Have you ever gone to the dentist and the hygienist pokes around your gums, calls out some random numbers, and then tells you that you need to floss more because your gums are bleeding? Well there actually is a reason for all that madness!
The main cause of bleeding gums is the buildup of plaque at the gum line. This will lead to a condition called gingivitis, or inflamed gums. Plaque that is not removed will harden into tartar. This will lead to increased bleeding and a more advanced form of gum and jaw bone disease known as periodontitis.
Let’s just back up a bit and go over the nuts and bolts of teeth, gums, and bone. Our teeth are made up of several layers. The outer most and hardest layer is called enamel, the next layer dentin, and lastly our nerve canal sits in the center of the tooth. The teeth are set and held into place by the bone of our jaws. The level or height of that bone should reach almost all the way up to where our enamel begins. Our gum tissue surrounds the teeth and is connected to our teeth by ligaments. There is a natural space around the teeth where the gum tissue is loose until it connects to the tooth by way of the ligaments. So, when your hygienist is poking around with an instrument called a probe he or she is measuring the amount of loose space around each tooth. The probe is calibrated into millimeters and healthy gums should measure about 2-3mm in depth. The shallower the space, the easier they are to keep clean and free of bacterial infection. If you hear measurements of 4mm that could be indications of gingivitis or inflammation of your gums. Your gums will look red, puffy, and will be tender. This is reversible if brushing and flossing is done correctly and routinely. Although, if measurements of 5mm and above are being recorded then that could be an indication of periodontal disease. This means that the bacteria has not been removed thoroughly and routinely and has caused not only gingivitis but now that inflammation is causing the bone around your teeth to recede. This unfortunately is not reversible, and at this point our goal is to try to keep the remaining bone around our teeth healthy to prevent any loss of teeth.
Now knowing this, if your gums bleed when you brush and floss at home, or your gums are tender and sore during your dental cleanings this may be a sign of gum disease. You should address this with your hygienist and have them recommend what would be best for you to keep them clean. Depending on the condition of your gums and bone levels there are multiple tools to help you at home to achieve a healthy mouth. For starters, electric toothbrush and floss alone can make a big difference on plaque removal, but if bone loss is also part of your diagnosis then maybe adding a water-pick and proxy brushes in addition to the electric toothbrush might be a better combination for you.
Common as it may seem to be, it’s never natural for bleeding to occur from brushing or flossing. Always try to take preventative measures before symptoms get worse. Happy healthy smiles!