Are bleeding gums something you should be concerned about? Dear Doctor magazine recently posed that question to Dr. Travis Stork, an emergency room physician and host of the syndicated TV show The Doctors. He answered with two questions of his own: “If you started bleeding from your eyeball, would you seek medical attention?” Needless to say, most everyone would. “So,” he asked, “why is it that when we bleed all the time when we floss that we think it’s no big deal?” As it turns out, that’s an excellent question — and one that’s often misunderstood.
First of all, let’s clarify what we mean by “bleeding all the time.” As many as 90 percent of people occasionally experience bleeding gums when they clean their teeth — particularly if they don’t do it often, or are just starting a flossing routine. But if your gums bleed regularly when you brush or floss, it almost certainly means there’s a problem. Many think bleeding gums is a sign they are brushing too hard; this is possible, but unlikely. It’s much more probable that irritated and bleeding gums are a sign of periodontal (gum) disease.
How common is this malady? According to the U.S. Centers for Disease Control, nearly half of allÂ Americans over age 30 have mild, moderate or severe gum disease — and that number increases to 70.1 percent for those over 65! Periodontal disease can occur when a bacteria-rich biofilm in the mouth (also called plaque) is allowed to build up on tooth and gum surfaces. Plaque causes the gums to become inflamed, as the immune system responds to the bacteria. Eventually, this can cause gum tissue to pull away from the teeth, forming bacteria-filled “pockets” under the gum surface. If left untreated, it can lead to more serious infection, and even tooth loss.
What should you do if your gums bleed regularly when brushing or flossing? The first step is to come in for a thorough examination. In combination with a regular oral exam (and possibly x-rays or other diagnostic tests), a simple (and painless) instrument called a periodontal probe can be used to determine how far any periodontal disease may have progressed. Armed with this information, we can determine the most effective way to fight the battle against gum disease.
Above all, don’t wait too long to come in for an exam! As Dr. Stork notes, bleeding gums are “a sign that things aren’t quite right.” Â If you would like more information about bleeding gums, please contact us or schedule an appointment. You can read more in the Dear Doctor magazine article “Bleeding Gums.” You can read the entire interview with Dr. Travis Stork in Dear Doctor magazine.
Wearing braces takes time, but if all goes well the changes to your smile will be well worth it. In the meantime, though, you’ll have to contend with one particular difficulty—keeping your teeth clean of disease-causing, bacterial plaque.
Don’t worry, though—while keeping dental disease at bay with braces can be challenging, it is doable. Here are 4 tips for minimizing your chances of tooth decay or periodontal (gum) disease during orthodontic treatment.
Eat less sugar. Like any living organism, bacteria must eat—and they’re especially amenable to sugar. The more they have access to this favorite food source, the more they multiply—and the greater your risk of tooth decay or gum disease. Eating fewer sugary foods and snacks and more dental-friendly ones helps restrict bacteria populations in your mouth.
Brush thoroughly. Brushing with braces can be difficult, especially in areas blocked by orthodontic hardware. You need to be sure you brush all tooth and gum surfaces around your braces, including above and below the wire running through the brackets. A soft multi-tufted microline bristle brush is a good choice for getting into these hard to reach places. Brushing around braces takes more time, but it’s essential for effective plaque removal.
Use flossing tools. Flossing is important for removing plaque from between teeth—but, unfortunately, it might be even more difficult to perform with braces than brushing. If using string floss proves too daunting consider using a floss threader or a similar device that might be easier to maneuver. You can also use a water irrigator, a hand-held device that sprays water under pressure to loosen and flush away between-teeth plaque.
Keep up regular dental visits. While you’re seeing your orthodontist regularly for adjustments, you should also see your general dentist at least every six months or more. Besides dental cleaning, your dentist also monitors for signs of disease and can prescribe preventive measures like antibacterial mouth rinses. Of course, if you see abnormalities, like white spots on your teeth or red, puffy or bleeding gums, contact your dentist as soon as possible. The sooner a problem can be addressed the less impact it may have on your orthodontic treatment and overall oral health.
If you would like more information on caring for teeth and gums while wearing braces, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Caring for Teeth During Orthodontic Treatment.”
Eaten in a fast food restaurant lately? If so, maybe you’ve noticed some changes in the big, colorful signs behind the counters. Many have begun promoting a few “healthier” selections (like salads and grilled items) and giving a more extensive listing of nutritional information. But there’s one thing you might not have noticed on those displays: a listing for soda among the beverage choices in the kiddie meal packages. That’s because they are no longer there.
Recently, Burger King quietly removed sugary fountain drinks from the in-store and online menu boards that show what you get with kids’ meals. They were following the lead of McDonalds and Wendy’s, both of which made similar moves in prior months. You can still get a soda with your kiddie burger if you specifically ask for one, but we’re hoping you won’t; here’s why.
For one thing, youth obesity has nearly tripled in the past three decades. As the U.S. Centers for Disease Control and Prevention (CDC) has noted, it’s now an epidemic affecting more than one in six children and adolescents. Many of the extra calories kids get are blamed on sugary drinks: According to a study by the Harvard School of Public Health, children’s daily calorie intake from these beverages rose by 60 percent in recent years. Obesity makes kids more likely to get many diseases, and can lead to problems in psychological and social adjustment.
