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Why have my child’s gums just started bleeding?

There’s nothing more terrifying as a parent than worrying that something might be wrong with your child. All parents have these moments, and if you’re anything like me, they happened a lot more with the first child than the second!

Worrying about our kids welfare is par for the course, of course, and we always want to do what’s best for them. But it’s hard to know who we need to get further help. What’s a big problem? What’s a small problem? When do we need to see a professional and when will the problem resolve itself without us needing to do anything else?

Seeing your child’s gums bleeding can be quite worrying, even if it’s just a bit of pink when they spit out. The simple question is, why are their gums bleeding?

Short answer: nine times out of ten, it’s because of plaque.

Plaque starts as a soft, mushy, yellow-white substance that grows on our teeth all the time and it feeds on sugar, which is why our teeth can feel “furry” after overindulging in sugary food and drinks. This is what we’re trying to remove when we brush our teeth.

Plaque is also what causes tooth decay and gum disease. It really is the source of almost every evil when it comes to dental health and it’s why we dental professionals spend the majority of our time, trying to help you keep the plaque off your teeth effectively, twice a day, every day, at home. The same of course applies to children.

When plaque is allowed to settle on the teeth and around the gum margin for more than 24 hours it starts to irritate the gums and makes them inflamed. We can sometimes see this a some redness or puffiness of the gums, instead of the sharp pinky-white edges of healthy gums. The technical name for this inflammation is gingivitis. Gingivitis is a reversible inflammation of the gums, simply caused by plaque in the vast majority of cases.

Some people seem to be more vulnerable to gum disease than others, meaning a small amount of plaque can do more damage, but the root cause is still the same thing, it’s just plaque.

The solution is really simple - get rid of the plaque.

This is where it becomes a bit more difficult with children because these inflamed gums are usually a bit sore to touch, unsurprisingly really, given they bleed so easily. Because it’s sore, younger children tend to pull away or purse their lips stopping you from cleaning the area properly. Older children who brush their own teeth will often simply avoid the area that’s sore, a completely understandable reaction.

Remember, it’s plaque that’s causing the problem and the only solution is to get rid of the plaque, this means persevering through the initial soreness. Don’t worry, it’s not really painful for your child when you clean these areas, it’s just a bit more uncomfortable than cleaning healthy teeth and gums. 

Once you’ve been regularly removing the plaque, twice a day, for a week, the bleeding should have stopped, or at least significantly reduced if there was quite a lot to start with.

But I’ve been cleaning their teeth really well!

I know. I’m a dentist and a father. I brush my own kids teeth and from time to time, I notice a bit of bleeding. On investigation, it’s usually up at the top, near the back, where it’s difficult to clean well, and I’ve repeatedly missed the plaque two or three times in a row. 

Confessions of a dentist! I sometimes can’t even clean my own kids teeth well enough!

It’s frustrating when you think you’ve been doing a really good job and then you find out you’ve actually missed a spot. It’s easily fixed though, just give that area a bit of extra attention for a couple of days and it’ll go straight back to normal. We've recently moved our kids on to using an electric toothbrush to help with the cleaning. In theory, you can clean perfectly well with a manual brush, in reality, nearly everybody does better with an electric brush, and that includes yours truly, both my own, and my kids' teeth. I've definitely seen a reduction in the amount of plaque on their teeth since they've had the electric brush.

The biggest problem is that you don’t always know where you’re not cleaning. If you’re always missing the same spot, you never end up knocking the inflamed gum, and so you don’t notice the bleeding. This is where we come in. Having regular appointments at the dentist helps to identify any small areas we may be missing. Again, when I check my own kids teeth, I often find a spot that I’ve missed.

Other causes of bleeding gums

It’s important to note that plaque isn’t the only thing that can cause bleeding gums, though it’s by far and away the most common cause. Other causes of bleeding gums include:

  • A baby tooth coming out - typically between the ages of 6-13 years old though significant variations do occur

  • An adult tooth coming through - the first back molars come through without any baby teeth falling out around age 6-7 years old. The second back molars also come through without baby teeth coming out, usually between 12-15 years old. 

  • Ulcers - when we’re stressed, tired, run down or ill, we can get ulcers in our mouths. These are really common, some people get them more than others and kids are no different. They are sore and can bleed when poked (with a toothbrush for example), and they should heal within 3 weeks. If you, or your child, has had an ulcer for longer than this, please make sure you get it checked by a professional

  • Tooth decay - when the decay in a tooth reaches the gum level, it can lead to inflammation in the area and this is often seen as bleeding

  • Dental abscess - abscesses can often form little blister-like lumps on the gum which can bleed spontaneously, or when knocked. Usually they’re accompanied by a significant amount of pain.

There are a small number of other reasons that are very rare that can cause bleeding gums so for sure, it’s always worth going to a dentist to get your little one’s teeth and gums checked if you’re not sure and the bleeding is not stopping despite plenty of cleaning.

If your child has sudden widespread unexplained bleeding gums, despite an excellent home oral hygiene, please visit a dental professional as soon as possible.

Remember, rare things happen rarely. It's very common to have some inflammation and bleeding from the gums, I see it on a daily basis. It's very simple to fix, get rid of the plaque, by twice daily, thorough toothbrushing.

If in doubt, always make an appointment to get their teeth check and definitely get it checked if the gums are still bleeding after a week of thorough twice daily cleaning.

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