Bleeding Gums: What It Means and When to See Your Dentist

Bleeding Gums: What It Means and When to See Your Dentist

Seeing blood in your sink after you brush your teeth can be alarming, but there’s no need to panic. You may be able to cure your bleeding gums without even seeing a dentist, depending on the situation. In this article, I’ll explain the common causes of bleeding gums, what you can do to stop the bleeding and how to know when it’s time to see the dentist.

How Your Gums Work

If you examine your gums, they should be a healthy shade of pink, not red. You can notice they make a C shape around the neck of the tooth (where your tooth begins to get skinnier). Where they touch your teeth, they form a small groove, like a collar around the tooth.

Though they are a tiny part of your body, gums have a big job. They protect the neck and roots of your teeth from bacteria. Without healthy gums guarding your teeth, bacteria can sneak beneath your teeth, damaging tissues. Over time, the tissues become too damaged to hold your teeth, leading to loose teeth that can even fall out.

What Causes Bleeding Gums
Gums usually bleed becomes something irritates them. Here are common reasons gums get irritated:

Gingivitis (Gum Disease)
If you don’t floss or brush regularly, bacteria (also called plaque) builds up in the groove around your teeth. Sometimes you can even see the plaque as white or yellowish marks by your gums.

As bacteria grow and move, they irritate your gums, causing gingivitis. Gingivitis is the early stage of gum disease, and its most common symptom is bleeding gums. Besides bleeding gums, you could also have gingivitis symptoms like red gums, sensitive gums and bad breath.

Luckily, this stage of gum disease is reversible. Your dentist can help scrape away plaque and bacteria. Brushing and flossing keeps the bacteria away for good so you can enjoy healthy gums.

However, if gingivitis gets worse, your gums may start to pull away from your teeth, leaving space for bacteria to travel into tissues below your teeth. The longer bacteria live in your tissues, the worse your dental health gets.

When you are pregnant, changes in your hormones affect your entire body. Your gums are no exception. Hormone changes can cause “pregnancy gingivitis.” Your gums may swell up and become sensitive, causing bleeding when your brush or floss. To avoid oral health issues, talk to your dentist about how to care for your teeth when you are pregnant.

The medicines you take can make your gums more likely to bleed even if you have excellent brushing and flossing habits. Blood thinners and aspirin keep your blood from clots that stop bleeding. These medicines especially increase your risk of bleeding gums and may cause your gums to bleed for a long time after brushing.

You should tell your dentist if you are taking these medicines. We dentists want to help your mouth be as healthy as possible, but if we don’t know about your general health, we can’t give you the right care.

A New Oral Health Routine
If you have just started a new oral health routine, such as brushing or flossing more often, your gums may bleed until your mouth gets used to the new habits. Brushing and flossing clears away bacteria and plaque from your gums. As you practice these good habits, you gums should bleed less and less and eventually stop altogether.

Keep in mind that brushing too hard can also irritate your gums and cause them to bleed. Always use a gentle motion when brushing and consider getting a brush with soft bristles.

When to See Your Dentist About Bleeding Gums
So do you need to see your dentist? Maybe.

Sometimes, if you practice good habits, your gums will get better without a visit to the dentist.

But if your gums bleed regularly, such as every time you brush your teeth for a few weeks, I encourage you to make an appointment to see your dentist soon. You should also call your dentist if your gums bleed for a long time after you have stopped brushing or flossing.

I also recommend that you see your dentist if you experience other symptoms of gum disease, such as:

Red or swollen gums
Sensitive gums, especially to hot or cold temperatures
Gums seem to be separating from teeth, leaving a gap between the gum and the tooth
Frequent bad breath or taste in your mouth
Loose teeth as an adult
Changes in the way your top and bottom teeth align
The sooner you see your dentist about signs of gum disease, the more likely you’ll be able to reverse the condition.

What to Consider if You Have Bleeding Gums
While bleeding gums aren’t a cause for panic, they are a sign that you need to make positive changes to your oral health routine. I would encourage everyone to improve their gum health with these tips.