But that’s not all. As dentists, we’re concerned about the potential for soda to cause tooth decay, which is still the number one chronic disease in children around the world. The association between sugary drinks and cavities is clear. So is the fact that tooth decay causes pain, countless hours of missed school and work, and expense that’s largely unnecessary, because it’s a disease that is almost 100 percent preventable.
While the new signage at fast food restaurants won’t make soda disappear, it does tend to make it less of an automatic choice. Anything that discourages children from routinely consuming soda is bound to help — and let’s point out that the same thing goes for other sweet and acidic beverages including so-called “sports” and “energy” drinks. It’s best to try and eliminate these from your child’s diet; but if you do allow them, at least limit them to mealtimes, and give your mouth a break from sweets between meals. That gives the saliva enough time to do its work as a natural buffer and acid-neutralizer.
What else can you do to help keep your child’s oral hygiene in tip-top shape? Be sure they brush their teeth twice and floss once every day, and bring them in for regular checkups and cleanings. But if you do suspect tooth decay, don’t delay treatment: Left alone, decay bacteria can infect the inner pulp of the tooth, resulting in severe pain, inflammation, and possibly the need for root canal treatment.
If you would like more information about children’s oral health, please contact us or schedule an appointment. You can learn more by reading the Dear Doctor magazine articles “How to Help Your Child Develop the Best Habits for Oral Health” and “Top 10 Oral Health Tips For Children.”
When you think orthodontics, you may instantly picture braces or clear aligners worn by teenagers or adults. But there’s more to orthodontics than correcting fully developed malocclusions (poor bites). It’s also possible to intervene and potentially reduce a malocclusion’s future severity and cost well beforehand.
Known as interceptive orthodontics, these treatments help guide jaw growth in children while mouth structures are still developing and more pliable. But timing is critical: waiting until late childhood or puberty could be too late.
For example, we can influence an upper jaw developing too narrowly (which can cause erupting teeth to crowd each other) with an expander appliance placed in the roof of the mouth. The expander exerts slight, outward pressure on the upper jaw bones. Because the bones haven’t yet fused as they will later, the pressure maintains a gap between them that fills with additional bone that eventually widens the jaw.
Functional appliances like the Herbst appliance influence muscle and bone development in the jaws to eventually reshape and reposition them. The Herbst appliance utilizes a set of metal hinges connected to the top and bottom jaws; when the patient opens and closes their jaws the hinges encourage the lower jaw to move (and eventually grow) forward. If successful, it could help a patient avoid more invasive treatments like tooth extraction or jaw surgery.
Some interceptive objectives are quite simple in comparison like preserving the space created by a prematurely lost primary tooth. If a child loses a primary tooth before the incoming permanent tooth is ready to erupt, the nearby teeth can drift into the empty space. Without enough room, the permanent tooth could erupt out of position. We can hold the space with a simple loop device known as a space maintainer: usually made of acrylic or metal, the device fits between adjacent teeth and prevents them from drifting into the space until the permanent tooth is ready to come in.
Interceptive orthodontics can have a positive impact on your child’s jaw development, now and in the future. For these techniques to be effective, though, they must begin early, so be sure your child has a complete orthodontic evaluation beginning around age 7. You may be able to head off future bite problems before they happen.
Did you see the move Cast Away starring Tom Hanks? If so, you probably remember the scene where Hanks, stranded on a remote island, knocks out his own abscessed tooth — with an ice skate, no less — to stop the pain. Recently, Dear Doctor TV interviewed Gary Archer, the dental technician who created that special effect and many others.
“They wanted to have an abscess above the tooth with all sorts of gunk and pus and stuff coming out of it,” Archer explained. “I met with Tom and I took impressions [of his mouth] and we came up with this wonderful little piece. It just slipped over his own natural teeth.” The actor could flick it out with his lower tooth when the time was right during the scene. It ended up looking so real that, as Archer said, “it was not for the easily squeamish!”
That’s for sure. But neither is a real abscess, which is an infection that becomes sealed off beneath the gum line. An abscess may result from a trapped piece of food, uncontrolled periodontal (gum) disease, or even an infection deep inside a tooth that has spread to adjacent periodontal tissues. In any case, the condition can cause intense pain due to the pressure that builds up in the pus-filled sac. Prompt treatment is required to relieve the pain, keep the infection from spreading to other areas of the face (or even elsewhere in the body), and prevent tooth loss.
Treatment involves draining the abscess, which usually stops the pain immediately, and then controlling the infection and removing its cause. This may require antibiotics and any of several in-office dental procedures, including gum surgery, a root canal, or a tooth extraction. But if you do have a tooth that can’t be saved, we promise we won’t remove it with an ice skate!
The best way to prevent an abscess from forming in the first place is to practice conscientious oral hygiene. By brushing your teeth twice each day for two minutes, and flossing at least once a day, you will go a long way towards keeping harmful oral bacteria from thriving in your mouth.
If you have any questions about gum disease or abscesses, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Periodontal (Gum) Abscesses” and “Confusing Tooth Pain.”
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