Causes of Bleeding Gums
Bleeding gums is considered to be one of the most common and noticeable symptoms in dentistry. On average, every third patient over 40 suffers from occasional bleeding gums. Ascending trend. The causes of such bleeding of the Gums can be varied, but the therapy is initially the same for almost all reasons. Only the prevention (prophylaxis) of a recurrence of the bleeding gums differs from trigger to trigger.
What causes bleeding gums?
As with most diseases within the oral cavity, the cause of bleeding gums is a long-term inadequate and / or inadequately performed oral hygiene.
In most cases, the bleeding of the gums (lat. Gingiva) itself is less a disease, but rather a symptom of gum inflammation (Latin: gingivitis). The term gingivitis is a severe inflammation of the gums that is mainly triggered by pathogens. In a large number of cases, these pathogens are germs of bacterial origin.
Similar to tooth decay, the formation of plaque plays a decisive role in the development of gingivitis with bleeding gums. The term plaque describes a tough bio-film that consists of both bacterial metabolic end products and food residues that have not been carefully removed.
If the oral hygiene is inadequate and / or inadequate, this soft dental plaque can even penetrate under the gumline and collect there. In these areas it can then settle on and around the tooth root and create deep gum pockets.
This creates the ideal breeding ground for bacteria and other germs. Within the gum pockets, both the soft coverings (Plaque), as well as immigrant pathogens for the development of extensive inflammatory processes. As a result, the characteristic bleeding gums then occur.
Furthermore, in the course of a disease of the gums (known as parodontosis, actually the disease is called periodontitis), bleeding gums may occur. While gingivitis is a "isolated“When inflammation of the gums is concerned, the inflammatory processes invade one
Periodontitis can also affect other structures of the periodontium. Since such periodontitis usually results from an untreated inflammation of the gums with bleeding gums, the two diseases cannot be completely differentiated from one another. The causes of gingivitis and periodontitis are therefore almost the same. To this day, poor and / or inadequate oral hygiene is considered to be the main cause of bleeding gums.
However, long-term studies of the occurrence of such symptoms within the family show that genetic factors must also be considered as a cause. In addition, tobacco consumption, increased mouth breathing, untreated carious teeth and the presence of inflammation of the gums in the life partner are among the causes of bleeding gums. The reason for the latter fact is that “infection” with the relevant germs can occur particularly quickly in these cases. The presence of a general immune deficiency (technical term: immunodeficiency) in the course of an infection or an HIV disease can be the cause of the bleeding in the gum area.
Bleeding gums can also be triggered by strong mechanical pressure. Too much pressure when brushing or a brush that is too firm damages the gums, causing the smallest, bleeding injuries to the tissue. In addition to triggering bleeding gums, this can even lead to pressure-related receding gums. A large number of affected patients notice bleeding from the gums during or immediately after brushing their teeth. This fact by no means excludes a bacterial cause in those affected, but it should be considered whether it is not due to injury-related bleeding gums.
Read more on the topic: What's the best way to stop bleeding gums?
When choosing a suitable toothbrush, care should therefore be taken to choose a medium-strength brush to protect the gums. Toothbrushes that are too soft are usually unable to remove plaque efficiently, while toothbrushes that are too hard sometimes exert too much pressure on the gums. Another important cause of bleeding gums are the hormonal changes that take place in the organism during pregnancy. Hormone surpluses can trigger strong inflammatory processes and thus lead to inflammation of the gums and bleeding gums.
Please also read: Bleeding gums during pregnancy
Bleeding gums due to inflammation of the gums
Gum inflammation can be recognized by swelling and reddening of the gums. In addition, there is increased bleeding, especially when brushing your teeth. A distinction is made between inflammation of the gums near the teeth (gingiva), which is caused by plaque and can recede again when the plaque is removed from periodontitis (colloquially called periodontal disease), in which the entire periodontium is affected. The latter is associated with special germs that infect the gingival pockets and also lead to bone loss. Periodontitis can have various causes.
Bleeding gums and plaque
First of all, a so-called “pellicle” forms on the enamel. This is an initial biofilm made up of proteins in saliva. It protects the tooth and controls the mineralization processes that take place between the tooth enamel and the oral cavity.
If this layer of proteins is now colonized by bacteria (typical cocci, rods and spirochetes) it is called plaque. This adheres firmly to the tooth enamel, but can still be removed by thoroughly brushing your teeth. The microorganisms accumulate and release a secretion of proteins and carbohydrates in which they can nest and multiply. The plaque grows.
