A persistent flow of blood from the gum tissue surrounding a tooth can be alarming. Persistent dental bleeding is defined as bleeding that lasts longer than 10 to 15 minutes of continuous, direct pressure or when an initial clot fails to form or re-establishes itself repeatedly. The reasons for this ongoing issue range from common local tissue problems to complications from recent procedures or systemic health conditions affecting the body’s natural clotting abilities.
Localized Inflammation and Trauma
The most common reason for persistent bleeding is chronic inflammation within the gingival tissue, which makes the blood vessels fragile. This condition, known as gingivitis, occurs when plaque, a sticky film of bacteria, builds up along the gum line and irritates the gums. The body’s immune response causes the gums to become swollen, red, and highly prone to bleeding with even minimal stimulation, such as light brushing or eating.
When gingivitis is left untreated, the inflammation can advance to periodontitis, which is a deeper infection that begins to break down the support structures of the tooth. In this state, the compromised gum tissue bleeds more readily and may also be accompanied by pus or a foul taste.
Mechanical trauma from improper oral hygiene techniques can also contribute to persistent bleeding. Aggressive horizontal brushing or improper flossing can physically abrade the delicate gum lining. Furthermore, chronic physical irritation from ill-fitting dental appliances, such as partial dentures or deep crown margins, can rub against the gum tissue, preventing a stable seal and leading to recurring bleeding episodes.
When Bleeding Follows a Dental Procedure
Bleeding following a professional dental intervention is expected initially, but its persistence suggests an issue with the normal healing cascade. After a tooth extraction, a blood clot must form within the empty socket to protect the underlying bone and nerves. Failure of this clot to form, or its subsequent dislodgment, is a frequent cause of prolonged post-operative bleeding.
Actions like vigorous rinsing, forceful spitting, or sucking on a straw create negative pressure that easily disrupts the protective clot. Once the clot is lost, the underlying capillaries are exposed, and bleeding can resume heavily.
Persistent bleeding can also result if the soft tissue around a new filling, crown, or implant site is irritated. If the restorative margin is rough or extends into the gum’s biological space, it causes localized inflammation and chronic seepage. A localized infection can further complicate healing by introducing enzymes that break down the newly formed clot.
Underlying Health Conditions Affecting Clotting
While local issues are the most common cause, persistent bleeding can signal that the body’s overall clotting mechanism is impaired. Medications are a significant factor, particularly anticoagulants (blood thinners), which directly interfere with the clotting cascade. Drugs like warfarin or newer oral anticoagulants make it difficult for the body to stop bleeding from even minor oral injuries.
Certain systemic diseases compromise the liver or bone marrow, which produce essential clotting factors and platelets. Conditions like liver disease, which impairs coagulation protein synthesis, or uncontrolled diabetes, can lead to prolonged bleeding episodes. Inherited bleeding disorders, such as hemophilia, also result in a deficiency or defect in specific clotting factors.
Nutritional deficiencies, specifically in Vitamin K or Vitamin C, can impact the body’s ability to maintain hemostasis. Vitamin K is necessary for the liver to produce clotting proteins, while Vitamin C is essential for collagen synthesis, maintaining blood vessel wall integrity.
What to Do Immediately and When to See a Dentist
The immediate priority for persistent dental bleeding is the application of firm, sustained pressure to the site. Take a piece of sterile gauze or a clean, damp tea bag, fold it into a thick pad, and place it directly over the bleeding area. Black tea bags are useful because they contain tannic acid, which acts as a natural vasoconstrictor and helps the blood vessels constrict and clot.
Bite down firmly and continuously on the pad for at least 15 to 30 minutes without checking the site. Avoid rinsing, spitting, or using a straw, as these actions can dislodge the forming clot and restart the bleeding process. Keeping the head elevated above the heart level can help reduce blood pressure in the area and slow the flow.
You should seek professional dental or medical attention immediately if the bleeding is heavy enough to soak through the gauze quickly or if it cannot be controlled after 30 minutes of continuous, direct pressure. Other warning signs include the onset of fever, significant swelling, or pain that rapidly worsens, as these may indicate an underlying infection or a more complex complication. If you are taking blood-thinning medication and experience persistent bleeding, contact your dentist or physician for guidance, as they may need to adjust your medication temporarily.