The gums act as a barrier in protecting your teeth and its underlying tissues. They act as an indicator for various underlying disease.
A healthy gum plays a vital role in preventing various diseases caused by the bacteria present in the mouth. Bleeding of gums is a highlighter for underlying irritant or bacterial activity. Frequent bleeding of gums must be taken care of immediately to prevent further progression leading to loss of bone around the tooth and thereby loss of the tooth eventually. Though bleeding gums is not a serious threat we have to make note of it to avoid any related future complaints.
REASON BEHIND BLEEDING GUMS:
- Gingivitis ( swollen gums)
- Brushing habits
- Vitamin deficiency
- Vitamin C
- Vitamin K
GINGIVITIS (Swollen Gums):
It is the inflammation of the gums due to bacterial activity. The gums become swollen, filled with blood and are very painful on brushing or when touched.
This occurs when hard or soft yellowish-white debris adheres to the tooth surface. These deposits act as a shelter for the bacteria to grow and multiply. These bacteria produce toxins to irritate the gums. It is the major cause of bleeding gums in adults.
The bacteria that cause gingivitis are Aggregatibacter actinomycetemcomitans, Prevotella intermedia, Porphyromonas gingivalis, Tannerella forsythia, Treponema sps.
The habit of smoking causes decreased vascularity (blood supply) to the gums. The gums of smokers appear pale, bluish, swollen and malnourished. Bleeding of gums occurs until they stop smoking and on pressure.
The use of certain medications like blood thinners (e.g: Aspirin) might cause bleeding. Patients undergoing anticoagulant therapy combined with antiplatelet drugs (e.g: Clopidogrel) show bleeding of gums. Other forms of drugs associated with swelling gums and bleeding are Antihistamines, antihypertensive, chemotherapy medication, and oral contraceptives.
Hormonal changes in pregnancy results in bleeding of gums. This is often termed as pregnancy gingivitis or inflammation of gums in pregnancy.
The hormones responsible for this are progesterone and estrogen. Progesterone increases vascular permeability i.e. the capacity of the free flow of smaller molecules. This capacity promotes the accumulation of blood in gum pockets and leads to bleeding. This hormone also reduces the ability of the tissues to repair itself. This form of gingivitis affects 60% to 75% of pregnant women.
They are observed from the second or third month of pregnancy with severity in 4th to 6th month. It gradually reduces by the last month of pregnancy. They show immediate response to any local irritants, bacterial plaque & calculus.
Reasons for bleeding of gums due to brushing:
- Use of an improper toothbrush
- Prolonged duration of brushing
- Improper brushing techniques lead to bleeding gums.
Vitamin C: Deficiency of this vitamin causes scurvy. Scurvy leads to decreased formation and maintenance of the collagen (this collagen is responsible for the clotting of blood and repair). This causes bleeding gums followed by increasing periodontal inflammation and loss of the tooth. Pregnant, breastfeeding mothers and kids are more prone to vitamin C deficiency.
Vitamin K: This vitamin is one of the essentials in promoting clotting of blood. Deficiency of this vitamin occurs with frequent usage of antibiotics & anticoagulants (blood thinner) leading
Well-being of an individual depends on balanced mental and physical health. Factors causing an imbalance in mental and physical health may express as the following oral complaints: bad breath, bleeding gums, mouth ulcers, burning sensation in the mouth. Consistent bleeding gums should be monitored and consulted with the dentist.
PRECAUTIONS TO PREVENT BLEEDING OF GUMS:
- Maintain good oral hygiene practices.
- Get proper guidance from your dentist on your choice of toothbrush and toothpaste.
- Quit smoking and follow a proper treatment for your affected gums to prevent and reduce bleeding gums.
- Have a dental check-up 6 months once or at least once a year.
- Monitor usage of medication. Consult your physician and dentist if you have bleeding related to the use of medicines.
- Pregnant women must take dental check-up in their second trimester (4th to 6th month of pregnancy). They should maintain their oral hygiene with proper brushing and use of fluoridated mouthwashes.
- Obtain proper guidance from your dentist on the selection of toothbrushes and toothpaste.
- Follow the instruction given by the dentist on how to brush and how long to brush your teeth.
- Increased intake of fruits and vegetables rich in vitamin C like tomatoes, broccoli, citrus fruits, kiwi, papaya, berries, and green leafy vegetables.
- Increased intake of good sources of vitamin K like green leafy vegetables, yogurt, milk, cabbage, eggs, tomatoes, and cauliflower.
POINTS TO REMEMBER:
- Brush twice daily for 2 minutes.
- Take toothpaste on your brush in the shape of a peanut.
- Ensure that you follow proper technique while brushing and using dental floss.
- Frequent dental check-up once in six months.
- Have a healthy and balanced diet.
- Quit the use of tobacco products.
- Pihlstrom, Bruce L., Bryan S. Michalowicz, and Newell W. Johnson. “Periodontal diseases.” The lancet 366.9499 (2005): 1809-1820.
- Steinberg, Barbara J., et al. “Oral health and dental care during pregnancy.” Dental Clinics 57.2 (2013): 195-210.
- Nishida, Mieko, et al. “Dietary vitamin C and the risk for periodontal disease.” Journal of periodontology 71.8 (2000): 1215-1223.
- Ojanotko‐Harri, A. O., Harri, M. P., Hurttia, H. M., & Sewoón, L. A. (1991). Altered tissue metabolism of progesterone in pregnancy gingivitis and granuloma. Journal of clinical periodontology, 18(4), 262-266.