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Bleeding gums.
Do your gums bleed when you brush your teeth? This is not at all uncommon—up to 90% of us experience this occasionally. But bleeding gums are never a normal condition, and brushing too vigorously is hardly ever the cause. While certain diseases, medications and poorly fitting oral appliances can cause bleeding to occur, it’s more likely that your gums are being irritated by dental plaque that has not been effectively cleaned from your teeth near the gum line.

Plaque is a bacteria-rich film that clings to your teeth in the absence of effective oral hygiene. It starts out soft and sticky, but can calcify (harden) into a substance called calculus or tartar. Your immune system reacts to the presence of this substance, causing your gums to become inflamed and prone to bleeding—a condition known as gingivitis (“gingiva” = gums, “itis” = inflammation). Pregnant women are particularly prone to this type of irritation; so are women taking certain birth control pills that contain hormones similar to those produced in pregnancy. But whatever your age, sex, or pregnancy status, you can and should reverse this situation, because uncontrolled plaque buildup can lead to tooth decay and gum disease—and these two diseases cause the majority of permanent tooth loss.

Improve Your Oral Hygiene

Cleaning your teeth effectively each day only takes a few minutes, but it’s time well spent. Start with flossing. There’s no better way to remove plaque from between your teeth. Curve your floss in a “c” shape and move it up and down both sides of every tooth. Then brush your teeth—gently—for a full two minutes with a soft brush and fluoride toothpaste. Clean every tooth—front, back, and along the chewing surfaces. Flossing should be done at least once a day, brushing twice.

Is it better to brush your teeth harder? Absolutely not! Over-vigorous brushing may not be any more effective at cleaning your teeth—but it certainly can be bad for your gums, causing gum recession. Don’t forget to change your toothbrush regularly; get a new one when the bristles begin to splay, or at least every three or four months.

See Your Dentist

The other key component to good oral hygiene is getting regular cleanings at the dental office. When you get a professional cleaning, any calculus that’s building up beyond the reach of your brush and floss can be removed. You can also ask your hygienist to demonstrate brushing or flossing for you if you need a refresher course. If any physical limitations—arthritis, for example—are preventing you from being able to clean your teeth effectively, the hygienist can suggest special tools and techniques. Your dentist will also examine you at these visits and make sure you are not showing signs of more serious periodontal (gum) disease. If you are, he or she may want you to see a periodontist (gum specialist).

Stepping up your oral hygiene routine may be all it takes to stop the gums from bleeding and prevent gum disease from progressing. However, if you find you can’t get the situation under control, make an appointment with your dentist—even if it is not yet time for you regular cleaning. Some people are genetically more prone to gum disease than others; if you are one, you should be monitored more frequently by a dental professional.

Why It Matters

Left untreated, gingivitis can progress to more serious periodontal disease (“peri” = around, “odont” = tooth). When this occurs, the inflamed gum tissues begin to lose their attachment to the teeth, forming deeper “pockets” between gum and tooth in which more bacteria can thrive. Sometimes these pockets can become sealed off, creating a painful gum abscess. If the pockets become deep enough, the bacteria can begin to attack the bone that supports your teeth; and if you lose too much of this bone, your teeth can become loose and eventually be lost.

Periodontists can treat serious gum disease even in its later stages, but it’s far easier to save teeth when gum disease is detected and treated early. That’s why it’s important to take action when you notice bleeding gums. If improved oral hygiene doesn’t solve the problem within a week, make an appointment to see your dentist or a periodontist. But whatever you do, don’t ignore the message about your oral health that bleeding gums are sending you.

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