DISCLOSURE: Noelle Copeland RDH is the oral care specialist and dental consultant to the Brilliant and Baby Buddy oral care lines.
One of the best ways to fight bleeding gums is prevention, and knowing why prevention is essential. Below I’m going to outline what may be causing your bleeding gums and what you can do to treat them. The benefit of a healthy mouth is always lifelong sustaining health. Systemic health and oral health are intertwined and directly affect one another in so many ways.
If you have bleeding and tender gums, you may also have gingivitis. Gingivitis is the number one cause of bleeding gums. Gingivitis happens when oral care is not consistent enough to keep plaque and bacteria balanced in the mouth.
As plaque builds up on the teeth, bacteria begin to feed off the biofilm. As this continues, the gums react by becoming inflamed and pulling away from the offending bacteria and plaque build-up. As the gums respond to this, they become tender to touch and bleed easily. Most gingivitis sufferers will notice bleeding when they brush and floss. This bleeding is the body’s way of warning you that something is going on.
The treatment for gingivitis usually entails a professional cleaning and an increase in home care compliance. Once you and your dental professional decide what needs to change, you can develop a routine that suits your lifestyle.
The good thing about gingivitis is that it is entirely reversible. Your gums will not suffer any long-term damage if gingivitis is detected and treated early. However, if gingivitis is left untreated and gums continue to bleed and become more inflamed, periodontal disease is lurking very closely around the corner.
Therapeutics that help with gingivitis
- Antiseptic mouthwash
- Electric toothbrushes
- Water irrigator
- Interdental stimulators
- Use of antibiotics, antiseptics, or analgesics may be needed while closely monitoring: chronic, aggressive, medically induced, or necrotizing ulcerative gingivitis.
If gingivitis goes untreated, eventually, it will lead to periodontal disease. Periodontal disease can look and feel like gingivitis for a long time before it ever progresses into something more painful or visually apparent. You may never know you have moved into periodontal disease until some of the more severe and aggressive symptoms present themselves, for instance:
- Loosening teeth.
- Draining abscesses.
- Broken or fractured teeth.
- Pungent halitosis.
- Rampant decay.
If your gums bleed regularly, that’s not a variation of normal. It’s not normal for your finger to bleed randomly, or any other part of your body for that matter, so it’s not normal for your gums to either. If your gums do bleed, something is causing it, and you need to figure out what that something is. If you have periodontal disease, the periodontal disease must be treated professionally and then maintained and checked quarterly until you are released to bi-annual visits.
Once periodontal disease has occurred, the damage it does is irreversible. You can get regeneration of tissue fibers with reduced inflammation that help decrease pocket depths. Other options may include replacing the natural bone lost to periodontal disease with synthetic bone or donor site bone. So if your gums are bleeding, be sure to nip it up quickly and don’t ignore your body when it’s telling you something is wrong.
Signs of Periodontal disease
- Swollen and inflamed gums.
- Red or purple gums.
- Seeing blood on your toothbrush.
- Gums bleed with slight pressure.
- Spit out blood after homecare routine.
- Halitosis or Bad breath.
- Loose teeth.
- Your bite feels different; teeth fit together differently.
- Hurts to chew.
- Gums appear to be pulling away from the teeth.
- Dark accumulations are arising under the gums.
Treatment for periodontal disease
- Professionally cleaning out the pockets around the teeth. Called an SRP, Deep Cleaning, or Root scaling, where the debris and deposits below the gums are removed with hand instruments, ultrasonic scalers, irrigators, medicaments, and therapeutics.
- Topical antiseptics.
- Surgery: Flap Surgery, Laser therapy, Gum grafts
- Increase professional dental visits and cleanings.
- Increase homecare routines.
Not many people think about how orthodontics can help treat bleeding gums or how they can cause bleeding gums. What do I mean by that confusing statement? Well, if you have crowded and misaligned teeth, oral care can be more challenging, leaving areas where plaque and bacteria can build up, which can, in turn, cause bleeding and sensitive gums. Orthodontic treatment straightens the teeth and balances the bite. This makes oral care easier to perform and maintain. Eliminating risk factors associated with malaligned teeth and gingivitis.
- Orthodontics can help reduce bleeding gums by straightening out the teeth and bite, making homecare easier to maintain in the long run.
On the flip side, orthodontics is notoriously challenging to deal with once they are on the teeth. This refers to brushing and flossing every day. I had braces as an adult, and I was shocked at how painful it was, first of all, and how much of a “pain” it was to floss my teeth and brush everywhere. There is nothing more challenging than trying to floss and thread around what feels like a million brackets and wires. Not to mention all the times you accidentally stab your gums or poke the floss through the wrong way as it shreds and then breaks, leaving you to start all over again.
Luckily, I was an adult, a dental professional, and I knew what I was getting into when I signed up for braces. Incidentally, I suffered through it, and after some learning curves, I finally got my brushing and flossing routine down to 10 minutes from my initial 20 minutes. Some people aren’t that lucky, though.
- Orthodontics can indirectly contribute to bleeding gums when homecare is not adequate and regular due to the challenges of performing oral care over brackets and wires.
