Tooth Troubles

Bleeding gums

Gums that bleed when brushing or flossing. This page explains what bleeding gums indicate and what a dentist may do. It does not assess your child — that needs an examination.

What this is

Bleeding from the gums is the sign dentists watch most closely. The AAPD describes bleeding on probing as the best parameter for monitoring gum health or inflammation over time, which tells you how much weight the profession puts on it.

It is also common. The AAPD states that gum inflammation occurs in half the population by the age of four or five and peaks at nearly one hundred per cent at puberty. Common and meaningful at the same time — which is why it is worth mentioning rather than either panicking about or ignoring.

Cozy says

If your gums bleed a bit when you brush, it usually means they need brushing gently right along the edge where the tooth meets the gum. Tell a grown-up, and keep brushing unless the dentist says otherwise.

Crumbs explains

Most people stop brushing where it bleeds. That instinct is understandable and often counterproductive, since plaque at the gum line is one of the recognised routes to gum inflammation — but what to do about it depends on why it is bleeding, and that is the dentist’s call. Ask before changing the routine.

What bleeding gums indicate

The AAPD is specific about why bleeding matters in children:

It is the key monitoring signal. The AAPD describes bleeding on probing as the best parameter to monitor gingival health or inflammation longitudinally. (AAPD)
In young children it indicates susceptibility. The AAPD states that bleeding on probing in primary teeth during early childhood, even at a low number of sites, indicates high susceptibility to periodontal disease, because of how gum tissue reacts to plaque at that age. (AAPD)
Plaque is part of the picture. The AAPD describes the diagnostic criteria for gingivitis as based on clinical features taking into account the presence of plaque biofilm. (AAPD)
It is not always only about brushing. Bleeding can accompany a tooth coming through, an injury, or something medical. Establishing which needs an examination.

That second point is the one worth carrying into the appointment. In a young child the AAPD treats even a small amount of bleeding as information rather than noise.

Three things worth knowing

Three things worth knowing.

Keep brushing, unless told otherwise

Stopping tends to make gum inflammation worse rather than better. But if bleeding follows an injury, or your child is unwell, or you have been advised differently, follow that instead. When unsure, ring.

Gums get assessed anyway

The AAPD states that assessment of periodontal status should be part of a routine dental visit and oral examination, and that probing may begin once the first permanent molars are erupted and the child can tolerate it.

Bleeding after an injury is different

Bleeding that follows a knock is an injury rather than a gum condition. See Bleeding after dental trauma, and contact your dentist or emergency services if it is heavy or will not settle.

What the dentist may do

An examination that includes the gums, not only the teeth. The AAPD describes periodontal examination and risk assessment as important parts of a comprehensive oral evaluation of children.

Assessing the gums directly. The AAPD states this should form part of a routine visit. (AAPD)
Probing where appropriate. The AAPD states probing may be initiated once permanent first molars are fully erupted and the child is cooperative, and notes that shallow pseudopockets may be present in children. (AAPD)
Looking at the routine. Where plaque at the gum line is involved, the conversation usually turns to technique rather than effort. See Brushing and Flossing.

Getting it looked at

Mention bleeding at the next checkup if it is occasional and settles. Ring sooner if it happens regularly, if it happens without brushing, if the gums are also swollen or painful, or if your child bruises or bleeds easily elsewhere.

Ring promptly rather than waiting if bleeding follows an injury, is heavy, or will not stop — and contact your local emergency services if you are worried.

Are we brushing too hard?

Are we brushing too hard? Possibly, or possibly not hard enough in the right place — and the two look identical from home. This is exactly the question to take to an appointment, where someone can watch the technique and look at the gums. Do not stop brushing in the meantime unless you have been told to.

Questions caregivers often ask

Is bleeding when brushing normal?

It is common, which is not the same as being nothing. The AAPD treats bleeding as the key indicator of gum inflammation and, in young children, as a sign of susceptibility even at a few sites. Mention it.

Should we stop flossing?

Ask your dentist before stopping. Bleeding when flossing is often about how and where rather than whether. See Flossing and raise it at the appointment.

Could it be something other than the gums?

It could. Bleeding gums can accompany eruption, injury, or general medical conditions. If your child also bruises easily or bleeds readily elsewhere, say so — the AAPD notes that bleeding risk may be affected by medical conditions and that a thorough medical history matters.

My child’s gums bleed only in one spot.

Worth saying clearly when you ring, because a single site is different information from generalised bleeding. If there is also a lump or swelling, see Bumps or pimples on gums.

Will it clear up on its own?

Sometimes, with a change in technique. But this page cannot tell you whether that applies here, and the AAPD is clear that gum assessment belongs in a dental examination. Let someone look.

Where this guidance comes from

Every clinical statement on this page comes from the American Academy of Pediatric Dentistry documents below.

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This website is for education only and does not replace care from your dentist, physician, or emergency services.