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

Pregnancy, Babies, and the Dentist

If you are pregnant or trying to become pregnant, you should inform your dentist so he or she can help you achieve optimal oral health for yourself and your baby.  It is recommended you continue your regular exam and dental cleaning schedule as recommended by your dentist.

Dental Tips for Pregnant Moms

• Brush your teeth twice a day with fluoridated toothpaste to remove plaque buildup.
• Floss daily to help remove plaque between the teeth.
• Inform your dentist and physician of any changes in your health, medication, and diet.
• Any elective dental procedures should be delayed until you give birth.  If dental treatment is necessary and recommended by your dentist, your dentist and obstetrician will advise you of any precautions to be taken. 
• Moms may develop pregnancy gingivitis, gum inflammation that may include swollen and bleeding gums.

What is Pregnancy Gingivitis

• Pregnancy gingivitis is gum inflammation induced by the mother's fluctuation in estrogen and progesterone.  Symptoms may include swollen and bleeding gums, sensitive teeth and gums, and gingival recession.
• Pregnancy gingivitis is common during the second through eighth month of pregnancy.
• Your dentist may recommend additional dental cleanings if the gingivitis promotes excessive bleeding and plaque buildup.

Nutrition Tips for the Mother

• Your baby's teeth develops during the first trimester, hence adequate calcium and vitamin D intake is important for baby's optimal teeth development
• A well rounded diet during all trimesters of pregnancy is needed for your baby to develop his or her teeth.  A balanced diet of fruits, vegetables, dairy, lean proteins, and essential fats is recommended.
• Morning sickness and nausea can make morning brushing difficult.  Be sure to consult with your dentist and obstetrician if you are not able to brush in the morning.
• Be sure to drink abundant amounts of water and calcium.  Water is good for your body and your baby's development.  Daily intake of water will also help clear your teeth free of plaque when you are not able to brush and floss consistently. 

If you have any questions or concerns regarding pregnancy and how it may affect your newborn, be sure to consult your family dentist.

From the desk of your gentle dentist in Bellevue,
Peter Chien, DMD, MPH
www.bellevuefamilydentistry.com
(425) 614-1600

Pregnancy and Going to the Dentist

Pregnant? Might be time to the dentist!

There has long been a common misconception to avoid the dentist when one is pregnant.  The previous thought process was that dental treatment may cause complications during pregnancy.  However recent studies are suggesting that going to dentist while pregnant is actually a good idea because of the excessive time constraints the newborn baby may likely require after the mother has given birth.

Physicians and researchers have determined that a pregnant woman's oral health can directly affect the newborn's systemic and oral health.  For example, a common health concern is cavity causing bacteria such as Streptocacus Mutans can be directly transmitted from the mother to the fetus.  The newborn baby may then be exposed to the bacteria, which can then multiply and grow in the fetus' body, affecting the tooth's development even before the teeth are erupted.  Such excessive bacteria, if not removed, may increase risk of tooth decay and subsequently periodontal and gum disease.

Another common occurrence is if an expectant mother is experiencing tooth pain or has a dental emergency related infection, this may cause physical stress on the mother, which may then indirectly cause systemic stress on the fetus.

Unfortunately most pregnant mothers do not receive sufficient dental care.  Census data in 2010 from the Center for Disease Control show that less than fifty percent of expectant mothers had a dental cleaning while they were pregnant.

It is our hope to increase public awareness the importance of seeing a dentist when a mother is pregnant.  If you have any questions regarding pregnancy and its relationship on the mother's and newborn's oral health, be sure to consult with your family dentist and hygienist.

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

Pregnancy and Dental Visits

As I see more and more pregnant women in the Bellevue, WA and Redmond area, I have found that pregnant women sometimes tend to neglect their own dental health.   They may delay or ignore their dental cleanings or treatment due to their pregnancy.   It is important to not only the mom-to-be, but also to the unborn baby, to continue with routine cleanings and careful management of dental decay and infection. Long term studies have shown pregnant women who do not take care of their dental health are at an increase risk for having an early premature delivery, which in turn increases the risk of having a low-birthweight baby. 

By working very closely with your primary care physician and obstetrician/gynecologists your dentist will work to ensure your oral health is at satisfactory so that mom and baby will be healthy and happy!   

From your family Bellevue dentist, 

Dr. Peter Chien

If you have any questions, feel free to contact us at 425-614-1600 or through our website:
www.bellevuefamilydentistry.com