why do my gums bleed?

Bleeding Gums

Why do my gums bleed?  Common complaint patients say to me is their gums bleed when brushing their teeth or when they are flossing.  And as such bleeding gums is often a sign of bacterial infection and gingival irritation.

What are some causes of bleeding gums?

• Gingivitis - Gums are irritated and may be swollen.  This may be due to plaque and bacteria buildup along the gum line, and is typically from insufficient brushing and flossing.  
• Periodontitis - Gums and supporting bony structures of the teeth have bacterial and calculus (hardened bacteria and plaque buildup) irritation.  
• Pregnancy - Swollen and bleeding gums may occur during pregnancy due to increased level of progesterone. 
• Immunosuppressants - Patients who have undergone organ transplants may be placed on medications such as cyclosporine.  Cyclosporine is an immunosuppressant used in organ transplant recipients and for psoriasis.  Calcium channel blocker agents such nifedipine and amlodipine have also been associated with gingival overgrowth.  Nifedipine and Cyclosporine may cause drug-induced gingival overgrowth, and thus in combination with plaque buildup, this leads to bleeding gums. 

How to treat bleeding gums?

Primary method would be to ensure daily habit of brushing and flossing.  Regular 6month checkups and dental cleanings are helpful  Main benefit of using dental floss is that it physically removes bacteria and plaque trapped in between the teeth and along the gum line.  A water pick may also be a useful adjunct tool.

Bleeding gums due to periodontitis may require a "deep cleaning" or root scaling and planing to remove hardened bacteria and calculus beneath the gum line.  After the deep cleaning is done, more frequent maintenance cleanings and diligent at-home care may be required to prevent the calculus buildup from reoccurring.

Pregnancy induced gingival overgrowth and bleeding gums would require the patient to be extra diligent with daily brushing and flossing.  After delivery when progesterone levels go back to normal levels, the gum inflammation and swelling would typically improve on its own.

For those on immunosuppressants such as cyclosporine and nifedipine, regular dental cleanings and at home daily brushing and flossing is critical to ensure optimal gum health.  Good oral hygiene is critical to ensure teeth and gums stay healthy during treatment.

If you have any questions regarding why your gums bleed, be sure to consult your family dentist and hygienist. 

From your gentle family dentist in Redmond and Bellevue,
Peter Chien, DMD, MPH
www.bellevuefamilydentistry.com
(425) 614-1600

Signs Teeth Need a Dental Cleaning

Bleeding Gums

So it's been a little while since you or your kid had your teeth cleaned.  Do the teeth appear more "yellow?"  Are the gums feeling itchy?  Do your gums bleed when brushing?  You may be wondering what's going on with your teeth and gums.  Today we'll discuss some of the common signs you may benefit from a dental cleaning.

BLEEDING GUMS

If you notice your gums bleed when brushing, it may be a sign of gingivitis or periodontitis.  If it's due to gingivitis (gum inflammation), then sometimes a simple course of oral hygiene instructions and regular dental cleanings (usually every 6 months) would help reduce gingival bleeding when brushing.

If bleeding gums are due to periodontitis, you may have hardened plaque and buildup beneath your gumline.  If such is the case, you may benefit from a deep cleaning, where the hygienist or dentist would generally apply local anesthetic.  They would then scale and clean areas beneath the gum line to remove hardened plaque deposits (calculus) that may be causing the gums to bleed and also subsequent bone loss. 

If you notice your gums bleed when you floss, the same treatment apply above as with bleeding gums.  Patients sometime will let me know their gums bleed when they floss, and they stop flossing as a result.  My recommendation would be to continue flossing on a daily basis, along with twice a day brushing.  Gums that bleed when one flosses is the body's sign that the gums are irritated by bacteria and/or hardened plaque.  By continuously flossing this allows repetitive bacterial removal, and eventually the bleeding will stop.

BLEEDING GUMS MAY ALSO BE A SIGN OF OTHER SYSTEMIC FACTORS.

Such factors may include:

• Scurvy (lack of vitamin C)
• Pregnancy
• Leukemia
• Brushing and/or flossing excessively hard
• Vitamin K deficiency
• Improper fitting denture
• Systemic infection
• Tooth infection

STAINED TEETH

If you noticed a gradual darkening of your teeth, this is called extrinsic staining.  Oftentimes due to foods and drinks such as coffee, tea, red wine, and blueberries may cause certain parts of the teeth to have dark or grey streaks and spots.

Your dental hygienist or dentist may use a scaler or cavitron to physically debride and remove such stains.  Be advised though if the teeth have been internally grey, such stains are called intrinsic stains and cannot be removed with a dental cleaning.  Such stains may require teeth whitening or possible porcelain veneers depending on the severity of the staining.

BAD BREATH

If you notice you have bad breath, also called halitosis, it may be due to two factors:

• Bacterial buildup on the tongue - Look at the top surface of your tongue and see if you notice a white, grey, or dark coating.  A normal tongue should be bright pink and red.  If such is the case, this dark coating is an abundance of bacteria that usually causes bad breath, and needs to be removed.  I recommend brushing the tongue with a tongue scraper to remove the bacteria.
• Bacterial buildup around and beneath the gums - If you notice a soft white and/or yellow buildup foam/film around the gums, this foam is a buildup of bacteria and remaining food particles.  You may benefit from a re-evaluation of your brushing/flossing habits, along with a possible dental cleaning.

In certain cases a referral to a periodontist (gum specialist) may be required.  If you have any questions on bleeding gums, be sure to consult your family dentist or dental hygienist.

From your gentle family and kids dentist in Bellevue,
Dr. Peter Chien
www.bellevuefamilydentistry.com
(425) 614-1600