My gums bleed when I brush my teeth, but isn’t that normal?
Let me answer a question with a question. Say you were in the shower, washing your hair. As you lather up…your scalp starts bleeding. What do you do? Scream…jump out of the shower…throw on your bathrobe without rinsing or even drying off, and drive to the hospital! Why, then, is it deemed “normal” when performing basic hygiene elsewhere on your body to see bleeding?
Bleeding in the mouth always indicates the presence of bacteria. Always. Yes, we do have “normal” bacteria in our mouths, but certain types of bacteria create inflammation in the gum tissues and if left unchecked, bleeding is the early sign of tissue destruction. The next step after bleeding and swelling of the gums is bone loss, which can lead to the loss of teeth. In 2013, there is no reason why patients should eventually lose teeth due to bone loss, when treated at the first sign of infection!
But I go to the dentist every 9 months for a cleaning…
Nine months for a cleaning is an interval created by dental insurance companies. In fact, many adults begin growing gum disease-causing bacteria within 12 weeks of their last dental hygiene appointment! Your insurance company is a business that is primarily concerned with their bottom line, not your overall dental health, and they make it as confusing as possible for the dental consumer to maximize dental benefits with regards to their gum tissue health. Did you know that most dental plans offer their insured benefits towards 3-6 dental cleaning appointments per year? (They don’t advertise this because they would still prefer to not have you maximize your plan.) The restriction on dental check-up appointment is actually for the dental exam, which only needs to be performed once per year.
I brush and really do try to floss daily…why do my gums still bleed?
I am not afraid to say in print that floss is not the answer on its own for every patient to control gum bleeding! In fact, the BEST dental tool you can own at home for keeping gums healthy is a Waterpik! They last forever, they are relatively low-cost, one unit can be shared amongst the whole family (with different colored tips for each person). They work so well because they flush out all of the debris on the teeth as well as the bacteria that clings to the teeth despite flossing.
The second best tool is a high-quality electric toothbrush. In our office, we recommend Sonicare toothbrushes…and don’t go cheap! These can also be shared amongst the whole family, with different colored heads for each person. Combine the Sonicare and the Waterpik and you have the best home care duo available today. It’s the one our dental team uses at home.
If I see my hygienist every 3 months, and use a Sonicare and a Waterpik…why do my gums still bleed?
As mentioned earlier, bacteria can begin to rebuild on the teeth in less than 12 weeks. The first thing we would try in our office is a thorough dental hygiene appointment with a scheduled re-evaluation for bleeding points in 6 months time. If there is still bleeding at the time, we would repeat the process and re-evaluate again in 6 months. If bleeding still persists, we would recommend bacterial testing, which can be done very easily and completely painlessly to see exactly which bacteria are present and causing the infection. We are then able to give antibiotics either directly in the area of the bleeding, if it is limited to a small area, or in pill form if the bleeding is all over the mouth.
If when checked at six weeks the bleeding has stopped, the next re-evaluation would be in 8 weeks time. If there is no bleeding, the following re-evaluation would be at 10 weeks time—slowly we increase the interval between appointments to find each individual’s ideal hygiene appointment interval. As well, we can use a dental laser painlessly at hygiene visits to vaporize bacteria and eliminate them from your gum tissues.
These procedures, accompanied with excellent oral hygiene, and sometimes antibiotics can get your gums super healthy with no bleeding. That’s the recipe for keeping your teeth for a lifetime!
Dr. Andrea Stevens is a cosmetic and family dentist in practice in Kanata, Ontario. If you have dental questions, you can call her at 613-271-7091 or visit her at kanatacosmeticdentist.com Please also feel free to leave comments or questions below, and Dr. Stevens will be happy to answer!