Brush and floss twice a day. Flossing pulls bacteria out of the grooves around your teeth and prevents plaque from building up. Brushing also removes the layer of bacteria on your teeth. If you bleed when you brush or floss, it does not mean that you should back off. Remember, healthy gums don’t bleed when brushed. So it’s not the brushing, it’s the inflammation, or state of disease that makes them bleed. In dentistry we call this “bleeding upon provocation”.
Use an electric toothbrush. Electric toothbrushes can remove plaque and bacteria around your gums more effectively than regular toothbrushes. These brushes move faster than you ever could move a brush while still providing a gentle clean.
See your dentist regularly. You should see your dentist for a cleaning at least every six months or more often as your dentist suggests. During cleanings, your dentist removes plaque build-up on your teeth. Your dentist can also answer questions about bleeding gums or other oral health issues.
Avoid tobacco. Tobacco products, including cigarettes and chewing tobacco, hurt all aspects of your health, including your oral health. Tobacco destroys your teeth and gums, leading to tooth decay and loss of teeth.
Eat a healthy diet. The foods you eat impact the health of your mouth. Sugars and starches provide food for bacteria, helping them grow. Eating throughout the day also can increase the amount of bacteria in your mouth. Reduce how many carbohydrates and snacks you eat to experience better oral health.
Nose breathe at night and during the day. If you are a mouth breather, find a solution (your dentist can help). Even healthy gums will change color and will be more likely to bleed as a dry mouth changes pH and allows the wrong bacteria to become dominant. If you see that mostly you anterior gums are swollen and red, and not the posterior gums, this could be a result of as simple as mouth breathing. Try mouth taping when you go to bed tonight to see if that helps!
So many of us find it easy to ignore the presence of blood in our mouth. We see at the dentist when we get our teeth cleaned.It’s routine, right? Remember It’s important to realize that gum disease has greater ramifications to the rest of the body. Gum disease is actually a greater predictor of morbidity than heart disease is. Next time you see blood on your floss you should think of this fact. The only real good solution to fixing those bleeding gums, ultimately, is a trip to the dentist. I hope this post has convinced you of that.


Complete Guide to Sugar

As a dentist, I get asked a lot about sugar. But as it turns out, sugar isn’t actually the worst thing for your teeth. Sugar also isn’t the cause of tooth decay; acid is. The most cavity-causing food is crackers and breads, not candy.

As someone with a major sweet tooth myself, I’ve wondered many of the same things: How bad is sugar, really? How much sugar can we get away with?

Sugar also doesn’t just impact oral health; it impacts overall health too. New research is starting to find that our levels of sugar consumption are making sugar a toxin that could be a driving force behind many diseases, such as heart disease, diabetes, Alzheimer’s, and breast, endometrial, and colon cancers.

I aim to answer all of your questions about sugar in this blog post, as well as share my tips for how to indulge a sweet tooth healthily and safely. If you still have a question by the end of this blog post, let me know in the comments and I’ll be glad to answer it! I read each and every one.

How does sugar cause cavities?

This is actually a myth. Acid causes cavities. When you eat something with sugar, bacteria that naturally reside in your mouth consume this sugar as well. Bacteria’s waste product is acid, so after they have a meal, they excrete acid. Acid is what causes problems for teeth. Enamel is strong, but not strong enough to resist acid. Acid decalcifies or demineralizes tooth enamel by taking away its structure, creating decay.

My pediatric patients are very impressed when I tell them that cavities are caused by bacteria “pooping” in their mouth. Whatever helps you remember!

Is sugar the only cause of cavities?

No! In fact, the number one most cavity-causing food is crackers. Goldfish and saltine crackers are the worst. That’s because they’re fermentable carbohydrates. What does that mean? It means foods that are easily broken down in the mouth, instead of later on down the digestive tract. Fermentable carbohydrates allow the bacteria in your mouth to have a feast, and thus, increase the acid attack on your teeth more than other foods.

How can I minimize the effect of sugar?

Optimize remineralization. Teeth don’t just sit there and dissolve; there’s an ongoing process of a tooth losing minerals and regaining minerals. You prevent tooth decay when the tooth regains minerals more than it loses minerals. How does a tooth regain minerals? This is a process called remineralization and it happens naturally in your mouth. You can optimize this process by having a good pH in your mouth and plenty of saliva (no dry mouth). Fluoride, vitamin D, and dark chocolate (yes, you read that correctly!) all encourage remineralization as well.

Stick to a grain-free diet. Some studies show that this is one of the best preventive strategies for reducing cavities.

Get orthodontic treatment. Having straight teeth can also help minimize tooth decay since straight teeth make for fewer nooks and crannies where sticky foods can get stuck. People with a proper bite have far fewer cavities than those with crooked teeth.

Eat what you like, but keep it to mealtime. If you sip soda or sweetened coffee throughout the day, snack, or suck on hard candies, you’re providing your mouth bacteria with a steady food supply to produce acid nearly constantly. Studies show that people who snack have more cavities than those who eat the same amount of sweets, but keep it to mealtime.

Have cheese for dessert. The Europeans have cheese for dessert, which is a great way to buffer the acids in your mouth after a meal. Acids have a low pH, so you can neutralize them with things with a higher pH. Water, cheese, and vegetables all have a neutral to basic pH that can help neutralize acid and lesson the attack on your teeth.

Chew gum with xylitol. Choose a gum that’s sugarless and that contains xylitol, which has been shown to reduce mouth bacteria and help buffer acids in the mouth to protect from tooth decay. Chewing on gum also produces more saliva in your mouth, which neutralizes acids as well. Just be careful with gum since it can easily bring on jaw pain and TMD symptoms.

