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Bleeding or receding gums? Gum disease: what it means, and how it is treated

Gums that bleed are usually inflamed by the tartar and bacteria that have built up at the gum line, and caught early they usually settle back to normal with a cleaning and care at home. The examination decides how far the inflammation has gone and what you need; if your gums are receding, treatment aims to stop them where they are, and the earlier you come, the more of your gums and teeth you keep.

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A thin terracotta line drawing on handmade paper: a row of teeth with the gum line hugging each tooth, a soft toothbrush and a curl of floss beside it, and olive sprigs around.

What it means, and how to tell

Just one question

Do your gums bleed when you brush or floss? If they do, that is the first sign, and it can be treated.

Most people who say “my gums bleed” see the blood on the brush or in the sink, and let it go because it does not hurt. The cause is usually the same: every day a sticky film of bacteria called plaque forms on your teeth, and what stays at the gum line hardens into tartar, which no brush or floss will shift. The gum around it becomes inflamed: it reddens, it swells, and it bleeds at the lightest touch. That is gum inflammation (gingivitis, if that is the word you know).

The good part is that it warns you early. At first the inflammation stops at the gum, the bone beneath is sound, and the gum usually settles back to normal with a cleaning and care at home. So the bleeding is not a verdict on your teeth; it is a chance to keep them.

How to tell

Bleeding when you brush or floss. If you smoke, you may not see it at all, because smoke masks gum bleeding, so the inflammation goes on in silence, and a regular examination is what catches it early.
Redness or swelling. Healthy gums sit firm against the teeth and do not bleed when you brush. Inflamed gums are darker and puffy, and sometimes sore to the touch.
Bad breath that does not go away. Even after brushing, because the bacteria live in the tartar and under the gum, where the brush does not reach.
Gums pulling back, and a tooth that looks longer. When the inflammation goes on for a long time, the gum can draw back from a tooth and expose part of its root. Treatment aims to stop it going further.
Sensitivity at the gum line. To cold or to sweet things, because the exposed part of the root has no enamel to protect it. There are ways to ease it, and the doctor decides which at the examination.
A tooth that moves, or a new gap between your teeth. This one is more urgent than the others, because it can mean the inflammation has reached the bone that holds the tooth. Call this week: the earlier you come, the better the chance of keeping it.

And often there is no pain at all. Gum inflammation usually does not hurt at first, which is why bleeding on its own is reason enough to be examined, even if nothing hurts.

The stages, simply, and what treats each one

Gum disease is not one thing. The stage decides the treatment, and that is found at the examination, not in the mirror. At every stage there is something you keep:

Gingivitis: inflammation in the gum only. The inflammation is still in the gum, and the bone beneath it is sound. The answer is a cleaning that removes the tartar, and proper care at home, and the gum usually settles back to normal. This is the stage where you keep the most.
Periodontitis: inflammation that has reached the bone around the tooth. When tartar stays under the gum for a long time, the inflammation moves down into the bone that holds the tooth, and the gum comes away from the tooth, leaving a pocket between them where tartar and bacteria collect. The answer is a deeper clean below the gum line, and closer follow-up. The aim is to stop the inflammation, so the bone around your tooth stays, and your tooth stays where it is.
Recession. The gum has drawn back from the tooth, and part of its root shows. Treatment aims to stop it going further, and care at home is half of that work. But the bone that is lost does not usually grow back on its own, and nor does the gum that has receded. So the gain here is stopping it where it is, and keeping what remains. And recession does not always come from inflammation: hard brushing with a hard brush pulls the gums back too, and the examination shows the cause in your case.

Drag and see: what happens under the gum

An illustration. The stage is found at the exam, by measuring the gum pockets, not in the mirror.

Why does early make a difference?

Not to frighten you: early simply leaves you more to keep. Inflammation that is still in the gum usually settles with a cleaning and care, and the gum usually goes back to normal. Once the inflammation stops, the aim is that the bone that remains stays. The examination tells you exactly where you stand, instead of guessing from the mirror.

How treatment happens, step by step

Treatment differs from stage to stage, but these are usually its steps. No minutes and no number of sessions, because for your case you hear that at the examination.

