Bleeding gums refers to a clinical state in which the gums appear swollen and often bleed during brushing your teeth or eating. The gums are the protector around the teeth. Below the gums, there is periodontium – it is the inner layer that protects the teeth. The infection of the gums manifests in many ways.
What are Bleeding gums?
The gums are attached to the teeth at the junction of crown and root. There is a small gap in between the tip of the gums and tooth surface. It is around 1-3mm and is normal. The problem begins when you don’t maintain the teeth and gums appropriately. There will be accumulation of small food debris, bacteria. The constant deposition of foreign materials leads to irritation of gums. The inflammation of gums is called gingivitis.
There are 4 signs of inflammation of gums – redness, heat production, pain, swelling and loss of function.
What are the causes of bleeding gums?
- Poor oral hygiene
- Some medical conditions like cancer, uncontrollable diabetes show bleeding gums even for less amount of deposits
- Its normal to have bleeding gums during pregnancy and early puberty. It resolves by meticulous oral hygiene practices and with time.
- New toothbrush – can cause trauma to the gums and cause bleeding.
- New flossing techniques – can cause bleeding due to trauma
- Pregnancy gingivitis – in the gestation period of 9months there is bleeding from gums even when less amounts of deposits are present. It resolves after delivery.
- Puberty gingivitis – it occurs during the first few months of puberty due to hormonal changes. It resolves on maintaining good oral hygiene and after few months of puberty.
- Other causes – vitamin C deficiency, Vitamin K deficiency, blood cancers
How does the bleeding gums affect the patient?
- You may have any one or all of the features of gum infection. Bleeding from gums on brushing, bleeding from gums on eating hard food, bad breath, red coloured gums, loosening of teeth, food getting lodged in between teeth and gums, dull itchy sensation in all the gums, sensitivity of teeth.
- Incases of severe gum infections – tooth loosen, pus discharge occurs from gums.
Bleeding gums treatment :
Your dentist will categorise the severity of the gum bleeding. The treatment would vary from patient to patient. They can include
- Deep Cleaning (Scaling and Root Planing):
The dentist or periodontist, removes the plaque through a deep-cleaning method called scaling and root planing. Scaling refers to scraping off the tartar from above and below the gum line. Root planing gets rid of rough spots on the tooth root where the germs gather, and helps remove bacteria that contribute to the disease. It show immediate relief in few days.
Medications may be used with treatment that includes scaling and root planning, but they cannot always take the place of surgery. Depending on how far the disease has progressed, your periodontist may still suggest surgical treatment.. Listed on the next page are some medications that are currently used.
|Medications||What is it?||Why is it used?||How is it used?|
|Prescription antimicrobial mouth rinse||A prescription mouth rinse containing an antimicrobial called chlorhexidine||To control bacteria when treating gingivitis and after gum surgery||It’s used like a regular mouthwash.|
|Antiseptic chip||A tiny chip of gelatin filled with the medicine||To control bacteria and reduce the size of periodontal pockets||After root planing, it’s placed in the pockets where the medicine is slowly released over time.|
|Antibiotic gel||A gel that contains the antibiotic doxycycline||To control bacteria and reduce the size of periodontal pockets||The periodontist puts it in the pockets after scaling and root planing. The antibiotic is released over a period of about seven days.|
|Antibiotic microspheres||Tiny, round particles that contain the antibiotic minocycline||To control bacteria and reduce the size of periodontal pockets||The periodontist puts the microspheres into the pockets after scaling and root planing. The particles release minocycline slowly over time.|
|Enzyme suppressant||A low dose medication of doxycycline||To hold back the body’s enzyme response — If not controlled, certain enzymes can break down gum tissue||This medication is in tablet form. It is used in combination with scaling and root planing.|
|Oral antibiotics||Antibiotic tablets or capsules||For the short term treatment of an acute or locally persistent periodontal infection||These come as tablets or capsules and are taken by mouth.|
Surgery might be necessary if inflammation and deep pockets remain following treatment with deep cleaning and medications. A periodontist may perform flap surgery to remove tartar deposits in deep pockets or to reduce the periodontal pocket and make it easier for the patient keep the area clean. This common surgery involves lifting of the gums and removing the tartar. The gums are then sutured back in place so that the tissue fits snugly around the tooth. After surgery the gums will heal and health of tissues is restored.
Bone and Tissue Grafts:
In addition to flap surgery, your periodontist may suggest procedures to help regenerate any bone or gum tissue lost due to periodontitis. Bone grafting, in which natural or synthetic material is placed in the area of bone loss, can help promote bone growth. A technique that can be used with bone grafting is called guided tissue regeneration. In this procedure, a small piece of mesh-like material is inserted between the bone and gum tissue. This keeps the gum tissue from growing into the area where the bone should be, allowing the bone and tissue to regenerate. Growth factors – proteins that can help your body naturally regenerate bone – may also be used..
Treatment results depend on many things, including how far the disease has progressed, how well the patient keeps up with oral care at home, and certain risk factors, such as smoking, which may lower the chances of success.
The suitable treatment to you will be assessed by your dentist. Early attention and good oral hygiene maintenance will help you in having healthy gums.
About the Doctor
Dr. Gowtham Kattamuri
Dr. Gowtham has done his BDS from Rajiv Gandhi University of Health Sciences in 2006 and MDS – Conservative Dentistry & Endodontics from Dr. MGR Medical University in 2010. He is a skilled Endodontist with an experience of over 10 years. Dr. Gowtham is specialized in replacement of teeth, Dental Implants, prosthetics for maxillofacial defects such as artificial eye, ear, nose and orbital defects, Smile Makeovers with laminates, Zirconia, veneers metal free ceramics. He also performs general dental procedures such as restorations and extractions. He also is trained as an International Patient Coordinator.