Swish with water after sticky foods. The longer food stays stuck in your teeth, the longer bacteria can feast and the more acids will be produced. This is why dried fruit and Goldfish crackers are the worst; they get stuck in your teeth. After you eat something sticky, swish vigorously with water to try to dislodge as much of the food from your teeth as possible before your next floss and brush session.

drink water to neutralize acid in the mouth

Help your kids develop their taste buds. Would you believe they even add sugar to baby food now? Help your kids appreciate the delicious natural sweetness of sugar snap peas and carrots. Get rid of the Goldfish, fruit juice, saltine crackers, and sugary cereals.

Eat it, don’t drink it. Soda and special Starbucks drinks often contain as much, if not more sugar than a slice of cake. I’d much rather have the cake and at least feel satiated! Some of my favorite indulgences: chocolate sacher torte, chocolate bars, and milkshakes. These are a rare treat, they make me feel satiated, and they don’t sneak their way into my day-to-day diet.  It’s also hard to go overboard on natural sugars present in apples, bananas, and some veggies. Orange juice will spike your blood sugar and won’t make you feel satiated, but eating a real orange will.

Avoid foods where sugar is listed as one of the first five ingredients. Ingredients in the packaging are listed in order from greatest quantity to smallest quantity, so if sugar is listed in the first five, I’d recommend avoiding it, at least for something you eat frequently. You’d be amazed at how many tomato sauces, “healthy” cereals, and energy bars have sugar as one of the first five ingredients.

Limit the frequency. When it comes to dental health, having your sweets all in one sitting is better than spreading it out by sipping a soda all morning or snacking throughout the day.

Don’t brush right afterward. After a sugary meal, wait thirty minutes to one hour before flossing and brushing. Otherwise, with all that acid present in your mouth, you risk etching away enamel.

Make a habit of limiting it. Use as little sugar as you can possibly get away with, and try to ween yourself off of it. By training your brain and your tastebuds, you protect yourself from getting addicted. A recent study suggests that sugary cookies could be as addictive as cocaine or morphine. Eating high-sugar foods lights up the same part of the brain as when a person shoots heroin. Excess sugar can cause changes in the brain and leave you feeling lethargic, anxious, and irritable. For more reading on sugar addiction and the brain, check out Dr. Nicole Avena’s book, Why Diets Fail.

harmful effects of sugar

Can I spread out my sugar consumption to reduce tooth decay?

It’s actually much better to eat a large quantity of candy all at once rather than spreading it out with a little piece here, and then another piece a half hour later. Frequency is the thing to worry more about than quantity, when it comes to your dental health at least.

How much sugar can I have?

To avoid cavities, the recommended level for sugar consumption is less than 40 grams per day, according to studies, but I would recommend aiming for less than 20 grams. The latest recommendation is that sugar be no more than 5% of your diet. That’s between 6 and 9 teaspoons, which is about the amount of sugar in half a cup of raisins!

Why do we like it so much?

We’ve only had processed sugar in our diets for a few hundred years. For most of human history, sugar was scarce, and usually meant something nutritious like berries or fruits, so we are programmed to like it and crave it. There was very little sugar in our ancestors’ diets, but this helped them stay disease-free for longer and square their life curves.

What does sugar do to our health?

Let’s shift from cavities to the rest of the body for a moment. Sugar can act like poison in high doses, according to Robert Lustig, M.D., a neuroendocrinologist at the University of California at San Francisco School of Medicine, and the amount of sugar in the typical processed food diet is beyond toxic.

How excess sugar wreaks havoc on the body:

  • Excess sugar can lead to high levels of insulin, making you feel hungry even when you’re full and triggering your brain to store glucose as belly fat.
  • Surges in insulin can eventually lead to Alzheimer’s disease, and at the very least, open the door for cravings and addiction-like neurochemistry in the brain.
  • If your cells become resistant to all this insulin production, you’re left with prediabetes or full-blown diabetes.
  • Excess sugar can also put extra load on the liver, over time, causing globules of fat to grow in the liver, which is the precursor to nonalcoholic fatty liver disease.
  • Excess sugar can also lower your “good” cholesterol and spur a type of fat called triglycerides which can migrate from the liver to the arteries, raising your risk for heart attack or stroke.
  • Your liver sends an S.O.S. for extra insulin (yep, the multi-tasker also aids liver function). Overwhelmed, your pancreas is now in overdrive, which can result in total-body inflammation that, in turn, puts you at even higher risk for obesity and diabetes.

Are certain sugars better than others?

Table sugar is sucrose, while other kinds of sugars are usually a mixture of glucose and fructose. This difference is largely irrelevant, because sucrose is converted to glucose and fructose in your stomach within minutes.

dangers of artificial sweeteners

How about artificial sweeteners like Sweet’N Low, Splenda and Equal?