Bleeding gums: causes and what to do about them

A little pink in the sink after brushing — that's normal, right? Not quite. Healthy gums don't bleed, even when you brush them or floss. Bleeding, even light bleeding, is almost always a sign of inflammation — and the good news is that at this stage, it's often easy to fix.

Why gums bleed

By far the most common cause is gingivitis: bacterial plaque builds up along the gumline, and the gum becomes irritated, red, puffy, and bleeds at the slightest touch. It's very common, and it's reversible. Left untreated, though, the inflammation can move down toward the bone and become periodontitis, which gradually destroys the support around the teeth — often without much pain, which is why it can go unnoticed for years.

Other factors play a role: brushing too hard or with a hard-bristled brush, picking flossing back up after a long break (the bleeding fades within days if you keep at it), the hormonal changes of pregnancy, certain medications such as blood thinners, smoking (which, paradoxically, sometimes hides the bleeding), poorly controlled diabetes and, more rarely, nutritional deficiencies or blood disorders.

What you can do at home

• Brush twice a day, for two minutes, with a soft-bristled brush, angling the bristles toward the gum and using small, gentle strokes rather than scrubbing hard.
• Floss every day, sliding the floss in a C shape around each tooth and just under the gumline. Keep going even if it bleeds at first: that's exactly where the cleaning is needed.
• Use interdental brushes if the spaces between your teeth are wider — they're often more effective than floss.
• Replace your brush every three months, or as soon as the bristles splay.
• If you smoke, know that quitting clearly improves gum health.
• An antiseptic mouthwash can help in the short term, but it doesn't replace brushing or flossing.

With a good routine, simple gingivitis improves within one to two weeks. If the bleeding lasts longer than that, or comes with other signs, it's time to be seen.

When to see a dentist

Book an appointment if your gums have been bleeding for more than two weeks despite good brushing, if they're receding and your teeth look longer, if you have persistent bad breath, if a tooth feels loose, or if you notice an unpleasant taste. See someone quickly if there's painful swelling or pus.

At the office, a gum exam measures the depth of the spaces between tooth and gum to tell gingivitis from periodontitis. A professional cleaning removes tartar, which brushing can't, and the hygienist shows you the technique that suits your mouth. If periodontitis is present, more thorough gum treatment can stabilize things. Either way, the earlier you act, the simpler it is.