This can happen to anyone. One day you’re brushing your teeth, and as you spit, you notice a little blood in the sink. Is it bad? Should you call a doctor? What’s happening?
Together with dental medical expert and lecturer at Curaden Academy, Mia Girotto, we break down the possible causes of gum bleeding, first steps you should take, and how to prevent this.
In brief
- A little blood in the mouth can be a sign of gum disease. It can also be caused by hard toothbrushes or other devices causing mechanical injuries.
- In itself, a little bleeding is nothing to worry about. But the causes of bleeding should be investigated. If caught early, gum disease can be reversed through proper hygiene and oral care.
- Best aids to prevent bleeding and gum disease: interdental brushes, soft brushes and single brushes. Electric brushes are also a good idea, but mind their bristle hardness and movement mechanism (go for oscillating rather than rotating).
Where does the blood in the mouth come from?
Our mouth is laced with blood vessels: there are larger vessels underneath our teeth, our tongue and at the top of our mouth; the smaller ones reach almost to the surface of our gums.
These vessels and capillaries are essential to healing, regeneration and the overall health of our mouth. There is always blood circulating underneath the surface of our gums and mouth.
Sometimes tissues in our mouth experience inflammation – for example, when there is a scratch or a burn, and part of the tissue is damaged. In these cases, the body initiates an immune response and sends more blood that carries immune cells and reparation agents. This army comes over and helps restore everything.
What can cause bleeding?
The tissues in our mouth, including gums, are prone to physical damage. If you’ve ever tried to chew a dry piece of bread or accidentally poked your gums with a fork, you’ve likely seen some damage and even a little bleeding.
But there is an important difference: when we accidentally hurt perfectly healthy gums, they will not bleed as much, and the blood will be lighter in colour.
On the other hand, when there is an inflammation in the gum tissues, you’ll get more bleeding and it will be much easier to provoke. This is because inflammation causes the body to increase the number of blood vessels and the overall volume of tissue.
As a result, if there is some inflammation going on, you might experience bleeding after as little as chewing hard foods or brushing with an old or hard toothbrush.
This is still not a reason to panic. Take it as a sign – it is time to visit your dentist and have your gums checked.
Can brushes really damage that badly?
Even without any inflammation, the bristles of a toothbrush can sometimes be really hard on your teeth and gums, especially when they are already labelled as “hard” on the box – or even “regular”.
Besides the bleeding that can occasionally occur, the serious danger of using harder brushes is in the possible long-term outcome of your gums receding: this means that they “shrink”: becoming smaller and shorter, getting pulled away from their regular position on the neck of the tooth.
Some people also tend to apply too much pressure while brushing, and combined with the hard bristles, this does some visible damage. This is the most common reason for the recession of the gums to occur. This is not only an aesthetic problem, but it can also cause hypersensitivity of the exposed tooth-necks, which causes major discomfort.
Damage to teeth and gums
❌ Hard brush
❌ Excessive pressure
Clean and protected teeth and gums
✅ Soft and ultra-soft brushes
✅ Little to no pressure
How bad is it when it bleeds?
Bleeding itself is nothing to worry about, if it’s just a tiny amount, and then it’s gone. The vessels in your mouth are small enough to clot really fast, so any damage to your gum tissue will be repaired very quickly.
If you experience bleeding over a prolonged period of time, this is usually the sign of an ongoing periodontal disease. This can be in various stages, so now it’s really time to visit your dentist and have your gums checked.
Besides the inflammation – which would be the most common reason for this prolonged bleeding – this can also be a sign of trauma, like tooth or bone fracture, but a person would normally know about this as they would be in a lot of pain.
What is gum disease?
Your gums can be affected with problems in many different ways, and there are many stages of inflammation. This is the most common/simplest explanation of what’s going on:
- There is bacterial plaque on one’s teeth. Plaque is nothing more than a strong bacterial colony living on a tooth.
