It starts with redness and inflammation, and then your gums may begin to bleed when flossing and brushing. At Sunrise Dentistry, one of the things we evaluate during a new patient exam is the wellness of your gums. One of the reasons our patients must fill out a health history form when they become a new patient is that there are common conditions, medications, and behaviors that can alert the dentist to reasons behind such things as weak teeth and bones, or gum disease. So, let’s start with some of the most common reasons for inflamed and bleeding gums, and then we’ll talk about what to do about it.
What Causes Gum Problems?
Poor hygiene and some lifestyle habits can hamper your oral health.
Smoking increases the risk of gum disease. It interferes with the PH balance and natural flora in the mouth and negatively effects the healthy functioning of the cells of gum tissue. The more cigarettes smoked and the longer years smoked, the more a person is at risk of periodontal disease, which cannot be reversed.
Not Brushing and Flossing
As days pass without brushing and flossing, plaque remains on the teeth and produces toxins that inflame the gums. Over time, the gum tissue starts to separate from the teeth, creating a pocket. The deeper the pocket, the more bacteria will collect in it. If a person combines a habit like not brushing and flossing with another factor that harms the gums, this process is likely to be accelerated, leading to damage like abscesses, abfractions, bone loss, and eventually the loss of a tooth.
People who do not eat a healthy diet are at higher risk for tooth and gum disease. Eating a diet high in starchy carbohydrates, sugars, and sugary drinks and juices increases harmful bacteria in your mouth. In addition, a poor diet does not usually provide adequate healthy vitamins and minerals to sustain the health of the body, including the teeth and gums, or give us the basic elements necessary to help us heal them. If you know you have a poor diet, work on changing it, and while you are working on that, be sure you brush and floss at least twice every day.
Clenching and Grinding
We see evidence of clenching and grinding in our patients every day. Often times, patients immediately say they don’t do that. While most of us are usually aware of what we are doing with our bodies when we are awake, we really don’t know what they are doing at night when we are sleeping. A person who has sleep apnea is likely to clench and grind their teeth, a result of the body trying to breathe and panicking.
Some big, telltale signs of clenching and grinding are include worn down cusps on the cuspids, especially the back molars and premolars. In patient x-rays, there will be evidence of angled bone loss and widened periodontal ligaments. People who grind and are not protecting their teeth with a hard acrylic nightguard are stressing the teeth and all the supporting structures like the gums, periodontal ligaments, and bones much more than normal. This can make the teeth hypersensitive and the whole supporting structure achy or painful.
Over time and without treatment, the teeth may start to move around. The space that is created between the tooth and the gum through extended clenching and grinding allows bacteria to penetrate deeper into the gum line, leading to inflamed gums, infection, bone loss and often, eventually an abscess that results in the patient needing to have the tooth extracted or treated with a root canal. Sometimes a dentist might know better than the patient whether or not they are grinding or clenching their teeth. This is also known as bruxism.
Other risk factors include stress, hormonal changes in females, onset of illnesses, and a need for medication. Also, genetic susceptibility can play a factor, making some people more likely to develop gum disease.
Now that you know the most common causes and risk factors that contribute to gum disease, let’s look at what you may need to do about it.
How Do You Treat Common Gum Problems?
Ideally, you want to know about the condition of your gums through a diagnosis with your dentist. If you do have regular gum bleeding, you should have your teeth and gums evaluated. Bleeding gums are not normal. The diagnosis should come with a set of x-rays. X-rays don’t just show us the condition of teeth; they also show the condition of gums and bone.
The other diagnostic tool that is used by both dentists and hygienist is the evaluation of the periodontal pockets around the teeth. This is done with an instrument called a periodontal probe. The probe measures the depth between healthy gums and each tooth. The average depth should be about 3 millimeters or less. The larger the depth, the more serious the degree of periodontal disease.
The less serious condition is called gingivitis. This part of the progression of gum disease is the only one that can be reversed. If the patient has excessive buildup on their teeth, it may require a debridement be done first. Once a person has progressed past gingivitis, the damage that has happened cannot be reversed, and the patient may need to be referred to an endodontist or a periodontist specialist in order to receive treatment.
Scaling and root planing is when the hygienist uses a small scaler or ultrasonic scaler to clean all of the periodontal pockets. This will remove all the plaque and tartar to the bottom of each pocket. After the scaling, the root surfaces of the teeth are planed or smoothed so that the gum tissue can heal and reattach to the teeth. The gums are given some time to heal before the next appointment, when the dentist or hygienist will evaluate the healing to determine if any further treatment is needed. Sometimes there are only a few teeth with pockets severe enough to require this procedure, and sometimes all of the teeth need it. It also may require several appointments.
If the gum disease is particularly severe, your dentist may refer you to a periodontist. A periodontist is a dentist that specializes in treating diseases that affect the bone and gum tissue. The periodontist can perform periodontal surgery, in which inflamed tissue is removed. This reduces the occurrence of additional bone damage and allows more space for the periodontist to access areas where tartar and plaque can accumulate. Other surgeries that may be needed include bone grafts and gum grafts.
Signs and Symptoms of Gum Disease
How do you know if you have gum disease? Any of the following can be an indication of a gum problem:
- Tender, bleeding gums
- Red and swollen gums
- Sensitive teeth
- Painful chewing
- Bad breath
- Loose teeth
- Pus around the teeth and gums
- Bad taste
- Changes in the way partials fit
It is possible to have no symptoms at all, so don’t rely on symptoms showing up before seeing a dentist.
In the simplest terms, gum disease is an infection of the bones and gums that support the teeth. Significant evidence has shown a possible correlation between gum disease and other health issues like diabetes, cardiovascular disease, bacterial pneumonia, and stroke.
A healthy diet helps us avoid the systemic imbalance that makes us much more prone to teeth and gum problems, as well as these other health concerns. If you are not sure what a healthy diet is, discuss that with a health care professional that understands how critical diet is for your overall health.