of the teeth. If you have such symptoms, then it already indicates the presence of periodontitis.

Important: gingivitis is the initial stage of inflammation of the gums and if not treated properly, it inevitably turns into periodontitis. The starting point for the exact transition of gingivitis to periodontitis is the destruction of the dentogingival attachment, after which the destruction of the bone tissue around the tooth and the periodontal attachment of the tooth to the bone tissue begins (over time, all this will lead to tooth mobility). The transformation of gingivitis into periodontitis always occurs in those patients who have been treating bleeding gums for years - exclusively with the help of various rinses, ointments and anti-inflammatory toothpastes.

Without removing the causative factor of inflammation of the gums (dental plaque) - all these drugs can only temporarily suppress the symptoms of inflammation. At the same time, the inflammation will not go anywhere, but will continue asymptomatically until the destruction of the bone tissue around the teeth becomes so great that their mobility appears. Know that, if you want to cure bleeding gums once and for all, you must see a dentist as soon as possible.