Bleeding from the gums is due mainly from inadequate plaque removal from the teeth at the gum line. This will lead to a condition called gingivitis, or inflamed gums. If plaque is not removed through regular brushing and maintenance appointments with the dentist, it will harden into what is known as tarter. Ultimately, this will lead to increased bleeding and a more advanced form of gum and jawbone disease known as periodontitis, Improper brushing and flossing technique may actually traumatize the gum tissue leading to irritation. Therefore, it is important to follow the prescribed oral hygiene homecare instructions from your dental professional in order to maintain a healthy oral cavity. If gum bleeding persists, then it may be a sign of serious medical disorders such as leukemia, bleeding disorders, platelet disorders, and/or overmedication with anticoagulants ("blood thinners" such as Coumadin).

• gingivitis
  • poor oral hygiene
  • inadequate plaque removal
  • tarter accumulation
• periodontitis (advanced form of gingivitis)
• anticoagulants such as coumadin and heparin
• self-inflicted oral trauma, such as toothbrush abrasion, improper flossing
• infection, which can be either tooth or gum related
• Vitamin C deficiency
• Vitamin K deficiency
• hormonal changes during pregnancy
• chemical irritants such as aspirin
• leukemia
• placement of new dentures can lead to denture sores/irritations
• idiopathic thrombocytopenic purpura

• For infection, treatment by the dentist is recommended.
• For effects of medication, prescribed adjustments of dose or use of substitute drugs is recommended. NEVER CHANGE YOUR MEDICATION WITHOUT CONSULTING YOUR HEALTH CARE PROVIDER.
• For vitamin deficiency, proper diet or vitamin supplements are recommended.
• Sore and bleeding gums can be aggravated by tobacco.
• Poorly fitting dentures will cause "sore spots". If dentures hurt or make the gums bleed, they should be adjusted and relined by your dentist.
• Use an oral irrigation device on the low setting to massage the gums.
• Avoid aspirin unless your health care provider has asked you to take it for a specific reason.
• Gum bleeding can be controlled by applying pressure with a gauze pad soaked in ice water directly to the bleeding gums.
• Eliminate between-meal snacks and reduce carbohydrate intake to help prevent plaque build-up on teeth.
• Visit the dentist at least once every 6 months for plaque removal.
• Brush teeth gently (with a soft-bristle toothbrush) after every meal. The dentist may recommend rinsing with salt water or hydrogen peroxide and water. Avoid using commercial, alcohol-containing mouthwashes, which aggravate the problem.
• Floss teeth twice a day to keep plaque from building up.

• the gums continue to bleed even after following all recommendations.
• the problem is severe or chronic or if other unexplained symptoms are associated with the bleeding.

• quality
  • Are the gums bleeding a large amount (massive hemorrhage)?
  • Can you control the bleeding?
• time pattern
  • Did the bleeding begin recently?
  • Do the gums bleed frequently
  • Has gum bleeding been present lifelong?
  • Does it only occur occasionally?
  • Have you had gum problems before?
• oral hygiene habits
  • How often do you brush?
  • Do you brush between meals?
  • How often do you floss?
  • Do you use a soft or hard bristled toothbrush?
  • How vigorously do you brush?
  • What other home care aids do you use (toothpicks or other)?
  • When was the last time you had your teeth professionally cleaned at the dentists?
• eating habits
  • Have you changed your diet?
  • Do you eat adequate amounts of fruits and vegetables?
  • Do you take supplemental vitamins?
  • Do you have a high carbohydrate diet (pasta)?
• medications
  • What medications are being taken? Especially, do you take:
    • anticonvulsants
    • anticoagulants (such as Coumadin, heparin)
    • aspirin

• other
  • Are you pregnant?
  • Have you changed mouthwash or tooth paste recently?
  • What other symptoms are also present? Is there:
    • breath odor (halitosis)
    • redness of the gums
    • abnormal color of the teeth
    • sore throat

• blood studies (such as a CBC or blood differential)
• X-rays of the teeth and jawbone

After seeing your health care provider:
If a diagnosis was made by your health care provider related to bleeding gums, you may want to note that diagnosis in your personal medical record.