Why do my gums bleed when I brush?

Gums that bleed when you brush are usually a sign of plaque built up along the gum line, which irritates the gum and is the early stage of gum disease, called gingivitis. Brushing too hard, restarting flossing, and pregnancy hormones can also cause it. Bleeding most days is worth mentioning to a dentist rather than something to simply brush more gently and ignore.

In short

• Bleeding when you brush is most often a sign of plaque along the gum line, which irritates the gum and is the early, reversible stage of gum disease, called gingivitis.
• Brushing too hard, a worn or stiff toothbrush, or starting to floss again after a gap can also make gums bleed for a short time.
• Hormonal changes in pregnancy make gums more likely to bleed, a common pattern sometimes called pregnancy gingivitis.
• Bleeding gums are not something to just manage by brushing less. If it continues most days, tell a dentist.
• Keeping up gentle, thorough brushing and flossing, rather than avoiding the area, is usually part of how bleeding settles.

What causes it most of the time?

The NHS explains that gum disease is caused by a build-up of plaque on the teeth, and that bleeding when you brush, floss or eat something hard, such as an apple, is one of the main signs. Left undisturbed, this plaque irritates the gum edge, which becomes red, swollen and prone to bleeding. This early stage is called gingivitis, and it is reversible with better cleaning, which is covered in more detail in What are the signs of gum disease, and how is it treated?

Could it be how I am brushing or flossing?

Sometimes the cause is more immediate than gum disease. Brushing too hard, or with a worn or hard-bristled toothbrush, can make gums bleed on its own, and a soft or extra-soft brush used gently is generally enough to clean well without this effect. Gums can also bleed for the first few days after you start flossing again following a gap, simply because the tissue is not used to it. A gentle, circular brushing motion, covering every surface, tends to be kinder to the gums than a hard back-and-forth scrub.

Is it normal to have bleeding gums during pregnancy?

It is common. Hormonal changes in pregnancy increase blood flow to the gum tissue, and South African Dental Association guidance notes that this leaves a large proportion of pregnant women with gums that are red, tender or prone to bleeding, a pattern sometimes called pregnancy gingivitis. It is still worth mentioning to a dentist, since keeping up thorough brushing and flossing, and a professional clean such as a scale and polish, can help it settle rather than worsen as the pregnancy continues.

When should I see a dentist about it?

It is worth being examined if bleeding happens most times you brush, does not ease after a week or two of gentle, thorough cleaning, or comes together with swollen gums, persistent bad breath, or teeth that feel loose. You do not need to wait for your next routine visit if this describes what you are experiencing, since how often a check-up is generally needed is a separate question from a new symptom that has already appeared. Ask for an appointment and describe what you have noticed.

How do I reach Dr Davies?

Dr Davies treats gum problems as part of general dental care at BRS Dental on Strand Street, in Cape Town City Centre, and the practice’s two hygienists carry out professional cleaning where this would help. To make an appointment, call her directly on her own mobile, which is shown on this page.