Healthy gums do not bleed

Skin on your arm does not bleed when you wash it. Gums are no different. Bleeding means the tissue is inflamed, and gum tissue becomes inflamed for one main reason: plaque sitting along the gumline for longer than it should.

The frustrating part is that the natural reaction — brushing that area more gently, or avoiding it — makes it worse. Less cleaning means more plaque, which means more inflammation, which means more bleeding.

Gingivitis is reversible. Periodontitis is not

At the bleeding stage, the condition is gingivitis: inflammation of the gum only. Clean it properly and it settles, usually within a couple of weeks, with no lasting damage.

Left alone, it can progress to periodontitis, where the inflammation reaches the bone holding the tooth in. Bone that is lost does not grow back. This is why gum disease is the leading cause of tooth loss in adults — not decay.

The gap between the two is often years, and almost entirely painless. That is exactly why it gets ignored.

What actually helps

Brushing twice a day matters, but the bleeding usually starts in the spaces a brush cannot reach. Cleaning between the teeth — floss, interdental brushes, whichever you will actually use — is the part that changes the outcome.

Mouthwash is not a substitute. It reduces bacteria on the surface; it does not remove the plaque film that is causing the problem.

Hardened plaque, or calculus, cannot be brushed off at all. That is what a scale and clean removes.

Things that make it worse

Smoking, poorly controlled diabetes, pregnancy and some medications all increase the tendency for gums to inflame. Smoking also masks it, by reducing the blood flow that would otherwise show you there is a problem.

If you smoke and your gums do not bleed, that is not reassurance.

Come and have it looked at

If your gums have been bleeding for more than a week or two, have it checked rather than waiting for it to hurt — it generally will not. We measure the gum around each tooth, which tells us whether this is still gingivitis or has gone further.

More detail here: periodontal treatment and check-ups and cleans.