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What are the common causes of gum bleeding?

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Gum bleeding, or gingival bleeding, is most commonly caused by gingivitis—the early, reversible stage of gum disease. This occurs when dental plaque, a sticky biofilm of bacteria, accumulates along the gumline and triggers localized inflammation. As a result, the gingival tissues become swollen, tender, and prone to bleeding during brushing, flossing, or even gentle probing.

Other frequent contributors include poor oral hygiene habits, infrequent professional dental cleanings, ill-fitting dental appliances (such as dentures or orthodontic devices), and aggressive toothbrushing with a hard-bristled brush or excessive force. Hormonal fluctuations—particularly during pregnancy, puberty, or menstruation—can also increase gingival vascular permeability and sensitivity, leading to heightened bleeding tendency.

Less common but clinically important causes include systemic conditions such as vitamin C or K deficiency, thrombocytopenia, leukemia, hemophilia, or other coagulopathies. Certain medications—including anticoagulants (e.g., warfarin, apixaban), antiplatelet agents (e.g., aspirin, clopidogrel), and some antihypertensives (e.g., nifedipine, phenytoin)—may also predispose individuals to gingival bleeding, either through altered clotting function or drug-induced gingival overgrowth.

If gum bleeding persists for more than 7–10 days despite improved oral hygiene—or if it occurs spontaneously, is accompanied by gum recession, loose teeth, persistent bad breath (halitosis), or systemic symptoms like fatigue or unexplained bruising—a comprehensive dental and medical evaluation is warranted to rule out periodontitis, underlying hematologic disorders, or other systemic disease.

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