1
The examination, and measuring the gum pocketsThe doctor examines your gums and all your teeth, not only where it bleeds. With a fine instrument he measures the space between the gum and the tooth all the way around each tooth, and that shows whether the inflammation is still in the gum or has gone beneath it. If an x-ray is needed, there are digital x-rays in the clinic that show the bone around the roots. Then you hear where the inflammation is, what you need, and why, before anything starts. The cost is discussed after the examination, and what decides it is explained on What decides the cost of your treatment.
2
The cleaning and tartar removalThe tartar and plaque come off the teeth above the gum line. If the inflammation has gone beneath it, there is a deeper clean below the gum line that cleans the root surface too, and the aim is for the gum to settle and tighten around the tooth again. The deeper clean can be done over more than one session, area by area, with local anaesthetic for the area if it is needed. What happens in the cleaning session itself is on Teeth cleaning and tartar removal.
3
Care at homeThis is the half of the treatment that is yours. You are shown how to brush at the gum line, how to clean between your teeth in the way that suits them, and where the places are that you miss. Not general advice: it fits your own mouth.
4
Follow-upAfter a while, the doctor sees how your gums are doing, and measures the pockets again if needed. After that, regular cleaning on the schedule he sets, because tartar forms again, and gums that have been inflamed before need closer follow-up.

And if your case needs something beyond this, you hear it at the examination, and why, before anything else.

The downsides and the limits, before the advantages

You hear the limits of treatment before its advantages, so you know what to expect:

Bleeding in the first days. Inflamed gums bleed at the lightest touch, during the cleaning and in the first brushings after it. The bleeding comes from the inflammation that was already there, not from any cut by the cleaning, and it eases over the days as the cause goes.
Temporary sensitivity. Tartar was covering part of the tooth at the gum line, and once it is gone that part is exposed to cold for a few days. It usually settles on its own, and if it bothers you, ask the doctor about a toothpaste for sensitivity.
Gaps that show. Between the teeth at the gum, where there used to be tartar and a gum swollen with inflammation. The gap was there and hidden; the cleaning revealed it, it did not create it.
The result depends on care at home. The cleaning removes the tartar that is there, but plaque comes back every day. If brushing and flossing do not become a habit, the inflammation comes back. Half the treatment is at the clinic; the other half is in your hands.
Receding gums do not usually grow back on their own. Treatment aims to stop them where they are, and that is one more reason early makes a difference.
Smoking slows the improvement. Smoke reduces the blood reaching the gums, so the improvement is slower. If you smoke, say so from the start, because it changes the follow-up.

Why the bleeding, the sensitivity and the gaps do not mean the cleaning harmed your teeth is explained in Cleaning or whitening: what is the difference.

And the advantages

It removes the cause, not only the sign. Tartar and bacteria are what cause the inflammation, and removing them is what gives the gums a chance to settle.
It is not reshaping the tooth. Nothing is prepared or covered, as with a crown: the cleaning works on the tartar and bacteria on the tooth and under the gum, and your tooth stays your tooth.
It aims to keep what holds your tooth. That is the bone and the gum around it, so your tooth stays where it is.

When it is not right for now, or should wait

Gum treatment usually does not wait, because the inflammation carries on for as long as its cause stays. But some cases change the order or need coordination, and you hear what has to happen first:

A swelling or an abscess in the gum. The swelling and the pain are usually treated first, and the deeper clean after them. And do not start an antibiotic on your own: the doctor decides. Any swelling in the gum does not wait for an ordinary appointment; call today: Dental emergencies and abscesses.
Pregnancy. Pregnancy gums are common: pregnancy hormones make the gums swell and bleed more easily with plaque, so a cleaning eases them. A cleaning in pregnancy is usually safe, and what does not wait is cleaning your teeth and gums. The doctor plans the timing, and any x-ray if one is needed, around your case and how far along you are, in coordination with your obstetrician if needed. Mention it on the first call.
Diabetes. Diabetes and gum disease run in both directions: high sugar makes the gums inflame faster, and inflamed gums make sugar harder to control. So for you, treating your gums is part of looking after your condition, not a luxury, in coordination with your own doctor.
Blood thinners. Not a closed door, but the plan changes: inflamed gums bleed more on blood thinners, and the doctor arranges the cleaning around your case, sometimes in coordination with your own doctor. Do not assume the bleeding is the medicine alone, because the inflammation adds to it, and the examination tells the two apart. And do not stop them on your own, before the appointment or after it. If the bleeding does not stop with pressure, call us today; if it is heavy, comes with dizziness, or the clinic is closed, go to the nearest hospital emergency department. If there is bruising or bleeding from somewhere else, speak today to the doctor who prescribed it.

