Why are my gums bleeding?
In the large majority of cases, the answer is plaque sitting along the gumline.
Plaque is a soft film of bacteria that forms continuously on teeth. Where it accumulates at the margin between tooth and gum, the gum tissue becomes inflamed in response. Inflamed tissue is fragile and rich in blood vessels, so it bleeds at the slightest disturbance — a toothbrush, floss, sometimes a hard apple.
Less commonly, other factors drive or worsen it:
- Hormonal change — pregnancy, puberty, and menopause all amplify the gum response to the same amount of plaque.
- Medications — blood thinners increase bleeding; some blood pressure medications, anticonvulsants, and immunosuppressants cause gum overgrowth that traps plaque.
- Smoking — which, counterintuitively, often reduces visible bleeding by constricting blood vessels while the underlying disease progresses faster. Smokers can have significant gum disease with deceptively little bleeding.
- Systemic conditions — poorly controlled diabetes in particular, and less commonly blood disorders or vitamin deficiencies.
- Technique — a brand-new flossing habit or an over-hard brush can cause some trauma, though this is a far smaller cause than most people assume.
Is bleeding when you brush normal?
Common, but not normal. This distinction matters, because a great many people have quietly accepted bleeding gums for years as just how their mouth is.
Healthy gums are pale pink, firm, and sit snugly around each tooth. They do not bleed when brushed with reasonable technique. If yours do, the tissue is inflamed — and inflammation is a process, not a fixed state. Left alone it tends to continue.
The good news is that the earliest stage is entirely reversible, and usually within a fortnight.
Gingivitis vs periodontitis: what is the difference?
This is the single most useful thing to understand about gum disease, because the two are separated by a line you cannot cross back over.
| | Gingivitis | Periodontitis | | --- | --- | --- | | What is affected | Gum tissue only | Gum, periodontal ligament, and bone | | Signs | Bleeding, redness, puffiness | Plus recession, pockets, loose teeth, bad breath | | Pain | Usually none | Often none until advanced | | Reversible? | Yes — completely | No — can be halted, not undone | | Treatment | Improved home care, professional cleaning | Deep cleaning below the gumline, ongoing maintenance, sometimes surgery |
Gingivitis is inflammation of the gum only. Remove the plaque consistently and the gums return to full health with no lasting damage.
Periodontitis is what happens when that inflammation persists for years and extends below the gumline, destroying the ligament and bone that hold teeth in place. That loss is permanent. Treatment stabilises the disease and prevents further loss; it does not regrow what has gone.
The reason this matters so much is that the transition is silent. Periodontitis is typically painless until it is advanced, which is why it remains the leading cause of tooth loss in adults — people feel fine right up until teeth start moving.
How to stop bleeding gums at home
For simple gingivitis, this genuinely works, and faster than most people expect:
Brush twice daily, for two full minutes
Soft bristles, angled at 45 degrees toward the gumline, small circular movements. Hard scrubbing damages gums without cleaning better. An electric brush with a pressure sensor helps if you tend to press hard.
Clean between your teeth once a day
Floss, interdental brushes, or a water flosser — the best one is the one you will actually use. A toothbrush cannot reach the surfaces between teeth, which is precisely where gum inflammation tends to start.
Keep going through the bleeding
This is where most people stop, assuming they are causing harm. You are not. Bleeding from inflamed tissue reduces as the inflammation settles, usually noticeably within a week.
Consider an antiseptic rinse, briefly
Useful as a short-term supplement. Not a substitute for mechanical cleaning, and not a long-term plan.
Reassess after two weeks
Settled? It was gingivitis and you have dealt with it. Still bleeding? Book an appointment — there is likely hardened tartar below the gumline that no amount of brushing will shift.
Once plaque hardens into tartar, home care cannot remove it. It requires professional instruments. That is not a sales pitch, it is simply what the material is — calcified, and bonded to the tooth surface.
Swollen gums: what causes them and what to do
Swelling and bleeding usually travel together, because both are signs of the same inflammatory response. But swelling has a few causes of its own, and one of them is urgent — so it is worth separating out.
Generalised swelling: puffy gums across the mouth
Gums that are puffy, red, and shiny along the gum line in several places at once are almost always inflammatory. The usual causes:
- Plaque and tartar build-up — by a wide margin the most common. The swelling is the body responding to bacteria at the gum margin.
- Hormonal change — pregnancy, puberty, and the menstrual cycle all amplify the gum response to the same amount of plaque. "Pregnancy gingivitis" is common and real.
- Medication. Certain drug classes cause gum overgrowth as a side effect, notably some anticonvulsants, calcium channel blockers used for blood pressure, and immunosuppressants. The gums thicken rather than simply inflame. If your gums have grown noticeably and you take any of these, mention it — the answer is usually managed cleaning, not stopping the medication.
- Mouth breathing, which dries the front gums and leaves them chronically irritated.
