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RE bleeding gums?

Hi again - sorry another question. For the fourth consecutive day I've brushed my teeth only to see spoonfuls of blood in the basin and my mouth tastes of blood for a while after. No pain or toothache - just a lot of bleeding when I swill and spit. Does anyone know if this is to do with the MTX? I know it's normal sometimes to see a bit of blood when you swill out but this is quite a lot more than I've ever had and is definitely not normal for me. Does MTX effect our gums too? TTx

28 Replies

Hi Tilda, I never had this problem with MTX but bleeding gums is usually a sign of gum disease, so it might be worth making an appointment to see a dentist.

Beth x


Thanks Beth - just wondered - I saw the dentist around Xmas and got a clean bill of health for my teeth and gums so if things are going wrong in my mouth it must be pretty new and no pain or hot/ cold stuff normally associated with gum disease and hadn't eaten anything sharp etc. I'm feeling really washed out and stiff today so wondered whether it mightn't be something to do with that but I trust you to know this kind of stuff. TTx


I'm not saying it's not MTX or another effect of RA but best to check with a dentist. I've practically moved into my dentist over the last couple of yr, had all sorts of problems with my mouth/teeth.

My last appointment was early Dec when he signed me off and now I'm back again, the gum around a root filling has become so loose my tooth is lifting out it's socket (that sounds much worse than it is). So I've now got another 3 appointments to look forward to. lol

Always best to check this sort of thing with the experts in that field.

Good luck hope it's nothing serious or the medications causing it.



Tilda dear, I do know that MTX will prolong bleeding times, as I have had to d/c doses atleast 2 weeks before a schedule surgery. Your gums may be bleeding from attacking them too vigourously??

Keep in mind, we can get RA in the jaw bones, which then causes teeth to loosen, which could cause bleeding. Maybe dentist could see on xray?

I have known of people who have had all teeth removed and claim they still get bad "toothaches" from the RA in the jaw. L. xxx


I only ask because I googled MTX after all this blood in the basin and on the very alarming blurb on Web Med it says that if you get any unexplained bleeding seek advice. Now it's not really unexplained as such but yesterday I snagged my nose with my nail when I was coming out of my last session of short wave physio treatment and it carried on and on bleeding for ages longer than a little scratch like that would normally cause but eventually after about an hour dried up - so annoying and a bit embarassing because I ended up going round the supermarket with a bleeding nose! And so, in new hypochondriac mode I wondered if I'm bleeding more than usual with the increased dose of MTX - but very, very probable than I'm being OTT. Will phone my dentist although I don't like him much and it's private so I have to pay for extra visits - I can't get onto the NHS waiting list up here so no choice on this. Thanks anyway though I will go and get my gums checked. TTx


Oh dear I hate dentists, and they always lecture me about brushing teeth which I do to best of ability. It sounds like its worth che king out though



Thanks Cathie - I've just got an apt to see my grumpy German dentist at 11.30 tomorrow. Wish I could change as I had the most lovely Czech man for a while who was the best dentist I've ever had but he went back home with his new wife and since I've been landed with surly man who didn't seem to have heard of RA or Methotrexate and does not inspire much confidence at all. Ah well at least I'll get checked out I guess? TTx


Hi there. Don't be nasty about dentists - my mum was one (treated Lucian Freud once, but he never paid his bill). Made me less than popular at school, but I do only have one filling. I think the culprit is probably RA not methotrexate. I seem to get more gum problems than I used to have and I recall others wailing about more problems with teeth no matter what drugs they're on. We also need to be scrupulous about mouth hygiene, as any inflammation is not good for us as our resistance is a touch low. But yes, best to go to dentist, grumpy or not. Px


Not being nasty about dentists per say Polly - just my new one! You would undoubtedly agree if you met him because he's about as personable as a jowly dog with challenging behaviour - looks a little like one too.

My teeth have been really good recently so I haven't needed treatment just check ups and hygiene stuff but my last dentist was so wonderful and came to my rescue when a tooth died slowly and agonisingly a few years ago and then when I needed root canal afterwrds - he did the whole thing without anaesthetic and I didn't feel a peep - but then the tooth has died by that time!

I don't know whether this one is any good or not but his couch-side manners are zilch.

Sure your mum would have been excellent though - what were Lucien Freud's teeth like I wonder?

