Have you ever brushed your teeth and looked in the sink and seen blood? Have you ever flossed and seen blood on your floss? Most importantly, do you know what this means?
The answer is simply: ‘Healthy gums don’t bleed.’ 
The intention of this post is to clear up the mystery around why gums bleed when we are cleaning our teeth, and what we can do about it. Bleeding is a sign of inflammation and it is a wonderfully obvious ‘red flag’ that your gums need extra attention. In dentistry, bleeding gums is one of several identifying features of gum disease.  It is not to be ignored!
Let’s look at just two aspects of gum health with a view to not seeing bleeding when we brush:
- How you care for your teeth at home
- Dietary and nutritional influences
Some people with gum disease can experience a remarkable improvement in gum health simply with improved technique for cleaning their teeth, and awareness of what they are doing. The aim of home care is to disrupt the soft plaque (oral biofilm) twice, every day.  Plaque is one word we use to describe a massive community of bacteria.
We could discuss toothbrush angles and how to hold the floss but you’d be best to ask your dental care provider to demonstrate these things on you with you watching in a mirror. For this article let’s consider some different tips!
Test with your tongue
Before you place the brush to the tooth, feel around your teeth with your tongue. Especially the top teeth along the side/back. Notice if it feels smooth, rough, furry – that rough furriness? That is plaque! After cleaning your teeth – feel it again. Is there a difference? There should be if you have brushed your teeth properly.
Use the mirror and watch what you are doing
Look at where you are placing the bristles of your toothbrush – they should be on the teeth and gums. To see better, use your free hand to move your lips and cheeks out of the way as needed.
Clean in-between first
Whether you use floss or an interdental brush, you are getting the most tedious part done first! All the ‘bits’ that come out get nicely brushed away after.
Brushing too hard?
Yes, there is such a thing. However, understand that brushing too hard, or somehow injuring yourself with the toothbrush bristles, is highly unlikely the cause of bleeding gums. Brush gently, yet thoroughly. Bleeding is a sign of disease so don’t avoid brushing if you see it!
As you reflect on these things: What are you already doing? What could you tweak for a better result? Here, we’re trying to make improvement easy by building on a habit that you already have – brushing your teeth twice a day! At first, you may notice bleeding when you start to focus more on what you’re doing – this means that you’ve reached an area that needed it, so persevere! See if the bleeding stops after a week. Importantly, discuss gum health with your dentist or hygienist. Ask them how your gums are looking and what areas might need a bit more attention.
Diet & Nutrition
Diet and nutrition also influence gum health – let’s look into this a little more with an example.
A 2017 experimental study in Germany showed that dietary changes can have an impact on gum disease. The study was carried out on a group of adults who already had active gum disease and a high carbohydrate diet.
Several people of the group were to eat an ‘oral health optimised diet’. That diet was low-carb, and featured Omega-3’s, vitamins C and D, antioxidants, and fibre. The remaining people – the ‘control group’ – did not change their diet.
The results showed an improvement in gum health for the people who ate the ‘oral health’ diet. An improvement of around 50%. This is significant considering there were no instructions given on how they cleaned their teeth at home. In fact, all people in the study were only instructed not to clean in-between their teeth at all during the experiment. 
If you want to ‘sink your teeth into’ more info on diet and oral health a great read is The Dental Diet by Dr Steven Lin.
So, you can see that bleeding gums can be improved in more than one way. What could you do within your current routine to improve your gum health if you’ve noticed blood in the sink?
Do take note that gum disease is not just one thing but can be categorised into multiple types, stages and severities.  Here, we are speaking broadly – your dental practitioner will be able to assess you for gum disease and provide a diagnosis and individualised advice.