5 reasons why your gums are bleeding when you brush

The night before a teeth cleaning, most of us like to get in there deep. We floss and brush the pants off our chompers, then spit a couple drops of blood into the sink. But here’s the thing: “Bleeding from the gums is never normal,” says periodontist Sally Cram, D.D.S. It’s actually a red flag for gum disease (a.k.a. gingivitis, or inflammation of the gums), which stems from the buildup of bacteria and plaque on your teeth.

You don’t want gum disease—it can weak havoc on your mouth (we’re talking tooth loss) and body (it’s been linked to heart disease, yo).

Aggressive brushing isn’t the only cause of bloody gums—there are actually a number of triggers (not all in your control) that can lead to that pink spit. Take a look so you know how to step in or when to ping the dentist.

“It only takes 24 hours for bacteria to make inflammation (the cause of blood) in your gums, so if you didn’t do a good job of brushing or flossing the day prior, you could notice a little blood,” says Cram. Slow your roll the next time you brush to hit all the sneaky spots bacteria hangs out, and the blood should stop. (If you brush and floss like an A-student but notice blood in your gums for a week or two straight, head to the dentist for a check up.)

When hormone levels fluctuate (for example: during puberty, pregnancy, your period, or menopause), we become more sensitive to plaque, which can trigger bleeding in the gums, says Cram. You can show your mouth special love with a mouth rinse or an extra floss sesh while you wait for your hormones to chill out.

Nothing like adding insult to injury: “We actually see bleeding gums often in college kids because they’re eating poorly, staying up late, and with schoolwork, and all those things impact your body’s ability to fight inflammation caused by bacteria in the mouth,” says Cram. Protect your chompers with a sensible diet (packed with protein, veggies, and vitamin C and D, which are key to gum and bone health) or try adding a daily multivitamin into the mix.

Certain prescription drugs, like antidepressants and blood pressure medications, may cause dry mouth, and that lack of saliva allows bacteria to proliferate. The result: red, swollen, and sometimes bloody gums. Check in with your dentist or doc if you suspect a medication is drying you up—there are products that can help keep gum tissues lubricated in these cases, says Cram.

Chronic illnesses like diabetes, or diseases like leukemia and HIV, can affect the immune system and lead to swollen and bloody gums. If you spot blood on the reg for more than a couple weeks, visit your dentist to determine whether or not it’s time to check in with an M.D.