Yes you maybe right that it's RA related not a dental problem as such because it doesn't hurt at all but just lots of blood that's all. And I brush my teeth very diligently but not roughly because hands not very strong can't clench toothbrush and also I don't want to damage my gums. I'm very conscious that good oral hygiene is especially important for those with RA and anyway I don't eat anything sugary at all now because desperate to lose weight.

Hey hark at me I sound like flippin' a saint but that's not the full picture at all of course!! TTx


Having just chewed through several oat biscuits I made with maple syrup & butter I really ought to make more of an effort to be saintly, but too cold. Anyway look up a post from Wiliby on 2nd Dec about gums & teeth, some good stuff there.


Aren't we all quiet today - maybe that's the cold too.


Just eaten loads of fried fish for supper - hubby cooks it once a week and it's so lovely but sure it's stuffed with calories with being fried. I know the cold has a profound effect on us all. Will look up Williby's old post on gums and teeth. I don't quite get how RA could make my gums bleed but then I'm still slightly in denial about having RA to begin with - silly I know but I am always wondering if I stopped eating this or took that vitamin if it mightn't just go away and stop pretending to be something for life that might well eventually get worse. Got to do the washing up and then go to choir practice - rehearsing for World Cancer day concert on Saturday evening. Can't help wondering why there isn't a World Arthritis Day or a World Autoimmune Day as well? Mind how you go and don't get beached in the bath tonight please. TTx


But there is a world arthritis day! 12th October. Mainly seems to be stimulated by the European League Against Rheumatism (EULAR) for us, not sure about our american friends. And Eular do prizes and things for writing & poetry about RA, which I think is great. The event that I noticed last year was someone in an "arthritis suit", meant to simulate what it felt like. I was dead keen to get hold of one for my OH..... Anyway, google it.

Bath night has been postponed as electricians managed to make problems worse, and have only just left. I can now use the toaster, but instead they seem to have blown up the washing machine and burnt out some lighting circuits. So too tired now to contemplate a restful bathe - I would be more likely to fall asleep and choke. Hope your choir practice is fun. Px


Tilda you may use this but if not try using the corsodyl toothpaste and mouthwash - i had a bit of gum disease when i was pregnant and my dentist recommended this and it definetly made a difference.


Thanks Mads will buy some tomorrow after the dentist - or maybe at the denists if they sell it. TTx


We are a really small core group singing very solemn contemplative music and then there's a dance group and it's all going to be in candlelight with people drifting in and out lighting candles for loved ones etc. On one hand rather lovely maybe - our music certainly would be if we managed to sing it properly as our choir mistress keeps saying - but on the other hand the dancing worries me as I'm liable to get an appalling attack of giggles during the dancing and that would be no good at all as the choir mistress said - looking very hard at me???! I can do solemn - really I can - but I find the idea of the focus always being on cancer a bit frustrating as we;ve had weeks and weeks of hearing how people feel on diagnosis and there's a drop in centre and so much support. I just keep thinking of a woman I sat next to in the pub yesterday who I last met walking around a shop as able-bodied and now, following a big stroke she is completely immobilised, needing round the clock total care -her and her husband's retirement ruined. I just feel so aware that there are a lot of terrible diseases out there, including RA. and yet cancer is still the one everyone fears the most?

A GP friend in my choir was saying tonight that she was at a big clinical meeting earlier today and all these doctors were saying "why is it always cancer that gets all the funding and attention up here these days? There are more people with heart disease by far and MS is a huge problem here?" so I wasn't the only one thinking about this at least.

There may be a World Arthritis Day Polly but we certainly don't hear about it in the same way here anyway,

How are you coping in the freeze with all these electrical problems you poor thing. Don't bathe on any account - just cosy up in bed and hope tomorrow brings some brighter news re the sparkies! TTx


Just a quick thought. Some medications make our blood a bit thinner, so a slight bleed might appear worse than it is. I think painkillers like diclofenac can cause this.

Hope the dentist is kind tomorrow.



Thanks Phoebe - I don't take any pain medicines or NSAIDs just now because my stomach wasn't doing well after long term use. So don't think it can be that - but thanks for the suggestion anyway - maybe I do just have some gum infection will let you know what he says - if he says a word that is - he didn't last time?! TTx


So did he speak? Or offer any sensible suggestions...?


Hmmm, such a challange!

Yes there is World Arthritis Day, on October 12. It is up to local offices relating to Arthritis Awareness and Research to promote that day, or even during the entire month of October.

