Bleeding Gums

Your gum tissue will look firm and pinkish in color if you have healthy gums. However, unhealthy gums may be red, swollen or puffy, tender, or you may be experiencing bleeding gums. When you brush and floss your teeth, a healthy gum tissue will not bleed. According to the World Health Organization, approximately 80% of American adults have some form of gum disease. Drs. Lepore and Dougherty at Lepore Comprehensive Dentistry in Dunedin, Florida, like to say, “if every time you washed your hands, your fingers bled, how concerned would you be? But bleeding when we “wash” our teeth with brushing and flossing is okay? A little blood in the sink is not okay.”

Bleeding gums may be a sign of gum disease. In addition to bleeding gums, other symptoms of gum disease include bad breath (halitosis), receding gums, or even loose teeth.

The most common causes of bleeding gums:

Inflammation caused by harmful bacterial plaque, which accumulates around teeth and at/below the gum line. This inflammation is your body trying to defend itself against bacterial invasion. These bacteria also release toxins that accelerate the inflammatory process. Bleeding gums, at a minimum, is gingivitis. When this process continues, the chronic inflammation can irreversibly erode the bone surrounding the teeth. This process is called periodontitis.

  • Hormonal changes (such as pregnancy and menopause)
  • Vitamin K deficiency
  • Blood thinners

Why is it so important?

The link between the health of your mouth and overall health is known as the oral-systemic connection. Certain bacteria in your mouth can result in chronic inflammation, which is linked to heart disease, diabetes, pregnancy complications, and more.

Ways to prevent or reduce bleeding gums:

  • Brush your teeth at least twice daily.
  • Floss your teeth at least once daily.
  • Visit your dentist a minimum of twice a year.
  • Establish baseline with tests (Salivary Diagnostics – see below) with follow-up testing to see improvement
  • Low-level hydrogen peroxide delivery via customized trays (PerioProtect – see below)
  • Changing the oral flora bacterial flora composition by use of oral probiotics (ProBiora Pro – see below)

Gingivitis: The do’s and don’ts with Dr. Lepore

Gingivitis: The do’s and don’ts
Bleeding gums are a common occurrence but should not be taken lightly. Dr. Lepore goes into detail and explains the implications and effects of gingivitis on your oral cavity. He even speaks from personal experience and denotes the importance of hygiene appointments and the insight the hygiene team provides in situations where you could lose tissue or bone mass if left neglected.

Hey, guys, Dr. Lepore back with another frequently asked question video. This time we are going to talk about “why do my gums bleed?” Is it really normal, is it really common? We’ll address that right now. So is a little blood in the sink really that big of a deal? And the answer is yes. I love this analogy, “if you wash your hands every single day and you scrubbed them together, and you looked, and every time you looked, they bled? You’d probably be concerned, and you’d probably go to a doctor about it. Now is it really that different when you’re scrubbing your gums or brushing your teeth? And the answer is no. Bleeding is a sign of inflammation, so we call that Gingivitis. I’m sure you’ve heard it on every toothpaste and toothbrush commercial since the beginning of time. But what does it mean really? It’s when the food you eat mixes with the minerals in your saliva and makes something called plaque. Plaque then gets hardened by the same minerals in your saliva into something that we called tartar and calculus. When that is there for a period of time, your body treats that as a war and wants to attack, attack, attack until it goes away. But just like barnacles on the side of a sea wall, unless you go and physically scrub that away, it stays there, and the problem is when it stays there. Gums that bleed for a very long period of time will start to cause bone loss around the teeth. It’s the same thing as when you get a splinter in your finger, and you left it there. Left untreated, if you looked down and it was taking away the finger or the bone in the finger, you’d be scared out of your mind. But in our mouth it doesn’t hurt, so we don’t see it, so we don’t think anything about it. But this is a number one cause of tooth loss; it’s not taking care of our gums and our teeth. It’s not the cavities; it’s the gums. So, embarrassingly enough, I’m one of those patients that have to get cleanings more often because I’m at a higher risk. What makes me a higher risk is that my gums notoriously have bled since I was a little boy. I thought it was just me, but even since becoming a dentist and brushing and flossing two to three times a day, I felt a little defeated when I wasn’t getting the results I was after. And that’s when believe it or not, I had to humble myself before our hygienist team, and they gave me some tips and tricks like a different toothpaste and even as simple as a different type of floss or insider trading secret; I had to learn how to floss better. A little embarrassing for a dentist, but they still were able to teach me these things, and I know that they can teach you these things as well. If for a long period of time, let’s say you are a patient that has a history of gum disease or periodontal disease. In our office, we can fabricate for you a custom set of trays that are made in a laboratory that help deliver medication. So let’s talk about that medication; it’s actually hydrogen peroxide, which your body produces naturally, so it’s a very natural ingredient that kills the bacteria that causes this inflammation, that causes the gums to bleed, that causes the bone to be lost around them. And then it’s something that I wear for 20 minutes every day once a day, and voila, things have been notoriously better since. So a lot of times, it’s just one or two simple tricks or tips that we can give you to get you over the hump to help take away that feeling of feeling defeated, that every time you brush or floss, there is always a little bleeding spot. We can help you, and we look forward to doing so.

