Frequently Asked Questions of Gum Problems

Gum bleeding is commonly caused by gingivitis. Gingivitis over the long term may cause gum bleeding under regular teeth brushing, eating, after sleeping, or sometimes spontaneous bleeding. This can be commonly controlled by regular dental cleaning.

In rare occasions, this may be a sign of more severe problems such as blood diseases, drug interactions, diabetes, etc. A dental check up is a good starting point to rule out other non-dental related causes of gum bleeding.

A person in his twenties should be examined by a periodontist at least once every four years. Then in their thirties or older, a periodontal examination should be done once in three years. This is in addition to any other regular dental visits.

Periodontal disease doesn't cause pain in the early years; but it is also most easily treated when discovered early. By the time there is pain, gum shrinkage is noted and tooth mobility is felt, the disease would be quite advanced!

Research compiled over the last five years has shown that untreated gum disease is correlated to diabetes, heart and blood vessel diseases, stroke, pregnancy complications, and perhaps even Alzheimer's disease, osteoporosis and some types of cancers. Mouth infections may also increase the risk for those who are undergoing several types of surgery.

A study published by the New England Journal of Medicine found that by treating severe gum disease, the function of the blood vessel walls could be improved, thereby improving heart health. Two studies in the Journal of Periodontology also found periodontal bacteria (which are present in inflamed gums) in the arteries of people with heart disease and in the placentas of pregnant women.

Another well established link has been between gum disease and secondary infection. An example is patients with heart valve defects. These patients are commonly warned by their doctors to take antibiotics before dental or surgical procedures so that the bacterial disruption in their mouth will not travel through the bloodstream to infect the valve.

Bearing all the above in mind, maintaining healthy gums is something that is simple to do, and yet, potentially can have a positive impact on the overall health of one's body. It certainly shows that prevention is better than cure, when it comes to taking good care of your teeth!

Bad breath often points to gum disease, since the collection of bacteria gives off a putrid smell. Other possible sources of bad breath are the sinuses and throat, but that should be answered by the appropriate doctor.

Prevention is better than cure. Starting from childhood, regular brushing, flossing twice daily and regular visits to the dentist for scaling and polishing twice a year is recommended.

When only superficial gingival inflammation (gingivitis) is present, a thorough scaling by the dentist followed by good home care will keep the disease in check. If there are misaligned teeth, for example, rotated and crowded front teeth, orthodontic treatment to even out the alignment can be helpful. Otherwise the tight spaces prevent proper cleaning and periodontal bone loss may set in later. Impacted teeth like the wisdom teeth that have not enough room to erupt are also best removed early (approximately during the late teens). These impacted teeth are not amenable to cleaning and either cause painful gum inflammation or decay.

By the time the supporting bone around the teeth is lost (periodontitis), extensive therapy by a periodontist will be needed.

Before any treatment can be recommended, the cause of these exceptionally long teeth must be determined. A thorough clinical examination and X-rays needs to be done to assess the dental condition and rule out any underlying problems. Gum disease is seldom symptomatic but can show up as exceptionally long teeth, i.e. the bone and the gums that support those teeth are destroyed, resulting in more root surfaces being exposed, and longer-looking teeth.

Gum disease is a serious problem that must be addressed early, so that those teeth can be preserved and not weakened further. If the diagnosis is receding gums, one option is gingival (gum) grafting – where gum tissue is added to the receded area.

If the gums are otherwise healthy, full ceramic crowns may be prescribed to shorten those teeth. However, root canal treatment may be required if the teeth are to be shortened substantially.

Orthodontics (braces) may be another solution. Braces (metal or ceramic) can align your front teeth to the same level. Invisalign® braces, where a series of transparent aligners are used to straighten the teeth, is another option. The cost will depend on which type of braces is used.

There are various ways to address the problem but this depends on the existing condition of the teeth and gums. Ideally, you should consult a dentist that can discuss the various options and their pros and cons so that the most appropriate treatment can be prescribed.