Vijaya Babu (43) from Coimbatore, Tamil Nadu, found his gums bleeding after brushing, and mouth freshness lasting only for a few minutes. In addition, Babu experienced bad breath and dry mouth. An oral examination by a dentist showed the presence of calculus (yellow deposits on the teeth surface) and weakened gums.
He was asked to check his blood glucose levels as he had diabetes. After his blood sugar levels were found to be high, he was told to control them before seeking dental management, as high sugar levels can delay healing of the gums. He underwent scaling (removal of calculus from the tooth) and curettage (removal of tartar from tooth roots) after his diabetes was brought into control.
“After scaling, I was asked to use an antimicrobial mouthwash for two weeks. The inflammation in the gums and bleeding started reducing gradually after the therapy,” Babu says.
Causative factors for bacterial growth
Experts say that unhealthy brushing habits leave food residue on the tooth’s surface. Bacteria tend to grow easily when food particles are present for an extended period. Our body’s immune system acts as a defence mechanism against bacteria, resulting in gum bleeding and inflammation.
The bacteria multiply and form a biofilm (an assembly of microbial cells) on the tooth surface called dental plaque. When the plaque stays on the tooth for more than two to three days, it starts forming tartar or calculus.
Toothbrush bristles are ineffective at reaching interdental areas (the space between two teeth), making them more prone to plaque-induced inflammation.
What do the gums indicate:
According to a 2020 study published in the European Journal of Molecular and Clinical Medicine, various factors other than plaque cause gum bleeding. They include diabetes, high blood pressure, vitamin K or C deficiency, hormonal imbalance, and stress. Blood in saliva after brushing, dull pain, bad breath, red, swollen and spongy gums are all signs of gum bleeding.
“Oral health is linked to the health of other organs in the body. So, bleeding gums may be an indication of digestive issues as well,” says Dr Saranya Sri, a dentist from Chennai, Tamil Nadu.
Experts suggest that bacterial accumulation in the mouth can affect the gut microbiome and cause digestive issues. Furthermore, unhealthy dietary choices can affect both oral and gut microbiome. Consequently, oral hygiene should be a priority when managing these issues.
Dr Sri says, “Diabetics are prone to chronic inflammation. They should be aware of mild inflammatory responses by the gums and follow a hygienic oral care routine.”
She adds that vitamin D has anti-inflammatory properties and is responsible for maintaining bone homeostasis (a self-regulating process by which an organism maintains stability). Alveolar bones (bones that support teeth), ligaments, and soft-tissue pockets aid in holding the teeth. A deficiency in vitamin D disrupts the structure of the alveolar bone causing gum related conditions and loosening of teeth.
Early intervention is key
A 2017 study reveals that gum inflammation caused by plaque has an increased tendency to bleed. Mechanical therapy like brushing, flossing, and professional cleaning significantly reduced dental plaque in the study population.
After the therapy, an antimicrobial mouthwash was prescribed for up to four weeks. However, prolonged use of antimicrobial mouthwash stains the teeth, alters taste, and produces a burning sensation in the tongue and cheeks.
“Long-term gum conditions should be managed as early as possible. A delay in this may result in gum recession, infection, discomfort, and swelling around the teeth,” says Dr M Mathan Kumar, founder of Mathan Dental Clinic, Coimbatore, Tamil Nadu.
“Flossing once daily reduces the risk of infection. Be gentle while flossing and avoid using excessive force as it may hurt the gums and adjacent teeth,” he adds.
Flossing removes the plaque in interdental areas and helps gums heal better. Flossing may appear to be a difficult task initially. However, doing it a few times will create a habit.
Oral care routine for healthy gums
Dr Sri insists on the following oral care routine for healthy gums:
- Use soft bristle brushes as they can flex and clean the interdental areas.
- Rinsing the mouth with water after every meal prevents plaque buildup.
- Oil pulling reduces plaque formation and improves gum health.
Read more about oil pulling here.
- Those with gum infections should gargle with warm saline water twice daily. It inhibits bacterial growth and lessens infection.
- Massaging the gums with coconut oil or olive oil for two to three minutes improves the blood circulation in the soft tissues around the teeth. To massage, apply oil on the index finger and rotate it in a circular motion around the gums.
- Scaling and root planing aid in restoring healthy gums. Visiting a dentist every six months for scaling and root planing is ideal.