So if you have braces or orthodontic appliances and have bleeding gums, that’s not normal either, and you need to figure out why and get it corrected. If you are thinking about getting Orthodontics, please understand how to perform oral care at home and see your dentist regularly.
Effective Oral Care
Here I’m going to talk about some of the best practices for good oral care at home. The better you do on your own with oral care, the less likely you will need professional intervention. That doesn’t mean you don’t need to visit the dentist regularly; it just means you should have a lot less for your dentist to discuss with you. And believe it or not, that’s what your dentist wants too.
Brush twice a day, preferably in the morning before breakfast or coffee and in the evening, at least one hour after your last meal.
In the evening, floss. Flossing is how you clean out the day’s food accumulation from underneath your gums and in between your teeth.
Use interdental cleaners, proxy brushes, toothpicks, or any other supportive tool as needed daily.
Before beginning your oral care routine, start with clean hands, washing them with warm soapy water.
Pre-rinse the bristles of your toothbrush with hot water to soften them and remove any debris lingering between the bristles.
Place a small amount of toothpaste onto your toothbrush bristles to brush your teeth. You don’t need a long swirly slab of paste. A pea-sized amount, maybe slightly more, works just fine. Too much toothpaste can clog up the bristles, and if it’s a minty paste, it causes a slight numbing effect in the mouth, which inhibits your ability to feel your teeth to determine how well you are doing with your brushing.
Brush your entire mouth for at least 2 minutes, more if needed but don’t over brush by using too much pressure or scrubbing. Reach every surface of every tooth, and don’t forget to brush the tongue.
When you’re finished brushing, thoroughly rinse the toothbrush bristles with warm or hot water while using a clean thumb to apply a little pressure, rubbing against the bristles, helping to dislodge any stuck food, stain, or debris.
Store your toothbrush upright, not lying down, inside of a closed cabinet. Ensure that air can fully circulate the brush head to air dry completely; you don’t want the bristles to retain moisture.
Replace your toothbrush at least every three months or sooner if needed. Always replace your toothbrush after recovering from an illness.
Floss between every tooth and on the backside of the last teeth on the top and bottom. Use gentle pressure against the sides of every tooth with the floss as you slide the floss under the gums while wrapping it around the front/back of the tooth. This gentle pressure is what removes plaque and bacteria between the teeth.
Spit out any excess and finish with an antiseptic rinse 3-4 times a week.
Diet and Lifestyle
Poor oral care can ultimately lead to innumerable problems. Those problems don’t always stay stationary to your mouth, either. Did you know that when your oral health is poor, not only can it cause disease and irreversible damage in the mouth, it can also harm your overall health?
The connection between oral health and systemic health is intricate, and they affect one another directly and indirectly. Here are just 2 examples:
Active periodontal disease overlaps cardiovascular risks utilizing inflammatory cytokines and antibodies produced in response to infection. Arteries that were measured in a study showed clinical findings that the plaques within the walls of a blocked or diseased artery contained up to 95% bacteria. Of that percentage of bacteria, anywhere between 30-50% contained periodontal pathogens. That means the pathogenic bacteria in our mouths are ending up in our arteries. Our body sends out antibodies to fight those periodontal pathogens anywhere they are located. If those pathogens are within the walls of heart arteries, they will cause inflammation and potentially impact overall health.
- Don’t smoke.
- Know your family history and be proactive with your lifestyle and nutrition.
- Don’t become obese or stay overweight.
- Stay active.
- Take care of your teeth and gums, don’t let oral care fall to the wayside, and get to the point where you get diagnosed with periodontal disease.
People with diabetes are also more prone to infections, overall, but especially in the mouth when their blood sugar is out of control. Glucose is present in the saliva, and when glucose is high in the saliva, it will contribute to the proliferation of harmful oral bacteria. Just like a diet that’s high in sugar can cause oral disease, when the body’s glucose pathways are malfunctioning, the result can be the same, disease progression and systemic inflammation. Inflammation in the mouth from gingivitis or periodontal disease can lessen the body’s ability to control blood sugar, increasing complications as oral health declines and systemic health falters.
Type 2 diabetes is largely preventable and accounts for almost 90% of cases. So prevent it by:
- Keeping your weight under control
- Eating a healthy diet that’s low in processed sugars and carbohydrates
- Don’t Smoke
- Type 1 diabetes is relatively autoimmune, cellular-mediated, with absolute insulin deficiency.
- Treat and control low-grade inflammation.
- See a dental professional regularly and possibly more than what is typically prescribed.
- Some diabetic patients may need to plan for quarterly dental cleanings vs. bi-annually
Be sure to check out our softest toothbrush for sensitive gums, “The Special Soft Toothbrush,” and our toothbrush for sensitive gums, “The Sensitive Toothbrush,” by visiting https://brilliantoralcare.com/collections/manual-toothbrushes. Brilliant has the best toothbrush for sensitive gums and teeth, so don’t forget to #BRUSHBRILLIANT.
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Noelle Copeland RDH is an Oral Care Specialist and Dental Consultant who provides content for Brilliant Oral Care and Baby Buddy.