How to treat gum disease:

Here at Lepore Comprehensive Dentistry, we can effectively treat your gum inflammation or, if applicable, gum disease through a variety of methods:

  • Salivary Diagnostics is a simple test completed in our office to detect oral pathogens that cause decay or gum disease and can threaten your oral and systemic health. This test can help determine if you are at an increased risk of periodontal disease, decay, heart disease, stroke, and more. Click here to learn more
  • Prophylaxis Cleaning (Basic Cleaning) – A prophylaxis or basic cleaning is otherwise known as a healthy mouth cleaning and is the removal of dental plaque. During your prophylaxis, Drs. Lepore and Dougherty, alongside their team, will do a thorough examination of your teeth and gums

If you have been diagnosed and treated for periodontal disease, your doctor may recommend what is called periodontal maintenance therapy to keep the disease under control. There are some important differences between this and a routine dental cleaning that are important to understand.

A routine dental cleaning is designed for prevention - meaning its purpose is to keep gum disease and tooth decay from developing. It involves your hygienist cleaning your teeth above the gum line - removing plaque, calculus, and stains, as well as polishing them. This usually takes place every six months. On the other hand, periodontal maintenance therapy is meant for treating patients who've already been diagnosed with gum disease to control it and prevent it from worsening. It involves your doctor or hygienist performing a deep cleaning of the teeth beneath the gum line and deep into the pockets, removing any harmful plaque and bacteria buildup that has occurred since the last visit. Any uneven surface areas of the teeth will be smoothed out to discourage additional bacteria from attaching. To keep up with the pace of bacterial growth, this usually takes place every three to four months.

Given that there is no cure for periodontal disease, periodontal maintenance therapy is crucial to prevent it from worsening and causing additional complications to your oral and systemic health. Your doctor will work with you to create a maintenance schedule that best suits your unique needs.

  • Periodontal SRP Therapy (Periodontal Therapy Cleaning) – SRP is the removal of harmful dental plaque and tartar from the surfaces of the roots.

If you have been diagnosed with periodontal disease, your doctor may recommend a more advanced cleaning called scaling and root planing as the first step in treating it. There are some significant differences between this and a routine dental cleaning that are important to understand.

A routine dental cleaning is designed for prevention - meaning its purpose is keeping gum disease and tooth decay from developing. It involves your hygienist cleaning your teeth above the gum line - removing plaque, tartar, and stains, as well as polishing them. This usually takes place every six months. On the other hand, scaling and root planing is a specialized procedure meant as an initial treatment for patients diagnosed with periodontitis to remove the excessive plaque and bacteria deposits that caused it and halt the spread of the disease. It involves your doctor or hygienist removing excessive calculus and bacterial deposits deep beneath the gum line, and is usually performed with a hand instrument and an ultrasonic cleaner that uses high frequency vibration to separate the calculus from the tooth. Additionally, any uneven surface areas of the teeth will be smoothed out to discourage additional bacteria from attaching. The procedure may require multiple appointments done in stages to ensure you are as comfortable as possible.

Scaling and root planing is a vital treatment to control the spread of periodontal disease and prevent additional complications to your oral and systemic health. Once completed, your doctor will work with you to create a maintenance schedule that best promotes the continued rehabilitation of your gum tissue.

  • Periodontal Maintenance (Maintenance for Perio Patients) – A type of dental cleaning following periodontal therapy that includes the removal of plaque and calculus from above and below the gum line. The difference between periodontal maintenance and a prophylaxis is periodontal maintenance treats active gum disease, whereas a prophy is preventive
  • Oral Probiotics: Support gum and tooth health by binding to the teeth and flourishing below the gum tissue. Oral probiotics also promote whiter teeth, fresher breath and greater overall oral health
Dr. Ryan Lepore - ProBiora Health – Consumer Product Overview

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Dr. Witt Wilkerson: These probiotics, we call them, help flood the whole mouth system with positive bacteria. I think it’s sort of like sending in the good troops to drive out the bad.

