Bleeding gums can be a sign that you are at risk for, or already have, gum disease. However, persistent gum bleeding may be due to serious medical conditions such as leukemia and bleeding and platelet disorders.

It is important to follow the instructions from your dentist in order to maintain healthy gums. Improper brushing and flossing technique may actually irritate or traumatize the gum tissue.

Bleeding gums are mainly due to inadequate plaque removal from the teeth at the gum line. This will lead to a condition called gingivitis, or inflamed gums.

If plaque is not removed through regular brushing and dental appointments, it will harden into what is known as tartar. Ultimately, this will lead to increased bleeding and a more advanced form of gum and jawbone disease known as periodontitis.

Other causes of bleeding gums include:

• Any bleeding disorder
• Brushing too hard
• Hormonal changes during pregnancy
• Idiopathic thrombocytopenic purpura
• Ill-fitting dentures
• Improper flossing
• Infection, which can be either tooth- or gum-related
• Leukemia
• Scurvy
• Use of blood thinners
• Vitamin K deficiency

Visit the dentist at least once every 6 months for plaque removal. Follow your dentist's home care instructions.

You should brush your teeth gently with a soft-bristle toothbrush after every meal. The dentist may recommend rinsing with salt water or hydrogen peroxide and water. Avoid using commercial, alcohol-containing mouthwashes, which aggravate the problem.

Flossing teeth twice a day can prevent plaque from building up. Avoiding snacking between meals and reducing carbohydrates can also help. Follow a balanced, healthy diet.

Other tips:

• Avoid the use of tobacco, which aggravates bleeding gums.
• Control gum bleeding by applying pressure directly on the gums with a gauze pad soaked in ice water.
• If you have been diagnosed with a vitamin deficiency, take recommended vitamin supplements.
• Avoid aspirin unless your health care provider has recommended that you take it.
• If side effects of medication are irritating, ask your doctor to recommend another medication. Never change your medication without consulting your doctor.
• Use an oral irrigation device on the low setting to massage the gums.
• See your dentist if your dentures do not fit correctly or if they are causing sore spots in your gums.

Consult your health care provider if:

• The bleeding is severe or long term (chronic)
• Your gums continue to bleed even after treatment
• You have other unexplained symptoms with the bleeding

Your dentist will examine your teeth and gums, and ask questions such as:

• Are the gums bleeding a large amount?
• Did the bleeding begin recently?
• Do the gums bleed frequently or only occasionally?
• Have you had gum problems before?
• How often do you brush?
• How often do you floss?
• Do you use a soft- or hard-bristle toothbrush?
• How vigorously do you brush?
• What other home care aids do you use (toothpicks or other)?
• When was the last time you had your teeth cleaned at the dentist?
• Have you changed your diet?
• Do you eat adequate amounts of fruits and vegetables?
• Do you take supplemental vitamins?
• Do you have a high carbohydrate diet (pasta)?
• What medications do you take? Do you take seizures medicines, blood thinners (such as Coumadin, heparin), or aspirin?
• Are you pregnant?
• Have you changed mouthwash or toothpaste recently?
• What other symptoms do you have? (for example, sore throat)

Diagnostic tests that may be performed include:

• Blood studies such as a CBC or blood differential
• X-rays of the teeth and jawbone