Gums, bleeding

Alternative names:

bleeding gums; gingival bleeding

Home care:

Home care depends on the cause. Follow your health care provider's recommendations.

• 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 citrus fruits and juices, rough or spicy food, alcohol, and tobacco. Take vitamin C supplements if citrus fruits and juices cannot be taken.
• If dentures make gums bleed, wear them only during meals.
• Avoid toothpick use. This may cause gum injury and infection.
• Use an oral irrigation device on the low pressure setting to massage 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 daily to remove plaque (unless the dentist says not to).

Call your health care provider if:

• the gums continue to bleed even after changing to a softer brush and following home care recommendations.
• the problem is severe or chronic or if other unexplained symptoms are associated with the bleeding.

What to expect at your health care provider's office:

The medical history will be obtained and a physical examination performed.

Medical history questions documenting bleeding gums in detail may include:

• 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; or does it occur repeatedly (recurrent)?
  • 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?
  • How often do you floss?
  • How hard of a toothbrush is used?
  • How vigorously do you brush?
  • What are other habits (use of 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?

• 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
    • redness of the gums
    • abnormal color of the teeth
    • sore throat

The physical examination will include a detailed examination of the mouth and gums.

Diagnostic tests that may be performed include:

• blood studies (such as a CBC or blood differential)
• X-rays of the jaw and mouth
• dental X-rays

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.