Over here, there are "Runs", where everyone participating gets sponsors who donate X number of dollars, for the purpose of Research and also bringing awareness to the public sector. Then they race, usually each has a tee shirt with graphics of some sort for Arthritis. Anyone can take part in a "Run", even if there's no way in hades you're ever going to win. It's a day of alot of fun and camerodery. (Need spellcheck!)

We also have one in November and December, called the "Jingle Bell Run".

Also there is a big banquet where recognition is given to all volunteers, teachers of Tai Chi classes, water aerobics classes, Support Group coordinators, ( :) yes, I have one ) etc.

So, maybe, in your village or small town, some of you could organize a simple version of activity, to bring awareness of Arthritis, to your community. Maybe at a church, or town hall, etc? Probably employees of NRAS could help with flyers, etc. Just a thought. L. xxx


Don't know about your patch, but it's true that there are so many "days" for one thing and another that it's hard to keep up with them all, and I don't think I'd have noticed world arthitis day at all if I hadn't got RA. Or maybe it's just that all of us with RA have so little energy that we don't think to organise loads of local events? I did manage to put up a poster about warning signs for RA in local docs surgery, but that's been my main contribution to the cause. But maybe this year I'll have some energy in early autumn - that would be a nice goal to have. Px


You are right about us not really having enough energy to devote to organizing An Arthritis Awareness campaign of any kind, maybe NRAS would like to make it their campaign for this year, just putting up flyers to list the kinds of disabilities caused by RA, the need for more public education and understanding, etc. Could be a start.


It's a good thought Loret. I do try and get people talking about it a lot now and in a way that seems more effective than linking with local groups because there are so many up here - charity and volunteering are huge in Orkney.

As I've just said to Polly I would like to get more involved while my RA is relatively mild - but there is no RA group up here and the local branch of Arthritis Care has a games afternoon today I heard on the radio - but I know that because it's in the day I'd probably be the youngest there by about 20 years. Because I'm approaching 50 now I find the thought of being with older people only in connection with RA a bit depressing - hope this doesn't sound too horribly ageist?

For me the worst thing I learn about RA is how it is for younger sufferers - and by that I mean younger than me so include those in their 30s and 40s. My instinct towards campaigning zeal is very much leaning in the direction of those who have to cope with RA and young kids or are students, teenagers, unemployed or trying to cope with full time work etc or have children with the disease - basically a lot of the people who's shoes I'm not in - and very relieved and fortunate for it too. It has really got to me learning that people get shouted at for sitting on disabled seats on buses because they are young - or for using their blue badges to park - or have to suffer horribly while waiting to qualify for anti-tnf. None of this affects me yet and hoping it never will of course. But all of it moves and troubles me terribly and I would like to try to raise awareness about what it means to have RA for many. TTx


I have quite a lot of energy just now Polly.I don't think everyone has the chronic fatigue side of RA - if I lived somewhere more central I could easily campaign more for people with RA now. In fact when I was on Arthritis Care site pior to diagnosis about three people said they didn't have it with theirs either, so perhaps it's just the bad luck of the draw?

I do get very tired after MTX and I also have always struggled with insomnia in patches - sometimes for year long stretches even as a kid. My boys are just the same as me and the oldest got really sick last year at uni and ended up on Diazipan for a week because of his insomnia caused by chronic eczema which then turned into blood poisoning. Sometimes I think we start blaming this disease for everything - when in fact we may have just landed ourselves with other illnesses or chronic fatigue that might be linked to meno or having babies or post viral fatigue?

I was trying to explain this to a friend today because of the bleeding gums - which the dentist (not too grumpy this time thankfully) said are nothing to do with gum infection or disease because my oral hygene is good and there is no sign of tooth decay and my x-rays are all clear. He suggested sinusitis relating to cold or possibly RA connecting to blood but Loret's suggestion sounds quite likely re the MTX. I'll see - he cleaned my teeth very vigorously and nothing bled so maybe it was a sharp grain of porridge which scratched the inside of my mouth. I brush very gently because of my stupid unclenching fingers/ knuckles and sore wrists so don't think it was that. Thanks so much all for your suggestions anyway! TTx


It is true that I blame everything on RA now, and perhaps sometimes it's just normal illness or aches. But then I used to be pretty fit & healthy so not really accustomed to being tired or ill, and easier to dump everything on evil RA rather than contemplate that it's age or gender related. And I used to manage on about 5 hours sleep, which would be impossible now. If I don't get about 8 I'm hopeless, and feel immense sympathy for insomniacs as really don't know how you manage (even if you don't have RA fatigue). But then I'm mega calm now, and I used to be manic, so perhaps that's got a lot to do with it too. A teeny tiny benefit of RA! Px


I think I've come from the opposite extreme in some ways to you Polly. I feel much better than I used to feel when I was covered in bleeding and pussy eczema that itched me day and night.

