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Why Do My Gums Bleed When I Floss?

Maybe you’ve heard the old saying, “Healthy gums don’t bleed.” Sometimes people get used to bleeding gums, and it might seem like they’re normal. But bleeding gums are far from normal, and you don’t want to ignore this signal that something’s not quite right in your mouth.

Think about it this way: If you took the surface area of your bleeding gums and laid them into one big patch, it would cover an area of about two by two inches  Let’s take it a step further:  If you had a four square inch section of skin on your stomach that was raw, red, and bleeding every day, would you be worried?

What about the risk of infection?  Would you be concerned that bacteria would contaminate this open wound and cause a serious problem?  Probably so.  At a minimum, you’d do everything you could to get it healed up as soon as possible.  If the wound continued to ooze for more than a few days, you’d be headed into see your physician.

Have You Ever Said This?

For some reason, we tend to ignore raw tissue in the mouth, and  often say, “My gums always bleed!”  But bleeding gums present far more risk to our overall health than we realize.  In most cases, gum disease doesn’t hurt until it advances and does irreversible damage to the supporting bone and gum around the teeth.

The warning signs are trying to talk to us:  A little bit of gum disease leads to a little bit more.  This process often ends in dentures but not before a long history of pain, abscess, and tooth extractions.

This Gets Serious

Bleeding gums tell you that there’s inflammation in your mouth, and that there’s an open doorway to your bloodstream.  The mouth houses billions of bacteria, over 700 strains of them:  Some good, some bad. But when the wrong types settle in around your gums, they produce a toxic waste that’s acidic and destructive. This doesn’t make your immune system very happy, and it responds defensively to stop the invaders.

Before long, an army of inflammatory cells rush into the gums to counter the bacteria.  The combination of these immune system helpers, organisms, and toxins combine to break open the micro-vessels of the gums.  Not only does blood leak out, but bacteria leak into the body.  Within a few seconds the bloodstream is full of bacteria. The complexity of this reaction is a topic for another day, but it’s not as benign as it seems on the surface.

The ongoing presence of inflammation in your gums may lead to destruction of the bone around the teeth. The mix of organisms, their waste products, and immune system components dissolve bone. Think of what acid poured on concrete does, eating away and pitting the surface.  That’s kind of what happens to bone when it’s under the influence of this toxic soup.

Sadly, once bone disappears, it never grows back.  At least 30% of the U.S. population deals with this problem, and it’s the leading cause of tooth loss in the world. It’s also the source of many frustrating abscesses and swellings as it advances and creates more bone defects for bacteria to migration into.

The area between your teeth is especially prone to gum disease since it’s a difficult area to clean.  Brushing with a manual brush takes excellent dexterity and skill, and it doesn’t even come close to removing plaque in these difficult recesses.  Floss presents the same challenge for many patients.  But if cleaning between the teeth gets neglected, 30% of the tooth surface area accumulates plaque that’s untouched and feeds the inflammation of the gums.  As a result, we often see bone loss between the teeth before it shows up in other areas.

So What’s A  Person To Do?

Although gum disease can’t be cured, it can be controlled with the right approach.  Millions of people walk around with many uncontrolled conditions that end up dramatically affecting the quality and quantity of their lives.  For example, high blood pressure can’t really be cured, but it can be controlled.

Stopping bleeding gums might help save your teeth, and it could help save your life.  This might sound extreme, but we in the last decade we’ve discovered eye-opening evidence of the link between oral and general health.  Take time to learn more about how gum disease increases the risk of many serious general health conditions, like heart disease and stroke.  The evidence is alarming and may just provide the extra motivation you need to control this problem.

Some patients deal with extra challenges to gum health. If you’re pregnant, taking aspirin or blood thinners, or have a bleeding disorder, you may find it more difficult to control bleeding in the gums. Women sometimes notice they’re more prone to this problem during menses, too. Regardless of the external factors at play, excellent homecare habits can minimize the effects in every case.

Bottom Line

Healthy gums don’t bleed. If you’re seeing red when you brush or floss, plan a visit to your dentist or hygienist for a complete evaluation. They’ll measure the levels of your bone around each tooth and carefully evaluate the color, thickness, heighth, and texture of your gums.  Diagnosing gum disease and establishing a classification is an objective process and the evidence speaks for itself.

Once you know what’s causing the symptoms, you can develop a personalized strategy together to control bleeding gums.  Your dental team deals with this problem every day, and a plan that fits you is vital to long-term success.  A protocol that works for someone else in your family could look very different than what works for you.

In addition, be sure you practice meticulous home oral care habits, and consider tools that help enhance your efforts. We routinely recommend that our patients choose a good electric toothbrush and add an oral irrigator from a reputable brand like Waterpik.  Regardless of what you find works best in your hands, consistent use makes all the difference.