And the other way round: whitening, braces and implants wait until the gums have settled, because none of them is done on inflamed gums. So the gums are usually the first step, not the last.

What to do from now, and when to call

1
Do not stop brushing because it bleedsThe first reaction for many people is to keep away from the place that bleeds, and that is what lets plaque build up more and the inflammation carry on. Brush gently, but do not stop.
2
Twice a day, with a soft brush, at the gum lineAim the brush at the line where the gum meets the tooth, with small, gentle movements, not hard scrubbing. Hard brushing with a hard brush pulls the gums back, and it does not clean any better.
3
And floss once a dayBetween the teeth is where the brush does not reach. For the first few days it may bleed; that is the inflammation, not the floss, and it eases as you carry on.
4
No strong mouthwash on your ownMouthwash does not remove tartar, and a strong one can mask the smell and the bleeding for a while as the cause stays. Any rinse for your case is the doctor’s decision. And no mixtures from the internet: the acidic ones eat into the enamel, and the abrasive ones scratch it.
5
If you are in Amman for a whileIf you are only in Amman for a stretch, a posting, a contract, a semester, or you come and go, say so at the first visit. A deeper clean can be spread over more than one session, so the order of the visits is built around your dates from the first visit, as far as the work allows, and the follow-up is talked through before you leave. If your gums have been treated in another clinic or another country, bring what you know: what was done, and roughly when.
6
Book the examinationIt tells you exactly what you need, and why. And you decide after it, in your own time, with no pressure.

When to call

Most gum bleeding can wait for an ordinary appointment, but not for months. And some signs do not wait:

Call today: a swelling in the gum or the cheek, a bump on the gum that leaks pus, or a salty taste in your mouth.
Call today: strong pain in the gum or in a tooth.
Call today: bleeding from the gums that does not stop with pressure. If it comes with dizziness or difficulty breathing, go to the nearest hospital emergency department.
Call this week: bleeding that has not eased after two weeks of proper care at home, gums that bleed on their own without brushing, or bad breath that does not go away with brushing.
See your doctor today: if your gums bleed on their own and it comes with bruising on your body or bleeding from somewhere else.
Call this week: a tooth that moves, or a new gap between your teeth.
Call this week: gums pulling back, a tooth that has started to look longer, or new sensitivity at the gum line.

This doesn't wait

Go to the nearest hospital emergency department now, not an appointment:

Difficulty breathing or swallowing.
Swelling that has reached the eye or the neck.

And let us know afterwards.

Call now:

Swelling under the jaw.
Fever with the pain.
Difficulty opening your mouth.

If the clinic is closed or you can't reach us: go to the nearest hospital emergency department. Don't wait. The details: Dental emergencies and abscesses.

If you are not in Jordan, go to the nearest emergency service where you are.

Call and we will find you the earliest slot, and tell you what to do until you arrive. Before any painkiller, ask the doctor first, so it suits your case. If a tooth hurts right now: Toothache: what to do right now.

And who treats you?

The clinic has a team of dentists, Dr. Adnan Alakhras among them. At the first visit you hear the state of your gums, and the bone around your teeth if an x-ray is needed, how far the inflammation has gone, and what you actually need, before you hear any plan. His qualifications are on his page: Read about the doctor and the clinic.

Questions people ask

Does it hurt?