In an effort to stop the RA catching hold I've lost a few stone and a half and walk and exercise a lot more than I ever have so perhaps RA is saving me from a worse fate in a strange way?

But the side I really hate at the moment is the wondering whether my gums are bleeding or my gut is hurting or my eyes are drying or my hair is falling out because of RA or MTX or both. I get so preoccupied trying to work it all out and keeping on top of my health is exhausting - whereas when the eczema was lousy it was very visible and I yet just ignored it and hated it alternately and did nothing to try and cure myself of it really.

I recall being stuck on a dermatology ward when I was about 5 months pregnant with my first child and had infected patches that they were trying to persuade me to take steroid infusions because it was potentially endangering my unborn child and of course myself too with blood poisoning etc I just kept looking at others on the ward and feeling sick and wanting desperately to get out of there because mine seemed so mild compared to theirs - even though it was pretty bad. But these poor people looked like the chap in the Singing Detective x10 and I just wanted to weep on their behalves. All I have to do is google RA or Ulnar Deviation images now and I decide that I haven't got it at all - in much the same way I suppose - not sure if this is denial or just thinking that at the back of my mind if the eczema can just clear off then so can this lot surely? TTx


Well stranger things have happened - and a couple of people on here have said they've gone years with no problems so it must be possible. I'm certainly set on achieving remission sometime soon, and I think we have to believe things will get better and that it isn't a sure thing that we'll all end up with failed joints and wobbly fingers and toes. But I know what you mean about the endless fretting about health issues - like Gina said the other day I don't want to be defined by this disease, but it's hard to get away from it. I think my pain is hugely less than other people's now, but it's rare to have a day where I'm not aware of it and don't think about it at all. Even tho' I'm nowhere near as bad as some, the RA has still had a big negative impact on my life. And hard to explain to outsiders, especially as it's so misunderstood as a disease, so plenty to do to raise awareness. (The one thing that I think I'd like to campaign on is the whole rigmarole in England about getting anti-TNF, as that just seems cruel). But at least thanks to HU I can have some areas of my life that are RA free!

Anyway it sounds as if you're doing a huge amount to help yourself, with pretty amazing weight loss & exercise, and that's got to make a difference. Not carting around over 2 stone must improve energy levels as well. So you're giving yourself best chance of putting RA back in its box as quickly as possible. Here's hoping... Px


Wow, did I open a big can of worms? You two are in really deep conversation!

Good thoughts! I have had a very busy and exhausting two days and am aiming at getting to bed earlier than 1am tonight.

Hope you all have had a good, quiet, peaceful, warm, snuggley night. ;) L.xxxx


Yes we've diverted away from bleeding gums now haven't we Loret?! I wanted to write back to Polly and say thanks for not taking my tone of yesterday too badly or for getting fed up with me suggesting that we are all a bit overly RA obsessed. What a thing for me to say on an NRAS site of all places?!

I do find myself obsessing and I think it's partly due to where I live and partly due to my bafflement at finding I have this RA thing and l am on MTX now where this time last year I was poddling about quite happily playing weekly badminton with my friend (and getting hellishly painful knees afterwards), full of my career as an artist and my passion for newly taken-up embroidery and to-ing and fro-ing from Edinburgh to install artworks in various public places and see friends and son. I was aching and tired a lot but thought that was all menopausal and to do with being terribly overweight and having lost both parents suddenly relatively closely together so was still reeling in the aftermath a little with lots to arrange and lots of travel.

Now a year on I don't quite know what to think because it's been such a rollercoaster few years and I've gone from being the me I've always been covered in eczema and physically lazy to the new me that has no eczema at all but who is obsessed with getting enough exercise and diet daily and keep waking through the night to unfurl my hands or negotiate with the duvet at the expense of my wrists or wondering if the pain in sole of my foot is going to hinder me from all that I have to do today (tons). It's a bit like the death of a parent actually in that it seems to require me to check in a lot to make sure I haven't dreamt it all up.

I know others here find it as all-consuming as I do but it's still so new and weird to me that I keep trying to find the positives - the way I can make it transforming in a good way as well as the bad stuff such as joints being tranformed. I don't really worry that it will define me - maybe I needed redefining after all these complacent years?


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