Although gum disease is the most common cause of bleeding gums, there are a number of other causes which need to be kept in mind, some harmless and easily treatable, while others may be more serious.
According to the severity of the condition, the gums may take on a red or dusky appearance instead of the pink color of normal healthy gums. Unhealthy gums may lose their sponginess and feel soft and edematous (swollen) and may be painful to touch.
Bleeding from the gums may occur while brushing or flossing, or sometimes spontaneously or on the slightest touch. The various symptoms may help to identify the cause of gum disease in a particular case. Some people are more prone to develop gum bleeding than others.
Causes of Bleeding Gums
- Gingivitis or the more advanced form, periodontitis, is the most likely cause of gum bleeding in a person.
- Bleeding from the gums may occur while brushing the teeth, flossing, eating, or applying slight pressure on the gums.
- There may or may not be accompanying pain but the gums are usually swollen.
Other mouth and teeth problems
- Ill-fitting dentures, braces or other mouth appliances can cause gum irritation and bleeding.
- Broken, jagged teeth
- Dental abscess
- Tooth cavity, decay and dental infections
- Injury caused by a fall or blow to the teeth or mouth.
- Insertion of toothpicks or other foreign objects between the teeth.
- Mouth sores (aphthous ulcers)
Improper Dental Care
- Excessively vigorous brushing or flossing may cause gum bleeding, but it is unlikely to occur with healthy gums.
- Home use of strong tooth whitening agents from unreliable manufacturers can lead to gum bleeding and pain.
- Oral cavity cancer.
- Gum bleeding is a characteristic feature of leukemia (cancer of blood-forming cells in the bone marrow), especially acute lymphocytic leukemia in children.
- Hormonal changes during pregnancy, puberty, menstruation, and less commonly during menopause may cause gums to bleed.
- Severe malnutrition may cause swollen and bleeding gums.
- Vitamin K is an important blood clotting factor hence its deficiency may cause gums to bleed.
- Prolonged vitamin C deficiency (scurvy).
Bleeding and Clotting Disorders
- Hemophilia is a rare inherited bleeding disorder where there is deficiency in clotting factors, which causes even mild trauma or a simple procedure such as a tooth removal to produce abnormal, excessive bleeding.
- Platelet disorders, such as idiopathic thrombocytopenic purpura (a bleeding disorder where the immune system destroys platelets) can cause persistent gum bleeding.
- Von Willebrand’s disease is the most common hereditary bleeding disorder caused by deficiency of one of the clotting factors known as von Willebrand factor. Gum bleeding is a common symptom, especially after tooth extraction, which may be made worse with aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs).
Drugs and Chemicals
- Side effects of drugs such as oral contraceptives, antidepressants, and antihistamines.
- Chronic use blood thinners – either an anti-platelet drug such as aspirin or anticoagulants such as heparin or warfarin may be lead to bleeding gums.
- Toxicity – mercury, lead or arsenic poisoning.
- Side effect of chemotherapy or radiotherapy for treatment of cancer.
- Drug interaction between certain medicines, including prescription drugs, over-the-counter medicines, or herbal preparations.
- Marked immunosuppression as in AIDS or cancer.
- Certain autoimmune disorders, such as rheumatoid arthritis, Hashimoto’s thyroiditis, and systemic lupus erythematosus (SLE).
- Smoking or chewing tobacco or areca nut and betel leaf may predispose to gum bleeding.
- Uncontrolled diabetes
- End-stage liver disease
Since gum bleeding can be a symptom of a serious disease, evaluation by a dentist as well as a physician may be advisable so as not to miss out any significant cause.