And only ProBiora has this unique trio of oral probiotics for healthier gums, whiter teeth, fresher breath. Adding ProBiora Plus and Xtra to your daily oral care routine can make a difference. Order today!

PerioProtect: Custom trays are fabricated to correspond to your individualized pocket probing depths and may be recommended for those with chronic gingivitis, periodontal disease, or undergoing periodontal maintenance.

Dr. Ryan Lepore - What is Perio Protect

Tanya Dunlap: It’s not a surprise that periodontal disease is so prevalent. It really is caused by a bacterial infection that you can’t clean very well at home.

Dr. Stacy Moody: The toothbrush? Great tool, but it can only get a couple of millimeters below the gum tissue. Same with flossing: Doesn’t get much further than that.

Dr. Steven Gordon: The problem with toothbrushes, rinses, and flosses is that they work on the surface; they do not work below the gum line.

Dr. Tim Pranger: When you have bleeding gums, and you have subgingival tartar and bacteria, brushing and flossing aren’t gonna treat the problem. It needs to be attacked subgingivally or underneath the gum tissue.

Dr. Duane Keller: You cannot control all the bacteria. You don’t kill all the bacteria. But what you do is, you change the micro-environment.

Tanya Dunlap: So, between the tooth and the gums is where the bacteria hide. And as they grow into a colony, a community we call a biofilm, it’s really difficult to manage them. So, that’s why the perio tray is nice. The trays get medication really deep under the gums where you need it, where your toothbrush, rinse, and floss can’t reach.

Dr. Darren Allinson: The depths of the plaque are very difficult for not only the dentist to get to, but for the patient to treat with almost any other method.

Dr. Duane Keller: The tray is a delivery device. The tray is like a syringe that delivers insulin for a diabetic. It’s the insulin that helps the diabetic. The tray just delivers the doctor’s selected medication down into and holds it in there long enough for the medicine to work.

Tanya Dunlap: And the tray is unique. It’s unique for you. So, your dentist or hygienist will take measurements in your mouth and send that to a dental laboratory, and they will create a tray with an internal peripheral seal, and that internal peripheral seal corresponds to measurements from your dentist or hygienist and it’s made for every single tooth. That seal corresponds to your unique conditions, and that seal and extensions beyond it work like a gasket: They prevent the medication from leaking all over the mouth, and they direct it very deep into the periodontal pocket.

Dr. Darren Allinson: The action of the periodontal jaw causing opposing pressure on the tray forces that medication to the bottom of the focus sockets and we will get treatment all the way down, whatever the depths may be.

Tanya Dunlap: In the beginning stage of treatment, you are gonna be asked to use the trays two, three, or four times a day, and that is because each tray application is gonna work against that bacterial community. So, imagine it’s like an onion and you are applying the medication with the perio tray deep into the pocket; you are gonna peel off that onion. Next application, peel off the onion. Pretty soon, your body has a chance to heal because you are fighting that bacterial community. Then, long-term use for most patients is one time a day, 10 – 15 minutes. Long-term use gives you a way to manage the bacteria on an ongoing basis.

Dr. Stacy Moody: These trays are needed so that the patients can have them at home, to do on a daily basis. Take their health into their own control and really get that medicine down to where it’s needed.

Tanya Dunlap: You want a healthy oral flora, and this is what the tray delivery is going to help you accomplish!

The only way to treat gum disease and stop your gums from bleeding is by seeking professional treatment. Call us today at (727) 608-4690 to schedule your dental cleaning.

Our Dental Savings Plans

Lepore Comprehensive Dentistry believes that everyone should have access to high-quality dental care and that financial constraints or insurance status shouldn’t stand in the way for anyone to receive such care. That’s why we have introduced Dental Savings Plans as we don’t want you to compromise on your dental health. We have two plans – Standard and Wellness - offered at an annual membership fee of $429 and $729 respectively.

Membership will entitle you to a host of benefits including free and discounted treatments with a focus on your overall health.

Review by Marietta Correale

As a person with extreme anxiety (especially at the dentist) I have to say, this is one of the few places I have ever felt comfortable. Well, as comfortable as I can, that is. The staff has always gone out of their way to make sure I was doing okay and never made me feel like I was being ridiculous (even though I usually am). I am greatly appreciative of their patience, humor, and honesty.

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