- When bacteria live, eat and breed, they produce toxins. When such toxins reach the tooth, they erode the enamel and cause tooth decay. When they reach the gums, they cause inflammation, which is our body’s natural response to dangerous chemicals.
- Plaque usually stays on teeth for a long time, gradually building up. The more plaque, the more toxins. The more toxins, the more inflamed and therefore vulnerable the gums become.
- In time, the gums can become so vulnerable that they can develop open wounds and even bleed spontaneously. But, hopefully you’ve managed to notice the bleeding and let your dentist check your gums before this stage.
When tooth decay and gum disease become rampant, the gum can literally erode. But in its early stages gum disease is easily reversible, so it is really of utmost importance to watch out for the signs.
As soon as you notice some bleeding, go to visit your dentist, check your gums and make sure you have the correct oral hygiene routine.
A proper brush is vital: your regular toothbrush has to be as soft and dense as possible and your interdental brush should be perfectly suited in size for each of your interdental spaces.
How does gum disease develop and what to do about it?
“What’s even more alarming is that gum disease can occur ‘seemingly’ without symptoms for years – this happens when you ignore a ‘little’ bleeding over and over again. This creates a constant burden to the overall health. But more importantly – it could develop into more advanced stages: to periodontitis, when the tissues are lost beyond the possibility of repair.
The irony is, most people only become interested in those areas when the symptoms become visible, which in most cases is when there is already an established periodontal disease going on.
The tissues lost during periodontitis – the advanced stage of the gum inflammation – are really hard, if at all possible, to restore. Such restorative procedures sometimes involve extensive, complicated and expensive surgeries. This means that by the time a person notices the symptoms, it is already too late to save the majority of the tissues, sometimes even the tooth itself.
In any case, we need to regularly maintain oral hygiene in the interdental spaces, even more so if we already have periodontal disease. This is one of the critical points in the course of therapy of periodontal disease, as well as for further maintenance.”
— Dr. Mia Girotto, dental medicine expert and lecturer at the Curaden Academy
How can gum disease be reversed?
Gum disease is a result of prolonged exposure to bacterial colonies in the tooth plaque. If you remove the plaque regularly, the toxic fallout will be gone, and the gum will regenerate naturally. Here are some tips:
1. Clean out the interdental spaces
A space between your teeth, where they usually come in contact (but not necessarily) is called an interdental space. When we are young and healthy, this space is usually covered with gums, in the shape of a small triangle.
This space is actually very important, as it is also the spot that is easiest for bacteria to settle, set up colonies and build up – especially if you never brush there and leave them uncontrolled.
Interdental spaces are easiest for bacteria to settle, set up colonies and build up – especially if you never brush there.
Regular toothbrushes are ineffective against interdental tooth plaque, because their bristles do not reach far enough into this space to disturb the bacterial colonies. Special aids are required. This is a very important space to clean regularly, as inflammation and gum disease usually start there.
To sum up, one of the most important things you can do for your overall health is to keep your gums healthy: regularly clean your interdental spaces with correctly chosen interdental brushes. A certified dental professional will measure your spaces precisely and recommend you the best sizes.
2. Brush your teeth “mindfully” at least twice a day, covering all surfaces
Try brushing consciously, in control of what you are doing, so that you don’t skip even the smallest parts of your teeth. Start with the most difficult places such as your back molars.
When you cut corners in brushing
“When a person leaves out parts of their teeth unbrushed, that’s where tooth plaque will become more dangerous, as it matures. And then, the dangerous bacteria can develop and damage the tissues – be it hard dental tissues or surrounding soft tissues.”
— Dr. Mia Girotto, dental medicine expert and lecturer at the Curaden Academy
Rinsing your mouth with a mouthwash alone is not effective, as it doesn’t penetrate the bacteria’s natural protection in the tooth plaque. Only mechanical action through brushing can help.
