When I look back, the first time I think I ever heard about bleeding gums, was actually in the Simpsons with good ole 'Bleeding Gums Murphy', and unknown to me (and probably Bleeding Gums Murphy) he was one of the 75% of adults who suffer from gum problems at one point or other in their lives. So if about 3 out of 4 of people have bleeding gums at one point or other, and its even been featured on the Simpsons I'm sure you, like a lot of people, would think that bleeding gums is completely normal, yes? Hmmmmmm

I always describe bleeding gums to my patients as not uncommon, but not normal. Yes lots of people suffer from bleeding gums BUT this is how your body tells you that there's a problem. Bleeding happens when there has been plaque sitting in and around your teeth and gums for more than 24 hours. At this cut off point your body sends in the cavalry in the form of loads of white blood cells to try and get rid of the bacteria present in this plaque. These white blood cells travel to these areas via the blood and so hey presto!! The gums start to bleed. When you improve your oral hygiene and effectively remove this plaque from your teeth and gums, there is no need for your body to send in the white blood cells. This means that less blood is traveling to the area and then the bleeding reduces and could eventually stop altogether. Subject to your Hygienist, there then may, or may not be, a happy dance.

When I get the opportunity, I like to check bleeding scores at every appointment and its really motivational. Things can get competitive, especially if I see a lot of people from the same family, but I think this is one of the best things I've done for my patients and it has really helped make everyone aware that bleeding from the gums isn't something that we should just accept. Patients are also starting to associate that there gums really do feel better when there bleeding levels have reduced between appointments which is super. So if your mouth is feeling a bit off, maybe the gums could be the problem.

"But my gums aren't bleeding at home"..Ahh that old chestnut. I hear this from my patients all the time, so I've left a couple of explanations here for you to mull over if you've got a few minutes.

You're doing your homework

If you have been sticking to a gold standard oral hygiene routine as outlined by your Dentist or Dental Hygienist it is more than likely that your bleeding will be low, so hats off to you my friends you're doing great. This routine can vary from person to person but the bones of it would usually be

Using something consistently in between your teeth, like floss, interdental brushes or a gadget like a water flosser, at least once daily or perhaps every time you brush to help you remember.
Timed brushing for 2 minutes angling the toothbrush 45 degrees to the gum line GENTLEY but effectively brushing this area as well as the tooth on the sides of the teeth closest to your lips and cheeks AND the sides of your teeth closest to your tongue and palate
Using a toothpaste that you like or has been advised for you to use by your Dentist or Dental Hygienist - Corsodyl toothpaste can be good for bleeding gums *this tastes different to regular toothpaste*
Potentially finishing this whole process with a mouthwash if you have been advised to do so and avoiding rinsing your mouth out at the end with water from the tap (although I would advise patients not to rinse altogether if they are using a sensitive toothpaste like Sensodyne

You've not been brushing in the right places hun

For some of my patients, the first time they've ever heard that they need to clean around the areas on the inside of their teeth, i.e. the areas closer to your palate and or your tongue, is the first time that they see me. This happens all the time and one of the fastest ways to get these people on track is to put a plan in place for even brushing. Also if you haven't been brushing these areas they will bleed like MAD the first few times you do this and might feel a bit tender. Don't panic or be put off by doing this, keep going and this being should resolve in a few days. You can make sure everywhere is being brushed evenly by

Dividing your mouth into 4 sections
Spending 30 seconds on each section - timing is key
The gums need to then GENTLY be MASSAGED like they're at Galgorm Resort and Spa. No scrubbing. We don't want to overdo this and cause recession, but we still want the area to be effectively cleared of plaque, a balance between ease and effort if you will. Again slightly more bleeding will occur when you do this, keep calm, it will resolve in a few days.

Another reason some of my patients have high bleeding scores without realising it at home is that the teeth are being brushed well but the gums are being neglected. We've gotta work on those angles. We want the toothbrush to point down to or up towards the gum line when brushing at about a 45 degree angle.

You're not cleaning in between your teeth

Any job doing is worth doing well, and even the most amazing brushing with the fanciest most expensive and electric toothbrush on the market will only get about 60% of the surfaces of your teeth. Fact. So we need to find something that you like (or will get used to using - not everybody likes it) consistently in between your teeth.

