Bleeding gums result from so many causes. It is a common phenomenon. It is frequently seen among people. Gums are very delicate structures. They are very rich in vascularity. So they bleed easily. In this article, you will learn details about the causes of gum bleeding. Since the symptoms of many complex diseases are manifested through bleeding gums, many people are afraid of it. But it is not scary most of the time. Reading this article will make it clear when you need to worry about bleeding gum
Let's not know first the difference between healthy and inflamed gums. Gums are the supporting soft tissues that surround alveolar bones and support teeth. Healthy gums are pink in color and firm consistency. The color indicates the clinical conditions of the gingiva. Red gums are inflamed gums. Whereas normal healthy gum tissues are paler pink. The more amount of melanin pigment in the epithelium makes them darker, but it is also normal.
Bleeding gums can be present as gingivitis, inflammation of the gingiva. Gingivitis is a non-destructive type of periodontal disease. It usually occurs because a film of plaque, or bacteria, accumulates in teeth. Day by day the plaque turns into calculus by mineralization. Hard calculus comes in contact with soft gingiva causes inflammation and resulting gingivitis. The gingival margin becomes red and swollen with edema. Bleeding on brushing, biting become regular events.
Now let's know about the causes of bleeding gums or gingivitis.
Causes of bleeding gums :
Bleeding gums causes are:
- Vitamin deficiencies.
- Gingivitis due to systemic factors i.e. hormonal change like puberty associated gingivitis, menstrual cycle-related gingivitis, pregnancy gingivitis.
- Sore gum due to Crowding and imbrication, ill-fitting dentures, or orthodontic appliances.
- Sore gum due to poor brushing technique and accident
- Gingival swelling.
- Poorly controlled diabetes mellitus.
- Down's syndrome
- Bleeding disorder i.e Haemophilia, leukemia, etc
- Non-plaque induce gingival lesion s due to bacterial viral fungal infections
- Intake of blood-thinning medication.
- Combined period-endodontic lesions.
- Allergic reaction
Among all bleeding gums causes periodontitis is the most frequent. Factors associated with, irregular tooth cleaning habits, poor tooth brushing technique, dental irregularities creating stagnation areas, not treating gingivitis. The initial stage starts within 24-48 hours of plaque exposure. Calculus form and periodontal disease start. Infiltration of inflammatory cells predominantly neutrophils and vasodilation occur resulting in bleeding gums In established cases, there is the loss of bones and disruption of periodontal ligament and also pocketing, bleeding gums become more frequent.
Deficiencies of vitamin C mostly and vitamin K sometimes result in bleeding gums. Lack of dietary intake of these vitamins cause reduces collagen synthesis. The deficiency of vitamin causes Scurvy. Vitamin C also helps in boosting immunity to fight against any infection. The following foods are full of vitamins C and K that should know to ensure getting the vitamins for staying healthy.
Vitamin C rich foods that help to prevent scurvy are:
- Citrus fruits like lemon, orange, etc
- Green leafy vegetables.
- Guava, etc.
Vitamin K rich foods are-
- Fruits like Kiwi, Avocado, Blackberries, Blueberries, Pomegranate, Tomatoes, etc.
- Spinach (raw)
- Mustard greens
- Beef liver
- Soybean oil
- Cheeses, etc.
Gingivitis due to systemic factors i.e. hormonal change:
Gingivitis also occurs due to hormonal changes in puberty, menstrual cycle, and mostly in the time of pregnancy. Sex hormones in females ( progesterone, estrogen ) fluctuate during puberty, menstruation, pregnancy, and menopause. Estrogen levels rise and fall almost twice during the time of the menstrual cycle. Hormone levels can cause an increased inflammatory response of the gums to the dental plaque during puberty. Similarly, the Inflammatory response of gum increase in pregnancy as estrogen holds fluid to the soft tissues. It results in swollen gums ( gingival fibromatosis) and red gums (inflamed gums) called pregnancy gingivitis. Another name of pregnancy gingivitis is pregnancy epulis.
