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

Floss, floss, floss :)

Dental Floss

It's mid November and patients are coming to the dental office to utilize their insurance benefits (a good thing!).  One trend I've been noticing is the hygienist talk to patients about flossing.  So I thought we can go through some benefits and pointers on why the dentist, hygienist, and American Dental Assocation favor the floss so much:

1) Dental floss is a composed of thin filaments; it can be made of plastic or silk, and is sometimes flavored.  Flossing removes food, bacteria, and plaque between the teeth.  It really is the best method to clean between the teeth, and around and underneath the gums.  Left alone, the bacteria can cause interproximal cavities (tooth decay).

The bacteria trapped between the teeth can then seep down into the gums, causing periodontal disease (gum and bone disease), gingival bleeding, and bone loss.

2) Flossing also helps clear out bad breath (halitosis).  The bacteria and food trapped between the teeth and left on the gums/gingiva can cause bacteria to grow within the warm and moist oral cavity, a favorable environment for bacteria.

3) Dental floss supplements tooth brushing.  Though tooth brushing is sufficient at removing bacteria and food debris/plaque, the toothbrush's bristles unfortunately cannot get between the teeth.  Some floss are waxed to facilitate movement between teeth.

4) Kids and adults of all ages should floss.  Ideally one should strive for daily flossing for optimal oral hygiene.  If not, a few times per week is better than no floss at all :)

If you have any questions regarding flossing, be sure to ask you family dentist and/or dental hygienist.  Remember to floss (and brush) lots!

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

Busy lifestyle dental tips...

School is in full force and working parents are busy, constantly on the go.  It can be easy to forget about one's oral health.

Below are some ways to keep one's teeth healthy and in tip-top shape:

1) Brush twice a day with fluoridated toothpaste to strengthen your teeth's enamel.
2) Floss at least once a day to help remove bacteria and food trapped between the teeth (ie. the interproximal surfaces).  This will also help reduce your gums from bleeding, and help control gingivitis.
3) Eat healthy foods (ie. fresh meats, vegetables, milk) to promote good oral and systemic health.
4) Mouth wash to help rinse off excessive plaque and loosen food debris from the teeth
5) Drink milk fortified with Vitamin D, preferably 2-3 servings a day.  The calcium and vitamin D will not only strengthen your body's bones, but also the bones holding your teeth as calcium also plays a role in teeth retention.  For those lactose intolerant, look for milk products that are lactose free.
6) See your dentist regularly twice a year for checkups and cleanings.
7) Limit sugar frequency; it's okay to eat sugar, just make sure the sugar intake is in controlled quantities and that one brushes his/her teeth after sugar consumption to decrease caries/teeth cavities risk.
8) For those who travel, considering having a travel sized pouch with toothbrush, toothpaste, and floss.

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

Happy October 31st! Healthy benefits of sweets, and teeth!

October 31st is finally here!  Many kids and families celebrate harvest on this day, and it usually involves lots of sweets and sugars!  Believe it or not, your family dentist may actually be in favor of kids and adults eating sweets.  Below are some guidelines to follow from a dental perspective:

• If possible, avoid hard whole sugar candies.  People usually like to leave these candies long term in the mouth, as the sugars from these candies can promote caries and cavities.  The bacteria in the oral cavity metabolize the sugars, resulting in a release of lactic acid that can cause dental decay.  A good alternative is to look for sugar free hard candies if possible.
• Chocolate is good for you! JAMA and ADA studies have shown that cocoa has excellent health benefits for the cardiovascular system, and for your teeth and oral health.  Chocolate, which is derived from cocoa beans, contain antioxidants polyphenols, flavonoids, and tannins.  Polyphenols actually inhibit bacteria effects, which can decrease bad breath and lower risk of tooth decay.  Flavonoids have been shown to decrease rate of tooth decay.  And tannins have been shown to prevent bacteria from adhering onto teeth.  Dark chocolate is best, and try to choose chocolate that is at least 70% cocoa for optimal health and dental benefits.  
• Chewing gum can help lower risk of cavities by promoting salivary flow.  With a healthy and excess flow of saliva, it helps "wash" teeth of plaque and sugars.   Watch out for gums that contain large amounts of sugars.  Sugarless gum is a good alternative to consider.

October 31st is a great time for adults and kids alike. Be safe everyone, and feel free to ask your family dentist if you have any questions on sugars and oral health.

From your local family Bellevue dentist,
Dr. Peter Chien
www.bellevuefamilydentistry.com
(425) 614-1600

Dental cavities linked to lower risk of head and neck cancer

From the JAMA Otolarynology - Head & Neck Surgery, a new study conducted by scientists at the University of Buffalo in New York is suggesting that people with MORE cavities are actually at LOWER risk of developing head and neck cancer.

How are dental caries/tooth decay formed?  Persistent bacteria that remain on teeth feed on the plaque left over from food debris; as a result the bacteria release lactic enzyme that demineralize and literally erodes the enamel, causing a cavity and sometimes necessitating the need for a filling.  

The study suggests that aside from the harmful effects of the bacteria in the mouth on the teeth, these bacteria are actually beneficial in the saliva and inside the mouth's mucosa, and may be a protective factor against head and neck cancer.


Read more about this study here:  http://www.universityherald.com/articles/4543/20130914/dental-cavities-lower-risk-head-neck-cancer-study.htm


Now does this mean that one should actually stop brushing and flossing?  Probably not, but rather take this article in heart and realize that one's oral health and body work in concert. Twice a day brushing combined with daily flossing is recommended for optimal oral and systemic health.

If you have any questions or concerns regarding oral hygiene, be sure to ask your family dentist or hygienist.  Have a great one!

From your Bellevue Dentist,
Dr. Peter Chien
(425) 614-1600
www.bellevuefamilydentistry.com

Baby boomers!

Americans are living longer than ever, and the segment of population >65 years old is expanding.  Hence it's even more important to take preventive measures to maintain your oral health, and the best way begins at home.  Daily brushing with a soft tooth brush and fluoridated toothpaste after meals, along with flossing one to two times a day, is a great and effective way to keep your teeth and gums healthy and free of plaque.  If you have a denture, be sure to brush it every day as well so its free of plaque and food debris.  Soaking the denture daily it in a denture cleanser is also a good way to keep your gums and adjacent teeth healthy.

Be sure to consult your dentist if you have any questions regarding preventive oral hygiene.

Warm Regards from your family Bellevue Dentist,
 Dr. Peter Chien
www.bellevuefamilydentistry.com
425-614-1600

Now that summer is about to end and fall about to start, parents and kids alike are often in that "back to school" rush.  Mornings are often busy times as the family is getting ready for school and work.  Try to take a few minutes of everyone's time to sufficiently brush for at least 2 minutes in the mornings. A good measure would be to try singing the ABCD song 2 times.  By the time the song is over, the brushing is done!

Then in the evenings, try and repeat the 2 minute brush cycle.  With a regular routine set aside, brushing becomes "automatic" and promotes healthy gums and teeth :)

From your family Bellevue dentist at Bellevue Family Dentistry,
Peter Chien, DMD
www.bellevuefamilydentistry.com
425-614-1600