Bleeding from a tooth socket: causes and ways to stop the bleeding

• why is the gum around the tooth swollen,
• The gum is swollen and hurts - what to do.

The article was written by a dental surgeon with more than 19 years of experience.

If your gums are swollen, what to do in this case will depend on the cause of the inflammation. There may be two main reasons. The first reason is associated with the development of periodontitis, i.e. inflammation at the apex of the tooth root (Fig. 1-3). The development of inflammation is associated here either with poor-quality dental treatment in the past, or with the lack of timely treatment. And in this case, you can always find a carious defect, filling or crown on the causative tooth.

The second reason that the gums are swollen and painful may be the development of localized or generalized forms of periodontitis in the patient. With these forms of gum inflammation, the attachment of the gingival margin to the neck of the teeth is destroyed - with the formation of so-called “periodontal pockets” between the gum and teeth (Fig. 4-6). In such gum pockets, good conditions are created for the growth of bacteria, which can also lead to the development of purulent inflammation in the gum pocket and the appearance of gum swelling.

Swelling of the gums due to periodontitis –

Swelling of the gums due to periodontitis -

A separate question in this article is what to do if the gums near the wisdom tooth are swollen. Most often this occurs in the lower jaw, and in this case the swelling of the gums is not associated with either periodontitis or periodontitis. This inflammation of the gums is called a special term - pericoronitis (which means inflammation of the “hood” over the wisdom tooth).

Why do my gums bleed?

Bleeding from the gums can occur for mechanical or pathological reasons.
The first group includes a blow to the jaw area or minor injuries due to an incorrectly selected crown or filling. In this case, bleeding goes away immediately after the problem is eliminated. Only a doctor can assess whether a crown has been chosen correctly or a filling has been installed during a face-to-face consultation, because it is difficult to see such nuances on your own. Gums can also be damaged by a brush that is too hard, intensive use of dental floss, or careless impact with other objects in an attempt to completely remove food debris. In this case, bleeding appears only after the procedure and disappears after a few minutes.

Pathological causes are associated with diseases of the oral cavity and other organs. Bleeding is a symptom:

• gingivitis - inflammation of the gums;
• stomatitis - ulcers on the oral mucosa;
• periodontitis - inflammation of the soft tissues around the tooth (localized - in several units, or generalized with damage to the entire jaw);
• leukemia (leukemia) - blood cancer with a characteristic decrease in immunity;
• intoxication with heavy metals (lead, mercury);
• diabetes mellitus, which causes weakness of the gums and blood vessels due to characteristic angiopathy.

Often gums bleed due to hormonal changes. It can be caused by pregnancy, menstrual irregularities, and puberty.

When your gums bleed when brushing your teeth

Most patients' gums do not bleed constantly. Symptoms only appear when brushing your teeth or eating hard foods. This occurs for several reasons:

• inflammation of the gums makes them more vulnerable to injury;
• the process of desquamation of the epithelium of the oral mucosa intensifies, which thins the tissue;
• capillaries located close to the gums become more permeable and bleeding occurs more easily.

The combination of all three factors leads to the fact that when brushing your teeth, your gums begin to bleed. This symptom should not be ignored. Cure the disease at an early stage is much faster and cheaper than in an advanced form. And the appearance of blood when brushing your teeth is not considered normal; it is always a sign of pathology.

Swelling of the gums due to periodontitis -

In case of poor-quality root canal treatment, due to tooth trauma, or in the absence of timely treatment of caries and pulpitis, inflammation occurs at the apex of the tooth root, which dentists call “periodontitis.” Sometimes the terms “granuloma” or “cyst” are used to refer to periodontitis, which you may well have heard. Such names are due to the fact that the focus of inflammation at the apex of the tooth root in these cases has the appearance of a purulent sac.

