Are bleeding gums something you should be concerned about? Dear Doctor magazine recently posed that question to Dr. Travis Stork, an emergency room physician and host of the syndicated TV show The Doctors. He answered with two questions of his own: “If you started bleeding from your eyeball, would you seek medical attention?” Needless to say, most everyone would. “So,” he asked, “why is it that when we bleed all the time when we floss that we think it’s no big deal?” As it turns out, that’s an excellent question — and one that’s often misunderstood.
First of all, let’s clarify what we mean by “bleeding all the time.” As many as 90 percent of people occasionally experience bleeding gums when they clean their teeth — particularly if they don’t do it often, or are just starting a flossing routine. But if your gums bleed regularly when you brush or floss, it almost certainly means there’s a problem. Many think bleeding gums is a sign they are brushing too hard; this is possible, but unlikely. It’s much more probable that irritated and bleeding gums are a sign of periodontal (gum) disease.
How common is this malady? According to the U.S. Centers for Disease Control, nearly half of allÂ Americans over age 30 have mild, moderate or severe gum disease — and that number increases to 70.1 percent for those over 65! Periodontal disease can occur when a bacteria-rich biofilm in the mouth (also called plaque) is allowed to build up on tooth and gum surfaces. Plaque causes the gums to become inflamed, as the immune system responds to the bacteria. Eventually, this can cause gum tissue to pull away from the teeth, forming bacteria-filled “pockets” under the gum surface. If left untreated, it can lead to more serious infection, and even tooth loss.
What should you do if your gums bleed regularly when brushing or flossing? The first step is to come in for a thorough examination. In combination with a regular oral exam (and possibly x-rays or other diagnostic tests), a simple (and painless) instrument called a periodontal probe can be used to determine how far any periodontal disease may have progressed. Armed with this information, we can determine the most effective way to fight the battle against gum disease.
Above all, don’t wait too long to come in for an exam! As Dr. Stork notes, bleeding gums are “a sign that things aren’t quite right.” Â If you would like more information about bleeding gums, please contact us or schedule an appointment. You can read more in the Dear Doctor magazine article “Bleeding Gums.” You can read the entire interview with Dr. Travis Stork in Dear Doctor magazine.
You have a great smile: beautiful white teeth all perfectly aligned. But unbeknownst to you, periodontal (gum) disease might even now be damaging your gum tissues, setting the stage for future tooth and bone loss — and a ruined smile.
While it’s easy to miss the early stage of this disease caused by bacterial plaque on tooth surfaces, there are a few signs if you pay close attention. Bleeding gums after moderate brushing or flossing could indicate normally resilient gum tissues have begun to weaken. You may also notice a slight redness and swelling around the margins of the gums and a bad taste or breath. As it progresses, you may experience painful abscesses (infected pockets that develop between the gums and tooth) and loose teeth, a late sign of tissue detachment and bone loss. If you are a smoker, nicotine reduces swelling and bleeding of the gums, removing signs you have a disease. If you smoke, you need to see your dentist regularly.
While renewed daily oral hygiene is important for stopping gum disease, you may also need professional care to bring it under control. The main treatment calls for the manual removal of plaque and calculus (hardened deposits of plaque) that are sustaining the infection. Dentists and hygienists both can perform scaling, which removes plaque and calculus at or just below the gum line, and root planing to clean accessible root surfaces.
In more advanced cases, though, you may need the services of a periodontist, a specialist in treating diseased or injured gums, bone and other connective tissues that support the teeth. They’re also skilled in more advanced treatments like gum flap surgery that more fully exposes a tooth’s root area for plaque and calculus (or tartar) removal, or tissue grafting procedures that improve the health and appearance of damaged gums.
If you suspect you have gum disease, the place to start is with your family dentist. They can determine if your case will respond to basic scaling, root planing or antibiotic treatment. If the disease appears more advanced or with complications, they will most likely refer you to a periodontist for treatment.
If you’ve already seen bleeding, swelling or redness, see your dentist as soon as possible. The sooner you begin treatment for any case of gum disease, the less likely it will lead to the loss not only of your teeth but your beautiful smile.
If you would like more information on the treatment of periodontal (gum) disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “When to See a Periodontist.”
If you notice your gums bleeding when you brush your teeth, you’re not alone — it’s estimated that as many as 90% of the population have at some time had the same experience. That doesn’t mean it’s normal, though; in fact, unless you’re pregnant, have a systemic condition like diabetes or take blood-thinning medication, it’s more likely a sign that an infection has caused your gums to become inflamed and tender. The infection arises from a bacterial biofilm that’s been allowed to accumulate on tooth surfaces due to inadequate brushing and flossing.
If not treated, the early form of this infection known as gingivitis can develop into a more serious form of gum disease in which the various tissues that help attach teeth to the jaw become infected and eventually detach. As it progresses, detachment forms voids known as periodontal pocketing between the teeth and gum tissues. The end result is receding gum tissue, bone loss and eventually tooth loss.
If you begin to notice your gums bleeding when you brush, you should make an appointment with us for an examination — and the sooner the better. During the exam we’ll physically probe the spaces between your teeth and gum tissues with a periodontal probe, a thin instrument with a blunt end marked in millimeters. As we probe we’ll determine the quality of the gum tissue — whether the probe inserts easily (a sign the tissues are inflamed) or gives resistance (a sign of healthy tissue). We’ll also determine the degree of detachment by measuring the depth of the insertion with the millimeter scale on the probe.
The presence of bleeding during this examination is a strong indication of periodontal disease. Taking this with other signs we encounter during the exam (including the degree of pus formation in any discovered pockets) we can then more accurately determine the existence and level of advancement of the disease.
While gum disease is highly treatable, the best results occur when the condition is discovered early, before the infection severely damages tissues around the teeth. Being on the lookout for bleeding and gum tenderness and responding to it quickly can significantly simplify the necessary periodontal treatment.
If you would like more information on bleeding gums and other symptoms of gum disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Understanding Gum (Periodontal) Disease.”