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What do Bleeding Gums Mean?

What do Bleeding Gums Mean?

Problems such as bleeding gums can be a sign that your gumline is not being properly cared for and may need more attention. While you don’t need to panic if you notice that your gums bleed, you do need to take action to help prevent the progression to a more advanced form of gum disease. Most commonly, gingivitis (inflammation of the gums) is the result of plaque – a sticky film of bacteria forming on the teeth around the gumline or under the gums. Plaque bacteria can lead to gum disease, tooth decay, and even tooth loss.

The Most Common Cause of Bleeding Gums

In most cases, gums bleed because of the harmful plaque – and the millions of bacteria in it – found at or around the gumline being left to develop gingivitis. Gingivitis, the early, yet still reversible form of gum disease, may require treatment and an improved oral hygiene routine to help reverse it.

When gingivitis begins to cause irreversible damage to the gum tissues or bone, the diagnosis would be periodontitis, or periodontal disease.

How to Stop Bleeding Gums

There are many ways to help improve your oral health and keep your gums from bleeding. Since gingival bleeding is mainly due to inadequate plaque removal from the teeth at or around the gumline, starting an effective oral hygiene routine is a great way to help treat and prevent your gums from bleeding.

Brush at least twice a day: Make sure to brush the dentist-recommended two minutes every session to better remove any plaque that can lead to gum disease and tooth decay. Consider switching to an electric toothbrush like the Phiips Sonicare

Clean in between your teeth: Flossing, softpicks or using proxabrushes between your teeth at least once or twice a day is one of the most important ways to help prevent bleeding gums and maintain good oral health. It removes plaque and food particles that may be just under the gumline between the teeth, which is where gum disease often starts.

  • Avoid Tobacco: Tobacco use of all types can damage your gums and can also make you far more likely to develop gum disease.  ***Smoking can mask severe gum disease, as bleeding is minimal or non-existent in smokers, but the damage to the tissues is occurring faster, with the blood supply cut off to help the tissues heal. Also, tar builds up on the teeth and harbors even more harmful plaque bacteria.
  • See a Dental Professional Regularly: Harmful plaque bacteria can even lead to issues beyond gingivitis like weakened tooth enamel. Regular dental hygiene visits at your dentist or periodontist’s office will remove plaque and tartar that can’t be removed at home. This will help prevent gums from bleeding and keep your mouth healthy.
  • Maintain a Healthy Lifestyle: The American Dental Association (ADA) recommends eating a balanced diet and avoiding between-meal snacking. Also, reducing stress from your life can help prevent gum disease to keep your smile healthy.

NEW STUDY LINKS GUM DISEASE AND COVID‐19 COMPLICATIONS

A team of international researchers published their findings in the Journal of Clinical Periodontology this month stating that patients with Gum Disease are more likely to have severe complications from COVID-19. 568 patients were studied and those with periodontitis – the most severe form of gum disease – were more likely to experience COVID‐19 complications. These complications included including death, ICU admission, and the need for assisted ventilation.

Dr. Todd Britten, a periodontist in Clearwater, Florida says that this study reinforces what he tells his patients every day – Oral health is extremely important for overall health. “This study, showing that patients with gum disease are at least three times more likely to have severe complications from the COVID-19 virus, shows us that treating and controlling periodontal disease remains extremely important, even in a pandemic.”

Dr. Britten stressed this study shows patients should still continue to see their periodontist or dentist. “Depending on your needs, your dentist or periodontist can treat gum disease infection through surgical or non-surgical therapy.” Dr. Todd Britten also said it is crucial that patients also keep dental hygiene cleaning visits to prevent gum disease and for those who have been treated for gum disease in the past stay on a 3 or 4 month schedule with their dental hygienist to avoid periodontal reinfection.

The findings also show the importance of good oral hygiene care at home during the COVID-19 pandemic, says Dr. Britten. According to the Academy of Periodontics, the nation’s leading organization of periodontists, “systemic inflammation is not only linked with periodontal disease, but to several other respiratory diseases as well.” Dr. James G. Wilson, President of the AAP states that this study linking periodontitis and COVID-19 complications, “Therefore, maintaining healthy teeth and gums in an effort to avoid developing or worsening periodontal disease is absolutely crucial in the midst of a global pandemic like COVID-19, which is also known to trigger an inflammatory response.” Dr. Britten states he emphatically agrees with the AAP.

What you need to know about smoking and gum disease

Dr. Britten is highly concerned about his patients who smoke. The likelihood of developing advanced periodontal disease or gum disease can be up to six times higher in smokers. Periodontal disease is an extremely serious condition affecting not only the gums, but also the membranes and ligaments and bone supporting the teeth.