Symptoms - usually periodontitis has a chronic asymptomatic course, or there is only slight pain when biting on this tooth. But sometimes periods of exacerbation of inflammation occur, and in this case, acute pain may first occur in the causative tooth (especially when biting on it), and a little later, swelling of the gums usually appears in the projection of the causative tooth. But sometimes pain may be completely absent, and patients complain solely that the gums near the tooth are swollen (Fig. 1-3, 7-9).

Please note that with periodontitis, the source of inflammation is located at the apex of the tooth root, i.e. quite deep in the bone tissue. Therefore, swelling of the gums during periodontitis usually develops not just in the projection of the causative tooth, but most often in the projection of the apex of the root of the causative tooth. And in multi-rooted chewing teeth - no less often in the projection of the bone interradicular septum. But periodontitis is not characterized by swelling of the interdental papilla or the gingival margin adjacent to the neck of the tooth.

In general, if you have swelling on the gum in one of your teeth, pain occurs when you bite on it, and there is a crown, filling or carious destruction on the tooth, and also if, in addition to swelling on your gums, you also have swelling of soft tissues face (again in the projection of the causative tooth) - you can definitely make a diagnosis of “Exacerbation of chronic periodontitis.” An X-ray of this tooth will allow you to accurately determine the cause of periodontitis and the required amount of treatment.

What treatment may be required -

As we said above, if the gums are swollen and painful, then in most cases the reasons are poor-quality filling of the canals, or the lack of timely treatment of dental caries and pulpitis. Only according to official statistics, root canal fillings are performed poorly by dentists in at least 60-70% of cases. The main errors during treatment are underfilling of root canals, poor obturation of root canals with filling substances, breakage of instruments, perforation of the tooth root...

As a result of this treatment, a focus of purulent inflammation appears at the apex of the tooth root. Moreover, in the absence of timely treatment of the tooth for caries and pulpitis, exactly the same focus of inflammation will appear at the apex of the tooth root, but only against the background of unsealed root canals. In Fig. 10-12 you can see how the inflammation at the apex of the tooth root looks like during periodontitis (on the diagram, x-ray and on the root of the extracted tooth) -

Below we describe several treatment options that may be possible for patients with gum swelling due to dental periodontitis. In any case, the doctor will first be forced to take an x-ray. The image will allow us to determine whether this tooth can be saved at all, the size of the inflammatory focus at the apex of the root, and whether root canals have been filled in this tooth previously. The treatment tactics will depend on the latter, and below we will tell you how to cure a tooth and remove swelling from the gums so that it does not appear again.

1) If the channels are not sealed -

If root canal treatment has not previously been carried out on this tooth, then standard treatment of periodontitis is carried out with mechanical treatment of the root canals and treatment of the source of inflammation behind the root apex. On your first visit, they will open your tooth, expand the root canals to allow pus to drain out through them, and leave the tooth open for several days, prescribing antibiotics and anti-inflammatory therapy.

If necessary, your dentist may then refer you to an oral surgeon to make a small incision in the gum to allow additional drainage of pus. After about 3-5 days, the doctor makes an appointment for a second appointment and, if the inflammation subsides, completes the mechanical treatment of the root canals and seals them - either first with a temporary medicinal paste, or immediately with gutta-percha (the latter depends on the size of the source of inflammation at the apex of the tooth root). You can read more about the treatment of periodontitis at the link above.

How the gum incision is made - significant swelling of the gums, or if your gums and cheek are swollen at the same time - indicates the formation of a large purulent abscess, which will require not only opening the root canals of the causative tooth, but also making an incision in the gums to release the pus. The incision is made under local anesthesia, the wound is then washed with antiseptics and a drain is inserted into it (see video below).

2) If the channels are sealed poorly -

If an x-ray shows that canal treatment has already been carried out previously and the cause of inflammation was incomplete filling of the root canals to the apex of the tooth root, then there are 2 treatment options: either standard conservative therapeutic treatment, or an option associated with resection of the root apex.