Bleeding gums and tartar
Tartar is mineralized plaque. If it is not removed in time, the plaque stores minerals from the saliva and turns it into solid tartar. This can no longer be removed with a toothbrush.
A distinction is made between tartar above the gum line and that under the gum line. The latter is called "concrement". These concrements sit even more firmly than the tartar above the gum level and receive minerals from the secretion of the gum pocket.
Read also under: Remove tartar
Bleeding gums due to a lack of vitamins
A lack of vitamins can also lead to inflammation of the gums and thus to increased bleeding of the gums. The focus here is on vitamin C, ascorbic acid. You have to get enough of these with your food, as the body cannot produce its own vitamin C. The clinical picture that arises when there is a drastic vitamin C deficiency is called scurvy.
The body needs vitamin C in collagen synthesis. Collagen is a fibrous protein that is needed to build all connective tissues in the body. The gums consist largely of connective tissue and the teeth are fixed in the bone by a fiber apparatus. If there is a lack of vitamin C for collagen synthesis, the gums are weakened and the risk of gum inflammation and bleeding gums increases.
Read more on the topic: Bleeding gums due to deficiency
Bleeding gums in periodontal disease
Periodontitis (often incorrectly called periodontal disease) is a sequela of gingivitis, i.e. The inflammation of the gums close to the teeth spreads to the entire periodontium.
A distinction is made between chronic and aggressive periodontitis. The chronic pardonontitis occurs most frequently. Most of those affected are older than 30 years old (there are exceptions). Periodontitis is characterized by the formation of pockets and receding gums, and in the advanced stage by bone loss.
External factors such as stress, smoking, certain medications and hormones can influence the risk of developing periodontal disease.
Aggressive periodontal disease often occurs in younger patients, often during puberty. A feature here is the good general condition of the patient apart from the pardontitis and the rapid, intermittent progression of the inflammation.
Learn more about this at: Aggressive periodontal disease
Bleeding gums from stress
Stress has an impact on our immune system. In the case of acute stress, the body adjusts to an emergency situation. The unspecific defense is ramped up.
However, if one suffers from chronic stress and is exposed to stressful situations more often, the body can no longer maintain the alarm state. The immune system is weakened, you get sick faster. Inflammation also occurs more quickly in the gums, since the immune system can no longer fight the bacteria that settle in the gum pockets as effectively.
Does the thyroid affect bleeding gums?
The thyroid is one of the endocrine organs in the human body, i. it can produce hormones. In the gums there are receptors for a.o. exactly these hormones. When released by the thyroid gland, these can get through the bloodstream to the gums, dock onto the receptor and develop their effect.
Thyroid hormones influence the body's metabolism and the mineral balance of the bones. The calcitonin formed there leads to a reduction in the calcium level in the blood. Its counterpart, the parathyroid hormone, is produced by the parathyroid gland. If this is diseased and produces too much parathyroid hormone, the ratio between calcitonin and parathyroid hormone is out of balance. The parathyroid hormone mobilizes calcium from the bone on the jawbone. This causes the bone to lose its stability and become porous. If the periodontal germs are added, the bone can be broken down more quickly.
The risk of periodontitis is therefore increased with an overactive parathyroid gland.
Bleeding gums from HIV infection
Already in the name "Human Immunodeficiency Virus“Hides the reason why people with HIV are at increased risk of developing gingivitis. The immune system's job is to fight bacteria and germs and to keep any associated inflammation at bay. If this system no longer works as it should, the inflammation can spread faster and more freely.
But not only inflammations in the mouth indicate an HIV infection. The immune system can no longer fight against special viruses and fungi. It is therefore important to examine the mucous membrane precisely for changes, inflammation and bacterial, viral or fungal infestation. However, having HIV does not mean that you have to develop bleeding gums and vice versa.
Learn more about the topic at: Bleeding gums as a sign of HIV infection
Bleeding gums from the liver
The liver plays an important role in blood clotting by producing a number of so-called clotting factors. These are proteins that, in the event of bleeding, ensure that the wound is closed again and the bleeding is stopped. In the case of liver insufficiency or liver cirrhosis, there is a lack of precisely these hemostatic proteins. If the gums bleed, for example due to the mechanical stress when brushing their teeth, the blood clotting is disturbed and bleeding is increased and longer than in people with healthy liver. In extreme cases, spontaneous bleeding can occur as part of gum inflammation.
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A selection of the previously published topics in dentistry can be found under Dentistry A-Z.