Many studies on smoking and periodontal disease have concluded that smokers have:

  • Deeper probing depths and a larger number of deep pockets in the gums.
  • More attachment loss including more gingival recession
  • More alveolar boneloss & tooth loss
  • Less gingivitis and less bleeding on probing
  • One of the major problems with smoking is that it tends to mask the damage being caused to teeth and gums. This damage can be difficult to detect, producing very few early warning signs of advanced periodontal disease. For years it was thought that nicotine being a vasoconstrictor was causing less blood flow to the gums, causing less infection-fighting white blood cells to reach the area.  Newer studies are showing that smoking appears to have a long-term affect the inflammatory lesions, or diseased gums of smokers, which have less blood vessels in them than in non-smokers.
  • More teeth with furcation involvement (where the bone levels have been destroyed below the area where the roots of the teeth meet, leaving this area exposed, making it prone to further destruction as well as decay.
  •  Additionally, nicotine affects saliva, causing it to become thicker so it is less able to wash away acid created after eating. As a result heavy smokers can be more likely to suffer from tooth decay than non-smokers, even though they may practice good oral hygiene.Smoking has a profound effect on the immune and inflammatory system. Smokers have more infection-fighting cells in their body, but fewer of these helpful cells make it into the gingival pocket. Studies also show that these good cells have a decreased ability to accomplish their function, which is to destroy harmful periodontal bacteria. Adhesion molecules are being found within smoker’s tissues, in the white blood cells, in the inflammatory lesions, and even in the supporting gingival tissues. Studies have shown impairment in defensive functions of other defensive blood cells, even those using smokeless tobacco due to the high concentrations of nicotine.Smoking also impairs the healing of dental implants and even in the healing from all other aspects of peroidotnal treatment including non-surgical treatments (including scaling and root planing or “deep cleaning”), surgical treatment, bone grafting and tissue grafting. Studies have shown that tobacco smoke and nicotine affect blood vessels in the gums, healthy bone-building cells, connective tissue matrix, the jaw bone and even the root surface itself. Tooth root surfaces in smokers have actually been shown to be contaminated by products of smoking such as nicotine, cotinine, acrolein and acetaldehyde, which may inhibit the gum tissue from healing around the roots of teeth as they should.  Smoking has been shown to affect human bone, and is a risk factor for osteoporosis, which is also a risk factor for periodontal disease.

    As a periodontist, Dr. Britten is a specialist in treating advanced periodontal disease and is able to provide patients with the very latest techniques and treatments to help slow down this condition. Where teeth are lost then one option is to replace them with dental implants, but smoking is not advisable during this treatment because it does slow down healing.

    If you do currently smoke and value your smile, it’s worth thinking about quitting.

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This is How to Prevent Re-Infection of Your Gums After Periodontal Treatment

If you’ve undergone treatment for periodontal (gum) disease, you know how involved it can be, whether your treatment required nonsurgical therapy, surgical therapy or a combination of both.

Following gum surgery or scaling and root planing, a nonsurgical periodontal therapy, plaque and calculus (hardened plaque deposits) are removed and as they heal swollen, red gums finally begin to regain their healthy pink color.

Treatment does not stop there. If it does, there’s a high chance of a re-infection of the gums.

Periodontal maintenance (PM) is important for gum disease patients after treatment. Plaque, a thin film of bacteria and food particles responsible gum disease, continue to grow again on your tooth surfaces as it did before. Diligent, daily brushing and flossing to curb that development.

It is also important to keep up regular dental visits for advanced cleaning to remove hard to reach plaque and calculus. For patients with gum disease it is usually four but for some advanced gum disease patients, six times a year, especially just after treatment. Many of our patients alternate visits for periodontal maintenance between our office and their general dentist so that their periodontal condition is closely monitored, as well as the health of their teeth.

Our goal is to reduce the chances of re-infection. To do this, we’ll thoroughly examine your teeth, gums and any implants for signs of disease (as well as an oral cancer screening). This includes an assessment the health of your teeth and gums and to see how well you’re doing with plaque control and review your recommended customized daily oral hygiene instructions.

Overall, we want to prevent the occurrence of any future disease and treat it as soon as possible if it relapses. Keeping up with homecare and a routine periodontal maintenance schedule will help ensure your gums continue to stay healthy.

If you would like more information on periodontal disease, please contact us or schedule an appointment for a consultation 727-586-2681.

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