It was a Monday morning at the dental clinic and Miss Ng walked in to see me. Young, graceful and elegant, she sat down in the dental chair. “Doctor, I need your help. My gums are bleeding and I don’t know what’s wrong,” she uttered in dismay. I listened to her concerns and offered to examine her to understand more about what could possibly be going on.
“Right, I’ve had a good look at you and your gums appear to be bleeding with some deep pocketing around the teeth,” I said as I finished her examination. After explaining the nature of gum disease and ‘deep pockets’, we decided that she would definitely benefit from a good professional clean and some homework that could be a game changer — interdental cleaning.
What Is Gum Disease?
Gum disease (known in the dental profession as gingivitis) affects 90% of people worldwide. I see it in action every day in most of my patients.
The most common cause for this is poor oral hygiene. Dental plaque (which forms when too much sugar combines with bacteria) sits on the tooth and around the edges of the gums. This can irritate the gums and the gums start to bleed. At this stage we have a reversible condition called gingivitis.
If the plaque hangs around for too long, the gum can start to drop back. Underneath the gum we have bone that supports the teeth. Think of this as scaffolding for the teeth. As the gum drops back, so does the bone and we end up in trouble over time as the teeth become shaky or ‘mobile’. This is not reversible and is known as periodontal disease.
Gum disease has several contributing factors including dental plaque, stress, epigenetics, smoking, diabetes, mouth breathing, hormonal changes, dry mouth and gut issues amongst others. The baseline in stopping bleeding gums is getting the teeth nice and clean. Once they are clean we can then see if there are any issues within other systems of the body that are affecting the gums.
What Are ‘Deep Pockets’?
Deep pockets occur when the gum moves away from the tooth. In these cases, the dentist can get a special instrument called a probe further down between the gum and the tooth than they should be able to. You may experience bleeding, pain, sensitivity or even shaky teeth in severe cases. We want to avoid these symptoms so that your smile is kept healthy.
What Is Interdental Cleaning & Why Should I Do It?
The mouth is the perfect environment for bacteria. Usually this bacteria is in balance and does not cause any harm. With eating and drinking all day long, when we consume too much sugar, there is a tip in the balance. We then get a build up of dental plaque, not only on and around the teeth but also IN BETWEEN the teeth. There is no way we can get this out by using a conventional toothbrush.
Enter interdental cleaning. This should be done once a day AS WELL AS brushing.
3 Ways Of Interdental Cleaning
Flossing has received some bad press over the years but remains a useful tool for removing dental plaque from in between the teeth. It requires a little concentration at first but is easy once you get the hang of it.
2. Interdental brushes
These are a little brush on a handle that can be pushed in between the teeth. Most people find them easier to use than floss and evidence shows that these brushes are very effective at removing plaque.
Waterpiks fall under the category of ‘oral irrigation’ and are high pressured water jets that are hand held and are directed between the teeth. I have seen these work wonders for patients. Evidence shows that oral irrigation is an effective tool when used with brushing to reduce plaque and bleeding in the mouth.
Not Sure What’s Going On?
If you cut your hand and it was bleeding every day would you see a doctor? Of course you would. The problem is, we can’t see what’s going on underneath the level of the gums. Bleeding gums could also be a sign that there’s something not right in the body. If left untreated it can progress and can even cause other health issues. If your gums are bleeding on brushing, see a dentist for an assessment. You may need some help with removing dental plaque that is stuck to the teeth or we may need to look at the rest of the body to get to the root cause. Until next time, keep brushing and keep smiling.