Certain products will be better tools for the job than others, I used to be pretty fussy at having the right tool for the job and only the right tool for the job was the thing to be using. Maybe I was being a bit of a tool..I have relaxed, use anything you like (apart maybe from a bit of wire the you find in the garage - you know who you are).

Interdental brushes tend to be better for back teeth, purely because of the shape of back teeth

On each section

Spend 10 seconds on areas closest to your cheeks
Spend 10 seconds on the areas you bite with
Spend 10 seconds on the areas closest to your tongue/palate

Another reason some of my patients have high bleeding scores without realising it at home is that the teeth are being brushed well but the gums are being neglected. We've gotta work on those angles. We want the toothbrush to point down to or up towards the gum line when brushing at about a 45 degree angle.

Its a good idea to have your Dentist or Hygienist size these up for you because it can be surprising what will fit into each gap. Floss is good for front teeth provided you have the right technique and your Dentist or Hygienist can help you with this. For crowded teeth or teeth that are close together, which is a common complaint, water or air flossers can be good and ill leave a link for these here.

Then there are more specific tools that you can use for restorative work like crowns bridges and implants but its generally best to go over these in the dental chair when we can model how to use them in the mirror.

All in all, give cleaning in between your teeth a bash, its hard to get it wrong, always make sure the area closest to the gum is clear of plaque when you're finished and in the unlikely even that anything ever gets stuck, take a moment, calm down, and move it up or down to the gum as this is the widest point of the tooth and should come out easily. Oh and just like brushing the right areas, if you're not doing this on a daily basis 9 times out of 10 there will be bleeding, so just keep going you're not doing it wrong.

Your toothbrush/toothbrush head needs changed

Show & Tell...What does your toothbrush look like at home?

This?

or this?

If its option 2, its time to change the toothbrush or toothbrush head. Its not cleaning where it used to and causing you all kinds of problems in the process. Why wait, get those new heads into your amazon basket! I'll just leave this link here. I would say a good rule of thumb is to change your toothbrush or toothbrush head 3 monthly and shout out to my patients who change their head after their quarterly hygiene appointments, its a great was to keep you on track.

You're a smoker

Nicotine present in cigarettes and also sometimes present in vaping oil constricts the blood vessels in and around your mouth, in other words in stops your body reacting how it normally would to bacteria in plaque as we were talking about at the beginning of this blog.

This means that if you're a smoker there will be less bleeding at the gum line or the bleeding will be slower to start so you might not notice it at home...but your Hygienist will...also no bleeding doesn't necessary mean no problems, one of the biggest contributory factors to developing Gum Disease is smoking, not to mention Oral Cancer, so its really important to still have regular checks with your Dental Hygienist and Dentist.

Also as a little side note, if you are a smoker and decide to stop or cut down altogether (high five) you might notice MORE bleeding. This is normal, apply the gold standard oral hygiene method as outlined above and the bleeding will hopefully begin to resolve, but of course if you're starting to notice any bleeding that doesn't seem to resolve in about a week, discuss this with your Dentist or Dental Hygienist.

Everybody is different

Some people's bodies react more to plaque than others, this is called host response. Some people's bodies overreact to plaque, which can be really frustrating for patients especially because I see them working really hard and not maybe always getting the results they deserve. On the flip side there are, on occasion, people who don't seem to get massive amounts of bleeding even with quite obviously higher plaque levels. Underreacters. Life isn't all fun and games for these guys though...if plaque sits there long enough it will also cause a dental cavity. So keeping things clean is the only way forward.

So, to sum up, don't put up with bleeding. Bleeding Gums Murphy was cool, I mean he plays jazz, gum issues however or not. Most of the time prolonged unresolved bleeding will lead to Gum Disease, and we don't want that now do we?

If you would like a Dental Hygiene appointment, you can visit me at Moira Cosmetic Dental or Bupa Dental Care Glengormley or you can follow me on Instagram @homegirlhygienist

https://www.tepe.com/uk/tips-and-advice/your-gums/gum-disease-gingivitis/

http://gumdiseaseinfo.co.uk/

#bleedinggums #gingivitis #gumdisease #dentalhygiene #gumbleedingisnotnormal