- Vitamin C deficiency, rare in Canada but a genuine cause where diet is very restricted.
This kind of swelling generally responds to professional cleaning plus consistent home care, on the same timeline as bleeding.
Localised swelling: one spot, one tooth
Swelling confined to one area around a single tooth is a different matter and is more likely to need attention.
- Something trapped below the gum — a popcorn husk, a seed, a fragment of floss — causing a local reaction
- A gum abscess, where infection has walled off into a pocket
- A tooth abscess draining through the gum, often with a small pimple-like spot
- Pericoronitis — inflamed gum over a partially erupted wisdom tooth, common in late teens and twenties and often accompanied by difficulty opening the jaw
- A cracked tooth or a failed filling irritating the surrounding tissue
Localised swelling with pain, a bad taste, or a visible spot on the gum should be seen promptly rather than watched.
Swelling that is an emergency
What to do about swollen gums at home
Short term, while you arrange to be seen:
- Warm salt-water rinses, a few times a day
- Keep brushing gently — swollen gums bleed more, and the instinct to avoid the area makes it worse
- Clean between the teeth carefully, which is where the cause usually sits
- Cold compress on the outside of the cheek for comfort if the area is sore
- Over-the-counter pain relief as directed
Do not place aspirin against the gum — it burns the tissue — and do not attempt to lance or squeeze a swelling yourself.
If swelling has not begun to settle within a few days of genuinely improved cleaning, or if it is localised, painful, or accompanied by fever, book rather than persisting with home care.
When bleeding gums mean you should book a visit
Book an appointment if you notice any of these:
- Bleeding that persists beyond two weeks of genuinely consistent home care
- Gums that are swollen, tender, or visibly receding
- Teeth that feel loose, or a bite that has changed
- Persistent bad breath or a bad taste that brushing does not fix
- Pus, or a gum abscess
- Bleeding that is spontaneous rather than provoked by brushing
Book sooner rather than waiting the full two weeks if you are pregnant, diabetic, taking a blood thinner, undergoing cancer treatment, or immunocompromised. In each of those cases gum inflammation carries more weight, and in the case of diabetes the relationship runs both ways — gum disease makes blood sugar harder to control, and poor control worsens gum disease.
What a dental visit for bleeding gums involves
Nothing alarming, and usually a single appointment:
- Assessment. Gums are examined for redness, swelling, and recession. A fine probe measures the depth of the space between gum and tooth at several points — this is how gingivitis is distinguished from periodontitis, and it is not painful in healthy tissue.
- X-rays where indicated. These show the level of the supporting bone, which is the definitive answer on whether attachment has been lost.
- Cleaning. Plaque and tartar are removed from above and, where needed, just below the gumline.
- Where periodontitis is present, a deeper cleaning of the root surfaces under local anaesthetic, sometimes across more than one visit.
- A maintenance plan. More frequent cleanings than the standard interval, and specific technique guidance for the areas you are missing.
Most people are surprised by how much improvement follows a single thorough cleaning combined with a fortnight of better home care.
Medical causes: medications, pregnancy, and health conditions
Worth flagging to your dentist, because each changes the approach:
Pregnancy. Pregnancy gingivitis is extremely common and typically most pronounced in the second trimester. Dental cleanings are safe during pregnancy and actively recommended — tell your dentist you are pregnant so timing and positioning can be adjusted.
Diabetes. The relationship is bidirectional and well established. Gum disease is both more common and more severe with poor glycaemic control, and active gum inflammation makes blood sugar harder to manage.
Blood thinners. Warfarin, DOACs, and even daily aspirin increase bleeding. Do not stop or alter any of them for a dental appointment — tell your dentist instead, and they will plan accordingly.
Medications causing gum overgrowth. Some anticonvulsants, calcium channel blockers, and immunosuppressants cause gum tissue to enlarge, creating pockets that trap plaque. This needs more frequent professional cleaning rather than a change of medication.
Immunosuppression and cancer treatment. Both reduce the ability to control oral infection. Dental assessment before starting chemotherapy or radiotherapy is standard practice for good reason. If you are due to have treatment involving antibiotics before dental work, see our guide to antibiotics before dental treatment.
How to keep gums healthy long term
Gum health is unglamorous and entirely habit-driven:
- Brush twice daily for two minutes with a soft brush; clean between the teeth once daily.
- Replace your brush or brush head every three months, or sooner once bristles splay.
- Keep regular professional cleanings at the interval your dentist recommends — for some people that is every six months, for others with a periodontal history it is three or four.
- Stop smoking if you can. It is the most significant modifiable risk factor for gum disease, and it also masks the warning sign by suppressing bleeding.
- Manage diabetes well, and treat gum health as part of that management rather than separate from it.
If it has been a while since your last cleaning, that is an ordinary reason to book rather than an awkward one. Our general dentistry page covers what a check-up and cleaning involves, and if you are looking for a practice in the area, dentist in Richmond Hill covers the clinic.