Most people feel a cleaning above the gum line as pressure, vibration and a spray of water. Inflamed gums are more sensitive than healthy ones, so you may feel a sting at the gum line, and measuring the pockets at the examination usually feels like light pressure. A deeper clean below the gum line may need local anaesthetic for the area: you are told before the injection, not after it. The prick itself is short and you do feel it; then the area goes numb. If you feel pain, you raise your hand and we stop, and the doctor can numb the area, or give more anaesthetic, if it is needed. After the cleaning, light bleeding and sensitivity to cold for the first few days are common, and they usually settle on their own. Before any painkiller, ask the doctor first, so it suits your case. If it hurts badly now and the clinic is closed: what to do until morning. If fear itself is the problem, say so from the first moment and we will go at your pace. When the visit is hard.

How long does it take?

One session or more, depending on the case. Gum inflammation on its own is usually cleaned in one session, and a deeper clean below the gum line may be split over more than one session, area by area. After that comes follow-up on the schedule the doctor sets, because the gums need time to settle, and that depends a great deal on your care at home. If you are only in Amman for a stretch, say so before anything starts, and the visits are planned around your dates, as far as the work allows. The timing for your case is discussed at the examination, as an expectation, not a promise.

Are there payment plans?

Not at the moment. The doctor is looking into it, and wants a trustworthy partner before he commits to anything; the details are under Payment and insurance on What decides the cost of your treatment. What you can do now: book the examination, and the decision after it is yours. You will find out whether a cleaning and care at home are enough or you need a deeper clean. The cost itself is discussed after the examination, not over the phone.

Will the bleeding go away on its own?

Sometimes it eases a little, but its cause stays. Tartar does not come off with a brush or floss, and while it stays, the inflammation carries on even if the bleeding eases. Smoking can also hide the bleeding while the inflammation is still there. So proper brushing and flossing help, but tartar needs a cleaning at the clinic. If the bleeding has not eased after two weeks of proper care, call. Early is easier on you and on your gums.

Do receded gums grow back?

On their own, usually not. Cleaning and care aim to stop them going further and keep what remains of the gum and the bone, but they do not bring back what has gone. The sensitivity at the exposed part can be eased, and the doctor decides how at the examination. And anything that promises to grow your gums back on their own at home, ask the doctor about it first.

Does a cleaning damage the enamel?

A cleaning at the dentist removes the tartar; it does not remove the enamel, when it is done by trained hands with the right settings. Tartar is a layer on the tooth, not part of it, and enamel is far harder than tartar. The sensitivity afterwards is because part of the tooth was covered and is now exposed, and the bleeding comes from the inflammation that was already there. What actually harms is the tartar that stays, and the sharp tools and mixtures that try to remove it at home. Does removing tartar damage the teeth or the enamel?

Does bad breath come from the gums?

Often, yes. The bacteria living in the tartar and under inflamed gums make a smell that brushing does not remove, and mouthwash only covers it for a few hours. But not every bad breath comes from the gums: the tongue, a dry mouth and decay can cause it too, and sometimes the cause is outside the mouth. The gums and the tartar are the first thing checked. Morning breath on its own is normal for many people, because there is less saliva while you sleep; the smell worth an examination is the one that stays all day.

We suggest only the treatment you need, we tell you why, and we protect your tooth before we think about extraction.

Your next step

The examination. You come in, you are examined, and you hear the state of your gums, and whether a cleaning and care at home are enough or you need a deeper clean, and why. Then you decide, in your own time, with no pressure, whether you live around the corner or are only in Amman for a while.

Book the examination Call

Pages that go with this one

Written by: RyanMedical review: Dr. Adnan Alakhras · pending approvalSources: The clinic's services as published: a routine prevention plan with regular check-ups and professional cleanings, professional cleaning for children, and digital x-rays in the clinic · American Dental Association, patient page on gum disease · American Academy of Periodontology, patient page on gingivitis and scaling and root planing · NHS, patient page on gum disease · American College of Obstetricians and Gynecologists, guidance on oral health during pregnancy · Questions patients actually ask, in Amman and from abroad

This page explains gum disease in general; it is not a diagnosis of your case. The decision is made at the examination, and the cost is discussed after the examination.