Symptoms, explained

Bleeding gums: what they’re trying to tell you

Most people first notice it as pink in the sink. And because it doesn’t hurt, it’s easy to shrug off. Here’s the truth worth holding onto: healthy gums don’t bleed. Bleeding is your gums telling you something — and the earlier you listen, the easier the fix.

This page can’t diagnose you. Different gum problems can look alike. The tests in the chair — a gentle measurement around each tooth, a look at how the gums sit, an X-ray to check the bone underneath — make the call. You’re not expected to know what’s causing it. That’s our job. This page just helps you understand what you’re seeing and what to expect.

The good news up front: the earliest stage of gum disease is fully reversible, and even the deeper stage can usually be stopped in its tracks.

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Blood when you brush — but nothing hurts

Blood on the brush or when you clean between your teeth, gums that look red and puffy — but no real pain. This is usually gingivitis: the gums reacting to a soft build-up of plaque along the gumline. Bleeding is the gums asking for help — not a normal part of brushing.

The genuinely good news: at this stage, nothing permanent has happened. The bone holding your teeth is untouched, and gingivitis is fully reversible. The fix is simple:

A professional clean to remove the hardened build-up your toothbrush can’t shift.
Honest, practical coaching on brushing and cleaning between the teeth — this is the part that keeps it from coming back.

One thing people often get wrong: bleeding doesn’t mean you should brush less, or skip the sore spots. Gently keep cleaning — the bleeding settles as the gums heal.

What you should do

Book a routine appointment in the next couple of weeks. Caught here, this is the easy end of gum care.

Bad breath, drifting teeth, gums pulling back — the deeper stage

If bleeding comes with ongoing bad breath, teeth that feel loose or have started drifting or spacing out, or gums that seem to be shrinking away, that points to periodontitis — gum disease that has moved deeper. The gum detaches from the tooth and forms pockets, and the bone holding the tooth slowly wears away.

Here’s the hard part, said kindly: gum disease is quiet. It usually doesn’t hurt until it’s advanced, so most people have no idea it’s there. That’s not carelessness — it’s just how this disease behaves. What matters now is stopping it, and that’s very doable.

Treatment runs in steps, gentlest first:

A professional clean plus coaching on home care — and help with the things that drive gum disease, like smoking and diabetes control.
A deeper clean below the gumline, onto the root surfaces inside the pockets where the bacteria actually live.
A re-check about eight to twelve weeks later. Stubborn pockets get cleaned again; a small number need minor gum surgery so we can reach the very bottom.
Then maintenance: a professional clean roughly every three months. Unglamorous — but this is where gum treatment is won long-term.

You might wonder why we don’t just prescribe antibiotics. The bacteria sit in a stubborn layer stuck to the root surfaces, where tablets on their own can’t clear them — the cleaning is the real treatment. Antibiotics are kept back for a small number of severe, fast-moving cases.

And being straight with you: bone that’s been lost doesn’t grow back on its own, and a tooth with too little support left sometimes can’t be saved. If that’s the case, we’ll say so honestly — with a proper conversation about what, if anything, should replace it. Everything we save from here on, we save by starting now.

What you should do

Book an appointment this week. Periodontitis can usually be stopped — but the bone it has already taken doesn’t come back on its own, so sooner genuinely matters.

A painful swelling on the gum next to one tooth

A tender, ballooning swelling on the gum beside a tooth, sometimes with a bad taste — often in a gum that already has a deep pocket. This is usually a gum abscess: infection trapped inside the pocket. The tooth itself is often still alive, which is one of the things our tests check — because an abscess coming from inside a dying tooth can look similar but is treated differently.

The fix is drainage, not antibiotics on their own. We release the trapped infection through the pocket and gently clean it out — that’s what brings the relief — then settle things with a rinse and pain relief. Antibiotics only earn their place if the infection is spreading or you’re feeling properly unwell, because once the pocket is drained there’s little left for them to do. Afterwards, the pocket itself needs proper gum treatment so this doesn’t simply happen again.

What you should do

Raw, grey, very painful gums — maybe with fever. Different rules apply

This one is rare, and it’s an exception to the rule that everyday gum disease doesn’t hurt. The little points of gum between the teeth look punched-out, grey and raw. The pain is real, the breath is noticeably foul, and there may be a metallic taste or a fever. Dentists call this necrotizing gum disease, and it moves fast.

It tends to arrive when life is hardest — heavy stress, smoking, an immune system under strain — which is exactly when a painful mouth is the last thing you need. Please don’t sit on it.

Treatment starts the day we see you: a very gentle professional clean of the affected areas, antiseptic rinses, and — if you’re feverish or feeling unwell — antibiotics. This is one of the few gum problems where antibiotics genuinely help, because the infection is invading the gum itself; they still work alongside the cleaning, not instead of it. We’ll review you closely afterwards, and if the picture doesn’t quite fit the usual causes, we may suggest a general health check — this condition can be a sign the body’s defences need looking at.

What you should do

Go to an emergency department NOW — don’t wait for us — if you have: swelling under the tongue or into the neck, difficulty swallowing or breathing, an eye swelling shut, or rapidly spreading facial swelling with fever. These are medical emergencies first and dental problems second.

What it costs

Whatever the treatment, we quote before we treat — always. If you’re on a medical aid, we claim directly: you pay only co-payments and anything your plan doesn’t cover or has already used up.

On a medical aid? See what your scheme’s published benefits say — and we confirm with a benefit check before treatment.

Not sure which pattern is yours?

Tell us what you’re feeling — we’ll take it from there.

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