• Conservative therapeutic treatment - on the first visit, the filling/artificial crown is removed from the tooth, poorly filled root canals are unsealed, washed with antiseptics, and antibiotics are prescribed.
  If necessary, the patient is referred to a dental surgeon to make an incision along the gum. Thus, to the treatment we described in the previous section, only 1 point was added here (unsealing the root canals). Then everything is the same - after the inflammation subsides, temporary or permanent filling of the root canals is carried out. If the source of inflammation is small, the canals are usually filled immediately and permanently with gutta-percha, and a permanent filling is placed at the next visit. If the inflammation is large, the canals are sealed with temporary medicinal paste for 1-3 months, and a temporary filling is placed. And only after this time the canals are filled with gutta-percha + a permanent filling or crown is placed.
• Resection of the root apex (Fig. 13) –

  
  This surgical method is much simpler and much cheaper than conventional therapeutic treatment, and it allows you to avoid removing the crown from the causative tooth in order to unfill and reseal the root canals.
  However, this method is only suitable for those teeth in which the root canal was poorly filled only at the very apex of the root (and throughout the rest of the length the canal should be filled normally). This simple surgical operation is carried out within 25-35 minutes and consists of cutting off the apex of the root with the unfilled part of the root canal using a drill. To do this, an incision is made along the gum and a flap of the mucous membrane is moved back to give access to the bone tissue in the projection of the apex of the tooth root. Next, a small hole is made in the bone with a drill, through which the apex of the root is cut off and removed from the wound along with the granuloma/cyst at the apex. The wound is sutured and antibiotics are prescribed. Pros: cheap, simple, no need to remove the crown and re-treat the tooth.

  → How is root resection surgery performed?

Predisposing factors

Bleeding gums can be caused by injury or disease. But there are a number of factors that make the risk of this symptom appearing higher.

Gums bleed in patients:

• with chronic inflammatory diseases of the oral cavity;
• with xerostomia - dry mouth;
• with reduced immunity, including HIV and AIDS;
• with vitamin deficiency, especially C and K;
• with mouth breathing;
• with poor or irregular oral hygiene.

These factors cannot be called the cause, but they contribute to the development of bleeding gums. Those for whom none of the points apply have a much greater chance of not learning about such a problem.

If your gums bleed in the morning or at night

Peak bleeding at night or in the morning indicates an unsuitable toothbrush. During brushing, the gums are injured. In this case, you need to visit the dentist and take a hygiene lesson with the selection of personal hygiene products.

Bleeding gums may not be normal. It is definitely worth finding out the cause and treating it before the disease reaches a chronic stage.

Folk remedies

They are sometimes included in the overall treatment strategy, and sometimes used as a temporary measure before going to the dentist.

If your gums bleed, the following folk remedies are usually used:

• Oak bark decoction. They rinse the mouth with it several times a day, as it strengthens the gums and helps eliminate the inflammatory process. The preparation is simple - you need to brew 1 tbsp. l. crushed oak bark in 1 glass of water. The product should be allowed to brew until it cools, decant, and then you can use it;
• Camomile tea. This plant is an effective antiseptic with healing and anti-inflammatory effects. Pour 1 tsp into a glass of boiling water. plants, after which the infusion should be left to cool. Next, it is expressed and used to rinse the mouth. The procedure must be performed several times/day;
• Sage tea. The plant is an excellent antiseptic that has a healing, anti-inflammatory effect. It is brewed at the rate of 1 tsp. for 1 cup boiling water. Cooled to room temperature and strained, the infusion is used for rinsing;
• Water pepper infusion. This is something you can rinse your mouth with to reduce bleeding. The plant helps strengthen the walls of blood vessels, thereby normalizing blood clotting processes. To prepare the product, add 1 tsp. raw materials 1 cup boiling water, let it brew. It is then expressed and used as a mouthwash;
• Horseradish or black radish juice. It must be freshly squeezed, and its properties are that it helps eliminate plaque and tartar. You need to mix 2 tsp. juice of one of the vegetables with wine (200 ml). You can not only rinse your mouth with it, but also use it as an immunomodulator, taking it orally in small portions.

