Bleeding gums

Bleeding gums means blood from the gum tissue, most often noticed on brushing or flossing, or as pink saliva. In the great majority of cases the cause is local: inflammation of the gums (gingivitis) from a build-up of plaque, which makes the gums red, swollen and prone to bleed. This is common, often improves with better oral hygiene, and can progress to more serious gum disease (periodontitis) if neglected. Other local factors include brushing too hard, poorly fitting dentures, and pregnancy, where hormonal changes make gums more likely to bleed. But bleeding gums can also be one sign of a more general tendency to bleed. This is more likely when the gums bleed easily or persistently alongside other bleeding — easy bruising, frequent nosebleeds, or heavy periods. Causes to consider then include blood-thinning medication (such as warfarin), a low platelet count, an inherited bleeding disorder such as von Willebrand disease, and, rarely, a blood cancer such as leukaemia. Severe vitamin C deficiency (scurvy) is now rare but classically causes bleeding, swollen gums. So while most bleeding gums are a dental problem, the wider pattern matters.

• Gingivitis — gum inflammation from plaque; by far the commonest cause, and treatable.
• Brushing too hard or flossing vigorously.
• Pregnancy — hormonal changes make gums bleed more easily.
• Blood-thinning medication — such as warfarin or antiplatelet drugs.
• Low platelet count (thrombocytopenia).
• Inherited bleeding disorder — such as von Willebrand disease.
• Rarely, leukaemia — especially with other bleeding, bruising or feeling unwell.
• Severe vitamin C deficiency (scurvy) — now uncommon.

Bleeding gums with obvious gingivitis and no other bleeding are a dental matter and don't need blood tests. When the gums bleed easily or persistently, especially alongside easy bruising, nosebleeds, heavy periods or feeling unwell, blood tests help: a full blood count (including the platelet count, and to look for leukaemia), and clotting tests (PT/INR and aPTT) — with the INR particularly relevant for anyone on warfarin. Von Willebrand factor testing is arranged if an inherited bleeding disorder is suspected. Mediora.AI can surface a low platelet count, an abnormal clotting time or a raised INR from your results that fits a bleeding tendency; the dental cause is assessed by a dentist and any blood finding by your doctor.