3. Replace your toothbrush regularly
An old toothbrush can be a source of bacteria, and it can also harden over time, making it more damaging to your teeth and gums, and less effective in the removal of the biofilm. Once the brush gets out of shape, it’s time to switch, but if it is happening within weeks check you are not applying too much pressure while brushing!
4. Minimise sweet and acidic foods
Bacteria love sugar, as it’s their primary source of nutrition. The more sugar that goes through your mouth, the easier it is for bacteria to breed.
Acids, mostly produced as a by-product of this “bacterial feast”, offset your teeth and gums’ natural protective properties, making them more vulnerable to tooth decay and gum disease.
An oral-care tip for a sweet tooth
“A regular diet of sweet soda drinks and chocolate is no-no. If you can’t resist, try not to brush immediately after the consumption of acidic foods and drinks for at least half an hour. But when you do, make sure you brush diligently and precisely.”
— Dr. Mia Girotto, dental medicine expert and lecturer at the Curaden Academy
5. Do not over-brush
There is no need to brush after every meal, as the food itself is not the harming factor. It is bacterial colonies that we need to keep under the control – so, we need to “disperse” them regularly, in order to prevent the conditions where the structure can mature and cause harm to the surrounding areas.
What are the best aids to protect my teeth?
Here is what you can pick up at your local pharmacy next time:
Interdental toothbrushes of the correct size.
Interdental space is the number-one place for bacteria to live, so taking care of that should be your number one priority. Before using interdentals we recommend visiting your dentist. A professional will measure each interdental space and find the right brush sizes.
👉 Among CURAPROX products, we recommend the CPS Prime series which are suitable for healthy gums.
An ultra-soft high-density toothbrush with rounded bristles.
Ultra-soft means each bristle is very thin, very soft and rounded on top, so it takes very little pressure to get the tips of the bristles “in action”. All this makes the toothbrush very effective and safe for your teeth and gums.
High-density means fewer strokes with a higher efficiency to remove and disrupt more bacteria. Typical over-the-counter toothbrushes have lower densities, so go for the most densely-packed brush you can get. Rounded bristles add an extra layer of protection to your gums and teeth.
👉 CURAPROX’s number one toothbrush is CS5460 – it contains 5460 ultra-soft rounded bristles that take the best care of your teeth that your money can buy. Learn more…
A single-tuft brush
A single brush is a good idea to clean out specific parts of your teeth, like the foundation of your molars. A single brush means that all the bristles are concentrated in one place for maximum efficiency. Direct the single brush to places you cannot reach with a regular toothbrush. It’s also indispensable for those who wear braces.
👉 We have the CS 1006, a single-tuft brush with soft round bristles for precision cleaning. Learn more…
An electric toothbrush
Electric toothbrushes are a good choice for people with braces, implants or those who just strive for perfection.
A fast and gentle mechanical movement of the correctly selected electrical toothbrush makes brushing more effective, so with one slow stroke across one side of your teeth you are getting hundreds and thousands of strokes.
Make sure you use an electric toothbrush safely: bristles barely (if at all) touching the surface of the tooth. We recommend carefully reading the instructions first. You can also consult your dentist.
Also, mind the density and thickness: many electric brushes feature low-density heads with hard bristles. In this combination, electric brushes can be extremely harmful to your teeth and gums.
👉 CURAPROX has developed a pro-grade electric brush system with soft bristles and Hydrosonic action. Learn more…
When is the time to call the doctor?
If you experience bleeding, feel a metallic taste in your mouth, and it seems that the bleeding isn’t stopping, contact a healthcare professional immediately. This can be a sign of serious trauma that should be addressed immediately.
If you notice a little bleeding – while brushing, or spontaneously – or you just notice your gums are swollen, most probably it is time to visit your dentist and check your gums, to be sure you don’t miss the opportunity to stop/reverse the inflammation in time. Do not self-medicate, and follow your dentist’s guidelines.
Cover and heading illustrations by Barbora Idesová