Traditional medicine suggests using sauerkraut and freshly squeezed carrot juice as ways to combat the problem. Please note that the methods listed above only help eliminate the symptom, but do not help cope with the cause of its occurrence. Therefore, visit your dentist, and only with his permission, use or discard them.

Bad breath due to bleeding gums

Bleeding from the gums is often accompanied by bad breath. There are several reasons for this:

• proliferation of bacteria against the background of inflammation;
• accumulation of soft and hard dental plaque;
• the presence of deposits under the gum that are not visible to the naked eye.

An unpleasant odor is a formidable symptom, since it does not appear immediately. This means the disease is already progressing. It is impossible to find out the cause and eliminate it on your own (without a dentist); The pathology will become chronic and it will be more difficult to cure.

A lump with pus on the gum against the background of bleeding

The appearance of a tumor on the gum can frighten anyone. The presence of a round swelling against the background of bleeding gums indicates one of the diseases:

• periodontitis - destruction of the soft tissue around the tooth with the formation of a characteristic lump;
• periodontitis - the presence of a capsule with pus on the gum due to destruction of the tooth root;
• intragingival fistula - a lump with pus inside, the contents of which, when ruptured, come out, significantly facilitating the patient’s well-being;
• periostitis (flux) - a red spherical formation on the gum, the appearance of which is accompanied by swelling of the cheeks and enlargement of the nearest lymph nodes;
• epulis is a neoplasm that does not contain pus, resulting from mechanical damage to the soft tissues of the oral cavity;
• Gingivitis is a painless lump on the gum.

Most of these conditions require urgent medical attention. If pus gets into the bloodstream or into the internal tissues of the tooth, it not only leads to severe pain, but also poses a fatal danger. If a lump appears on your gum, you should immediately go to see a dental surgeon. He will determine the cause of its formation and select treatment.

Gums bleed in pregnant women

While carrying a child, a woman’s body undergoes restructuring: special hormones begin to be produced, and the body changes. This also applies to the oral cavity. Every second pregnant woman is diagnosed with hypertrophic gingivitis. It is manifested by an increase in gingival papillae and the appearance of bleeding.

The cause of this condition in a pregnant woman can also be the accumulation of bacteria due to an increase in the depth of the gum pockets. Bacteria accumulate in them, causing inflammation. Proper brushing helps to avoid the development of bleeding gums. It is better to use an irrigator and mouth rinses for this.

Children's gums bleed

Young children enjoy brushing their teeth the least. If parents do not control the quality of oral hygiene, gingivitis occurs. In this case, the main symptom of the disease is bleeding gums.

The physiological cause of this condition in children is the process of teething. In this case, the integrity of the gum is compromised and it can bleed.

Problems with the gums are also caused by an incorrect bite. In this case, soft tissues are injured by teeth that are incorrectly positioned relative to each other.

Wearing orthodontic appliances can damage the integrity of the gums. This especially happens when wearing braces with uneven edges. To prevent injury, locks must be treated with special wax. But children often forget to do this; as a result, braces damage soft tissues, causing bleeding.

“Disease of dirty hands” - stomatitis, also more often affects children. They take less care of hygiene, which provokes the appearance of characteristic ulcers on the mucous membrane.

Some parents believe that children do not need to treat their baby teeth, because they will still be replaced by molars. This opinion is erroneous, because caries is caused by bacteria, and their constant presence in the mouth leads to periodontitis. The disease is characterized not only by bleeding gums, but also by the appearance of bumps with pus. This condition requires immediate medical intervention, otherwise serious complications arise.

Which doctor will help if my gums are bleeding?

If you have bleeding gums, you should consult a dentist. In the absence of complications, the doctor’s specialization does not play a role.

If the condition is complicated by the appearance of a lump with pus, you should immediately go to a dental surgeon. He will determine the type of tumor, choose treatment tactics and, if necessary, perform urgent surgery. At the Matisse Dent clinic, you don’t need to make an appointment several weeks in advance, endure pain and wait for help. With an acute condition, doctors will accept and perform surgery on the day of treatment.

