Your gums are red around the margins and bleed whenever you brush or floss but there's minimal to no pain... You: (select the most appropriate answer[s])

1. are brushing or flossing too vigorously
2. have an accumulation of dental plaque where the teeth meet the gums
3. are using a toothbrush that's too firm
4. are experiencing early signs of gum disease
5. should see your dentist if this persists for more than 6 months

Kudos if you picked b) and d). The most common cause of bleeding gums is the accumulation of dental plaque (bacterial deposits) at the gum line, which is an early sign of periodontal (from the Latin “peri” – around, and the Greek “odont” – tooth) disease. It is usually painless so people tend to underestimate the risk of allowing gum disease to progress and become a more significant problem.

It's a common misconception that bleeding gums are caused by brushing or flossing too vigorously or using a toothbrush that's too firm. This is sometimes the case, but the abrasion would probably cause noticeable pain. Instead, it's likely that you're not brushing and flossing effectively enough, allowing bacterial deposits to accumulate at the gum line and feed on food particles that haven't been adequately flushed from your mouth.

The bacterial deposits form a whitish film that is hard to detect when you look in the mirror. But you will notice bleeding and redness and eventually inflammation of the gums — an immune response to disease-causing bacteria that flourish in the plaque. As the biofilm grows, with time it also hardens (calcifies), making it increasingly difficult to dislodge. Eventually, only professional cleaning can remove it and sometimes antibiotics are needed. If no action is taken, gum disease will progress, and eventually cause loss of the underlying bone that anchors the teeth.

There are other reasons that gums may bleed, such as elevated hormone levels in women, a side effect of certain medications, or a systemic (bodily) disease. Whatever the cause, it's important to get a professional diagnosis promptly and take appropriate therapeutic action as needed. Optimally, with good oral hygiene and regular checkups, you can avoid this problem entirely!

If you would like more information about preventing or treating bleeding gums, 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 “Bleeding Gums.”

Having someone tell you that you have bad breath can be humiliating, but it can also be a sign that you need to see your dentist. Bad breath (or halitosis) can be a sign of an underlying dental or health problem, so before you run out and stock up on breath mints, make an appointment with our office. Using breath fresheners will only disguise the problem and not treat the root cause.

It's important to remember that if you have bad breath, you're not alone — it's the third most common reason people seek a dental consult. We use a systematic approach to determine the cause of your halitosis and offer a solution.

Causes: Ninety percent of mouth odors come from mouth itself — either from the food you eat or bacteria that may be present. Most unpleasant odors originate from proteins trapped in the mouth that are processed by oral bacteria. When left on the tongue, these bacteria can cause an unpleasant smell. Dry mouth, sinus problems, diet and poor oral hygiene can also cause bad breath. In rare cases, a medical condition may be the cause.

Treatment: The best solution will depend on determining the real cause of your halitosis. If bad breath emanates from the mouth, it most commonly is caused by gum disease or even tooth decay, which need to be treated to correct the problem. If halitosis is of systemic (general body) origin, a more detailed examination might be needed from a physician. But the solution may also be as simple as demonstrating how to effectively remove bacterial plaque from your teeth, or offer instruction on proper tongue cleaning. If the cause is gum disease, we may suggest a deep cleaning and possible antibiotic therapy.

Contact us today to schedule an appointment to discuss any questions you may have regarding bad breath. Read more about this topic in the Dear Doctor magazine article “Bad Breath: More Than Just Embarrassing.”

Did you know that recent research has shown diabetes is a risk factor for increased severity of periodontal (gum) disease and that periodontitis is a risk factor for worsening blood glucose (sugar) control in people with diabetes? Periodontitis can even increase the risk of diabetic complications for people diagnosed with diabetes. When you combine these facts with the following, you will clearly see how important it is to understand and manage these two diseases.

• Over 23 million people in the United States currently have diabetes and over 170 million worldwide.
• 14+ million Americans have a condition called pre-diabetes.
• Another estimated 6 million people in the US have diabetes but are unaware and thus not diagnosed.
• Periodontal disease is the second most common disease known to man, only surpassed by tooth decay.
• Diabetic individuals with periodontal disease have a greater risk for cardiovascular and kidney complications than those diabetics not having periodontal disease.