Sore gum due to crowding, imbrication, Ill-fitting dentures or orthodontic appliances:
These are indirect causes of bleeding gums. Crowding and imbrication i.e. overlapping teeth create stagnation areas. It is difficult to clean food debris in these types of malocclusion. similarly, ill-fitting dentures or orthodontic appliances also create stagnation areas to accumulate plaque. Accumulation of food particles and the formation of plaque results in gingivitis. The overextended denture border or appliances sometimes impinges delicate gingiva resulting in sore gums. When a patient undergoes orthodontic treatment, sometimes feels pain and feels less interest in tooth cleaning resulting in gum disease.
Swollen gums definitely bleed. There are many causes of swollen gums along with the causes of gingivitis. Like gingival hyperplasia due to drugs (anti-epileptic drugs, ca channel blocker, immunosuppressive drugs), HIV, anemia, lymphoma, etc.
Poorly controlled diabetes mellitus:
Gum disease or gingivitis is called the fifth complication of diabetes behind heart, nerve, kidney, and eye disease. High blood sugar levels also cause an increase in sugar levels in saliva. It promotes bacterial growth and causes gum disease. Again people with diabetes are more susceptible to infections. Long time diabetes causes immunosuppression that reduce bodies defensive capacity against opportunistic infections.
Bleeding gums is a sign of leukemia, a type of blood cancer. Platelet deficiency, Coagulation factor disorder (hemophilia) also causes gum bleeding. In some cases, pernicious anemia associated with Vitamin B12 malabsorption also causes bleeding from the gums.
Intake of blood-thinning medications:
Blood-thinning medicines like warfarin, aspirin, and heparin are used as prophylaxis of angina pectoris and ischaemic stroke. Also by cardiovascular risky patients. They might experience bleeding gums as a side effect. Patients with the risk of venous thromboembolism take rivaroxaban. The most common side effect of rivaroxaban is bleeding more easily than normal, such as having epistaxis, heavier periods, bruising, bleeding gums. It tends to happen in the first few weeks of dose started. Nowadays this medicine is frequently used in the treatment of aged or diabetic corona patients. So drug history is very much important to explore the reasons for bleeding gums.
The other causes like ANUG, combined period-endodontic lesions, allergic reaction, Sore gum due to poor brushing technique, and accident, non-plaque induce gingival lesions due to bacterial viral fungal infections, dry mouth, xerostomia, family history are also important causes to be noticed while treating bleeding gums. Now let's know the effects.
Effects of bleeding gum:
- Halitosis, bad breath, bad smell in the mouth are common complaints of patients who are suffering from bleeding gums.
- The patient finds blood while biting on foods like banana, apple, snacks which may be embarrassing.
- Bleeding gum causes a pocket later where food particles accumulate easily and caries develop.
- Development of period- endodontic lesion of periodontal origin.
- If gum diseases are left untreated it will progress into mobility and finally tooth loss.
- Alarming are some studies that suggest that people with gum disease are more likely to have heart disease or diabetes.
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Treatment of bleeding gums:
Bleeding gum treatment is not possible at home mostly if the cause is calculus. Scaling is a must. Hand scaling or ultrasonic scaling both will be effective. It must be done by a professional dentist.
At home, mild hot salt water mouth rinse will give the best outcome. It is a kind of exercise to the gum. It makes the gum healthy by increasing blood circulation.
Chlorohexidine or povidone-iodine mouthwash also reduces bacterial growth and improves the condition.
Other treatments depend on the causes of bleeding gums. Removal of causes should be the first plan of treatment. later scaling will help to get back healthy gingiva.
If it bleeds more blood tests like complete blood count, bleeding time, clotting time is must evaluate bleeding disorders.
Hopefully, you get detailed ideas about the bleeding gums causes, effects, and bleeding gum treatment. Bleeding gum is not a condition that you need to be tensed but awareness is needed. And finally, prevention is better than cure. so take care of your oral hygiene properly. Go to the dentist 6 constructive months for a check-up.