Content

• Causes of bleeding
• Possible complications
• Treatment regimens
• Prevention

If your tooth is bleeding, gum disease may be the cause. Inflammatory processes develop as a result of gingivitis and periodontitis, in the absence of proper oral hygiene. If there is pathology, bleeding can be caused even by regular brushing of teeth.

To fix a problem, you need to understand the cause of its occurrence. In some cases, it will be enough to eliminate the source of the problem; sometimes the approach to treatment should be complex, using medications.

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SOS remedies against bleeding gums

Sometimes it’s impossible to get to the doctor and you need to wait 1-2 days until the appointment. In this case, several SOS tools will help.

1. Rinses: chlorhexidine, oak bark decoction, LACALUT Aktiv rinses with aluminum lactate and sodium fluoride, PRESIDENT Antibacterial with plant extracts - relieve inflammation, prevent bleeding.
2. Gels: Cholisal, Parodontocid - reduce pain, remove signs of inflammation.
3. Pastes: Forest balm - contains oak bark, stops bleeding, strengthens gums.

All means must be used comprehensively. First, brush your teeth, then rinse (1 minute). After this, the solution is spat out and the gums are dried with gauze: this way the gel is better fixed. Then use ointments, applying with your finger to the entire inflamed surface. If saliva comes out during treatment, you should not swallow it, you need to spit it out.

After the procedure, you should refrain from drinking for 30 minutes and from eating for 2 hours. Treatment is carried out twice a day: after breakfast and at night.

The most effective remedy for diseases in which the gums begin to bleed is antibiotics. They help to quickly relieve inflammation and improve well-being. But they are available with a prescription and are taken only as prescribed by a doctor. Therefore, you won’t be able to buy and prescribe antibiotics yourself. It is better to immediately make an appointment with a specialist so as not to waste time and money on something that will not solve the problem, but will only delay the inevitable.

The treatment regimen includes:

• systematic professional teeth cleaning – removal of plaque and tartar;
• a course of physiotherapeutic procedures to relieve inflammation;
• sanitation of the oral cavity.

The next stage of treatment is home therapy: rinsing with disinfecting solutions (salt and soda, chlorhexidine).

For a purulent infection, the patient is prescribed antibiotics.

At home, you can independently use traditional medicine methods, including decoctions and infusions of medicinal plants:

• oak bark;
• chamomile flowers;
• sage herbs.

You can use these decoctions and calendula tincture as lotions on problem areas of the mouth.

Use of pharmaceutical products:

• fluoridated toothpastes with the addition of medicinal herbal extracts;
• dental anti-inflammatory gels (Cholisal);
• vitamin complexes.

Mistakes in self-medication

When trying to get rid of bleeding gums on their own, patients make a number of mistakes. Never worth it:

• start taking antibiotics without a prescription - they may not be needed, but the blow to the body will be dealt;
• Stop brushing your teeth - this will only lead to a worsening of the condition;
• getting too carried away with oral hygiene - this will not save you from complications and will not cure, but will only aggravate the situation due to systematic injury to soft tissues;
• be afraid to go to the dentist - modern treatment methods are painless and do not cause discomfort, unlike purulent complications.

Lack of timely and competent treatment of bleeding gums leads to the spread of inflammation to bone formations. As a result, teeth become loose and fall out, requiring implants to be inserted. This is much more expensive than contacting a specialist in time to solve a gum problem.

You should not let the disease progress and self-medicate; come to the Matisse Dent clinic and receive competent medical care.

Common reasons

The most common of them is a sharp rise in blood pressure as a result of a hypertensive crisis, excessive physical activity, and thermal procedures (bath, sauna, hot bath).

In second place are diseases that affect blood clotting: hemophilia, leukemia, hemorrhagic diseases.

Profuse bleeding occurs with unrecognized vascular tumors (hemangiomas). Therefore, it is important to conduct an X-ray examination, which shows such changes.

Taking anticoagulants can also provoke socket bleeding after removal.