The most common cause of bleeding gums is Gingivitis. Also known as inflammation of the gums, gingivitis is a disease of the soft tissues surrounding and supporting the teeth. It is a bacterial infection caused by microbes in plaque which is allowed to settle and grow around the gum edges.
One of the most significant signs of gingivitis is bleeding from the gums. This is not normal, but is an inevitable indication of disease. It might be noticed on the toothbrush following brushing, in the toothpaste on spitting out, or even on biting into some fibrous foods, eg. apples. In severe cases, the gums might bleed spontaneously, particularly during the night when blood may be found on the pillow.
Most gingivitis is of the chronic type: it is generally painless, has slow onset and is most easily detected by bleeding. Most gums are pink in colour, although they are sometimes pigmented, especially in dark skinned people.
When diseased, the gums look red and may be swollen and loose at the margin where the tooth emerges. There may even be some tenderness if the inflammation is severe.
Who is susceptible to gingivitis? Almost anyone, particularly if their cleaning is inadequate. In between the teeth is a very common area for gingivitis to occur if dental floss is not used daily, and also on the tongue side of the teeth because this is a harder area to reach with the toothbrush.
Some people are unusually susceptible: eg. during hormonal changes as in young people during puberty – the so-called puberty gingivitis, and during pregnancy. Smoking makes people more prone to gum infection from plaque. Other risk factors are stress and general disease, particularly poorly-controlled diabetes.
If left untreated, Gingivitis may progress to Periodontitis, in which the disease spreads along and around the root of the tooth, destroying the bone attachment, and eventually leading to tooth loosening and loss.
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