Why Do My Gums Bleed When I Brush?

You spit after brushing and the foam is pink. You brush a little more gently the next day, then skip flossing because it makes the gums bleed worse. A week later it’s still happening, and you’ve decided to avoid looking at the sink.

What it is

MedlinePlus² calls gingivitis the mildest form of gum disease: the gums become red and swollen and can bleed easily. If untreated, it can progress to periodontitis, where the gums pull away from the teeth and form pockets that become infected. The NIDCR³ describes periodontal disease as an infection that causes inflammation of the tissues that hold your teeth in place. Without treatment, MedlinePlus says, the bones, gums and connective tissue that support the teeth are destroyed, potentially leading to tooth loss.

The signs on the lists: red, swollen, tender gums that bleed easily, and bad breath or a bad taste. Later signs, the NIDCR³ says, include gums pulling away so teeth appear longer, and loose or sensitive teeth. If your breath is the bigger worry, see why breath can smell even after you brush, and for taste, a bad taste in your mouth.

The ADA⁴ adds a warning: gum disease is usually painless, so you may not know you have it, which is why regular checkups matter.

Why it happens

The ADA⁴ says gum disease stems from plaque, the sticky film of bacteria that constantly forms on teeth. The NHS¹ says that when plaque isn’t removed by regular cleaning, it builds up and irritates the gums.

Some people are more prone. The NIDCR³ calls smoking the most significant risk factor and says tobacco delays healing. It also lists diabetes, older age, genetics, stress, certain illnesses, medicines, and hormonal changes in girls and women. The ADA’s⁴ list includes poor oral hygiene, tobacco, genetics, crooked teeth, pregnancy, diabetes and certain medicines. The NHS¹ singles out pregnant people, people with type 2 diabetes, and smokers as needing to be especially careful.

If dry mouth is also in the picture, waking up with a dry mouth is worth reading.

What helps

The ADA⁴ says gingivitis is still reversible and can usually be eliminated by a professional cleaning at your dental office, followed by daily brushing and flossing. MedlinePlus² says you can usually reverse it with daily brushing and flossing and regular cleanings by a dentist or dental hygienist.

The NHS¹ spells out the daily routine: brush with fluoride toothpaste at least twice a day, and clean between your teeth daily with floss or interdental brushes. It also says not to use mouthwash straight after brushing, and to avoid smoking. The ADA⁴ adds a balanced diet and regular dental visits. The NIDCR³ says any treatment requires keeping up good oral health care at home.

If it has advanced, the NIDCR³ describes scaling and root planing, a deep cleaning, and surgery in advanced cases. The NHS¹ adds that severe cases may need deep cleaning under the gums, antibiotics or tooth extraction.

The play

Try this: the two-part reset

Book a cleaning and tell the dentist or hygienist your gums bleed.

Until then, brush twice a day with fluoride toothpaste and clean between your teeth once a day, gently and thoroughly, along the gumline.

Write down whether the bleeding is easing, staying the same or getting worse, and bring that to the appointment.

When to get checked

The NHS¹ says to see a dentist, non-urgently, if your gums bleed when you brush or eat, and to ask for an urgent appointment if you have badly sore and swollen gums, loose teeth, or ulcers or red patches in your mouth. The ADA⁴ says to see your dentist if you suspect gum disease, because the sooner you treat it, the better.

Book an appointment if any of these fit:

• Your gums bleed when you brush or floss, and it keeps happening
• Your gums are red, swollen, tender or pulling away from your teeth
• Your breath or taste has changed and brushing doesn’t help
• You smoke, have diabetes, or are pregnant and haven’t had a recent checkup
• A tooth feels loose
• You can’t remember your last cleaning

Pink foam in the sink is a message. Answer it with a dentist, and keep brushing.