What You Can Do

One of the most important steps you can take if you have either of these conditions or suspect that you might have one or both is to make an appointment with your physician or with our office for a thorough examination. You should schedule an appointment with your physician for an exam and blood work so that your general health and well-being are monitored. Be certain to share your medical information and any family history of diabetes with our office, as it tends to occur in families.

Learn More

Learn the risks and how to take care of types 1 and 2 diabetes, as well as the stages of periodontal disease (with detailed full-color illustrations) when you read the Dear Doctor article, “Diabetes & Periodontal Disease.” Or if you want to schedule an appointment to discuss your questions, contact us today.

Tongue and other piercings are a current fad or trend, but can often lead to unforeseen problems.

Piercing the tongue and installing a metal ornament called a tongue bolt commonly leads to chipped teeth, sensitivity, and pain. More frequently, it can cause problems with the gums, such as recession, inflammation, infection, bone loss, and even nerve damage.

In one case reported by the American Medical Association, a teenager suffered 20 to 30 daily electrical shocks in many areas of her face after having her tongue pierced and installing a tongue bolt. A neurologist found that the bolt irritated the nerves to her tongue, causing the symptoms. After the bolt was removed, the shocks and symptoms ceased and her tongue healed.

Having the bolts placed may be painful. The tongue is rich in nerves and blood vessels and a lot of bleeding can occur, which can be difficult to stop. Think about how painful it is when you bite your tongue or lip accidentally. And tongue and lip bolts are not generally placed by health professionals or under sterile conditions.

If you are considering getting an oral piercing, make an appointment with us to discuss all the possible ramifications before you make the decision to go ahead. If you already have an oral piercing, be sure to come in for frequent checkups.

Contact us today to schedule an appointment to discuss your questions about oral piercings. You can also learn more by reading the Dear Doctor magazine article on “Body Piercings and Teeth: The dangers of tongue and lip piercing.”

Do you constantly feel like you are running on empty? Do you snore, feel like napping every day, or even drink multiple cups of coffee just for the caffeine boost? You may have a sleep related breathing disorder (SRBD) or Sleep Apnea (“a” – without; “pnea” – breath) in which your airways become obstructed causing chronic loud snoring. The good news is that we can help both diagnose and treat this disorder, which means you will be able to finally get the rest that you (and your sleeping partner) so desperately need.

The reason that sleep apnea is so disruptive to daily living is that it causes awakening for a few seconds up to 50 times per night, significantly decreasing the amount of deep sleep that is necessary for full rejuvenation. Airway blockage during sleep commonly results from obesity, an enlarged tongue or tonsils, and other factors that can cause your airway to close off when you lie down, all increasing the likelihood that you will suffer from sleep apnea. These conditions are dangerous and impair the brain and heart from receiving adequate oxygen, increasing your risk for both stroke and heart attack.

The study of sleep and its disorders is relatively new. One successful way to treat sleep apnea is with a “CPAP” machine which uses a Continuous Positive Airway Pressure mask overnight to keep air passages open while sleeping. Another more comfortable, less noisy, and unobtrusive method is to use Oral Appliance Therapy, which features an appliance like a retainer that can be custom fitted to your mouth made by a dentist trained in sleep medicine.

And yes, dentists are increasingly being recruited to help study and treat sleep disorders. There are actually several ways in which we can help. Because we see our patients on a regular basis, we are uniquely qualified to diagnose early signs of SRBDs. For example, if you start to snore almost immediately after falling asleep in the dental chair, we will be able to discuss this important warning sign with you. We can also examine the back of your mouth to see if you possess any of the traits that point to SRBDs, including large tonsils and/or an elongated uvula — the tissue in the back of your throat that looks like a little punching bag.

So, if you want to stop snoring and start sleeping well or you think you may have a SRBD, call our office to schedule a basic oral exam and consultation. If you would like to learn more about the link between dentistry and the treatment of sleep disorders, read the Dear Doctor magazine article “Sleep Disorders & Dentistry.”