Healthy gums are firm, pale pink in color and have a smooth surface. It hugs the neck of the tooth like a turtleneck, provides support and protects the root of the tooth from the penetration of bacteria and pathogens. If there is occasionally a little bleeding when brushing your teeth or using dental floss, this is usually caused by inflammation of the gums (gingivitis). It becomes dangerous if it develops into periodontitis.
How are the gums structured?
The gums (gingiva) are part of the periodontium. It is divided into free and attached gingiva. The movable gingival papillae, which appear like a small triangle exactly between the teeth, and the “turtleneck hem” made of gums belong to the free gingiva. The attached gums are further below and are firmly connected to the jawbone by connective tissue fibers. In contrast to free gums, it cannot be moved. The periodontium consists of the gums, the alveolar bone, the cementum and the periodontium. If the periodontium is healthy, it holds the teeth securely in their position and allows them to withstand extreme chewing forces.
Why do the gums bleed?
Poor oral hygiene
Bleeding gums when brushing your teeth are a sign of gum inflammation (gingivitis). This is primarily due to poorly brushed teeth. Bacterial deposits (plaque) can then accumulate on the gums and irritate them, causing inflammation. It is a reaction of the immune system, which tries to flush the bacteria out of the gums with increased blood flow. The result: bleeding gums.
Gingivitis in the early stages usually disappears without any problems with consistent oral hygiene. The spaces between the teeth should also be carefully cleaned with dental floss or interdental brushes, because this is where bacteria can hide particularly well. Plaque must be removed by regular and thorough brushing. If the plaque is not removed, it hardens over time to form tartar, on whose rough surface bacterial plaque can attach itself even better.
Mechanical injuries
The gingiva is sensitive. A hard toothbrush and brushing too vigorously can cause bleeding gums. The same applies to dental floss that is pulled too forcefully into the gums when cleaning. Interdental brushes should also be the right size (if in doubt, ask your dentist) so that the spaces between the teeth are cleaned well even when used sensitively. Use a soft toothbrush with rounded bristles, it is gentle on sensitive gums and removes soft plaque very well. If you use an electric toothbrush, it will indicate too much pressure when brushing with a light signal. You can also get useful tips for the right cleaning technique at home from your dentist.
Periodontitis
If gingivitis is not permanently eliminated or treated, it can develop into periodontitis. Periodontitis is almost always painless and is often only noticed too late. Inflammation of the gums becomes chronic periodontitis and affects the entire periodontium. The gums no longer enclose the tooth necks, but recede and detach. Deep gum pockets form on the teeth, and regular bleeding from the gums indicates a deep-seated inflammation. The supporting tissue is gradually broken down and the jawbone degrades. In the worst case, there is a risk of tooth loss due to the lack of support in the bone.
The chronic inflammation of the periodontium can also reach other parts of the body through the blood vessels and, in the worst case, cause cardiovascular diseases, strokes or premature births. Periodontitis requires special treatment at the dentist to prevent serious consequences for the teeth and the entire body. Since July 2021, the statutory health insurance companies have been covering significantly more services for the lengthy treatment. Smokers and diabetics have a greatly increased risk of developing periodontitis.
Other causes of bleeding gums
Hormonal influences during pregnancy can lead to gum swelling and bleeding gums. Certain hormones loosen the gums and make it easier for bacteria to colonize the teeth.
Certain physical illnesses can be the cause of inflamed gums and bleeding gums. Diabetes mellitus, HIV and tumor diseases change the metabolism, an accompanying symptom is bleeding gums. Excessive alcohol consumption, anorexia or malnutrition lead to vitamin C deficiency and can cause scurvy-like symptoms, including bleeding gums. Other possible causes of bleeding gums include ill-fitting dentures or blood-thinning medication.
Rarely, necrotizing ulcerative gingivitis is a possible cause of severe bleeding from the gums. This mainly affects young people with negligent dental care and smokers. The disease develops in the spaces between the teeth and spreads. It is accompanied by yellow plaque on the gums and bad breath.
How can you prevent bleeding gums?
The most common cause of bleeding gums is poor oral hygiene. Prevention is therefore relatively simple: Regular brushing of teeth and cleaning of the spaces between the teeth keep bacterial deposits in check and prevent inflammation from developing in the first place. An antibacterial mouthwash after brushing your teeth is an additional support to fight inflammation. At least once a year, the dentist should check the teeth and examine the mouth and teeth for possible diseases.
Professional tooth cleaning in the practice removes tartar, discolouration and also the last residues of food and harmful bacteria in hard-to-reach corners. It is an optimal supplement to oral hygiene at home and should be done at least once a year.
Conclusion:
Bleeding gums are caused by poor dental care and careless removal of bacterial plaque. Inflammation of the gums is initially easy to treat yourself. However, the symptom should not be taken lightly. Good oral hygiene, regular dental check-ups and professional teeth cleaning at least once a year ensure healthy, clean teeth without inflammation.
