Periodontitis, Gum Disease, Gingivitis? Oh My! …Bleeding & Sore Gums
What on earth is Periodontitis? What is Gum disease? Bone disease? Bleeding gums? Why are my gums sore? What is this stuff? Do I really have it? Do I have to go see a Periodontist, as they said?
Lots of questions happen when you start thinking about the health of your mouth. Maybe you’ve recently been told that you have gum or bone disease? Maybe you’ve been told that you need a deep cleaning? Maybe you don’t believe them? Well, after you read all of this info below, you’ll have a much clearer idea if you truly do have these problems...
Gingivitis IS…gum disease.
They’re one and the same.
ANYONE who has bleeding gums when they brush, or when they floss, has GUM DISEASE.
Anyone …who’s… gums… bleed.
Some people are more prone to it than others, and it just isn’t fair, but it’s true. So, we’ll just focus on how to get rid of it instead.
The good news is, if it’s “just” gum disease you can get rid of it, no problem. The bad news is, if you don’t get rid of it, it will turn into BONE disease….and bone disease is not reversible.
Let us explain more:
Gum disease is caused by plaque. Plaque is the white, sticky, acid-secreting, gunky, LIVE bacteria that sticks to our teeth. It sticks to all sides, and secretes an acid. This acid is responsible for everything that goes wrong in our mouths.
Here is a picture of plaque. See how the teeth look rough, dirty, and have some areas of white chunky stuff at the gum line? These teeth would feel like they are “wearing sweaters” if you ran over them with your tongue. This is the stuff we need to brush and floss off asap. This is plaque, and these gums bleed when they are brushed and flossed. No doubt.
Some people have plaque that wants to eat their teeth, causing cavities.
Others have plaque that wants to eat their gums, causing gingivitis and periodontitis.
People are generally more prone to one over the other. So, we ALL have a reason to floss.
If your gums are bleeding when you brush or floss, but you’ve been getting regular dental cleanings, all you usually need to do is get back on the flossing, brushing, and mouthwash wagon for 7 days. After 7 days, the bleeding should go away. The gingivitis will be gone.
BUT the catch is, you’ll have to keep it up or it will come right back. Gingivitis will come back quicker than it left if we don’t become regular flossers.
We recommend flossing at least Monday, Wednesday, and Friday to maintain consistency and keep the gingivitis from returning. Many people maintain well with this amount of flossing.
If we don’t brush that gunk off and floss it off while it is soft and alive, you’ll grow “barnacles” on your teeth.
Yes, “barnacles.”
Our saliva is meant to help us. It doesn’t just aid in digestion but also helps fight off the bacteria. It’s our built-in, natural defense mechanism!
Saliva helps by shooting minerals into the live, white gunky stuff. It kills the plaque. When the minerals in the saliva hit the plaque, it dies and becomes just like a rock stuck to your tooth.
Once it’s dead and mineralized like this, it is now called tartar or calculus. It’s stuck to your tooth like a “barnacle.”
The whole difference between plaque and tartar is… “alive vs dead.” Plaque is “live bugs”. Tartar is “dead bugs.”
Tartar irritates your gums and creates a home for more live bacteria to stick to, so more disease can continue.
Once plaque has developed into a tartar “barnacle” on your tooth, it won’t come off with the brush or floss. You must go GET YOUR TEETH CLEANED. Only the dental hygienists’ expertise and special metal instruments can find it all and scrape it off for you.
None of us, even dental hygienists, are so perfectly perfect that we remove everything all of the time at home. We’ll always leave some of the plaque behind, and tartar will always form on our teeth.
It’s, therefore, so important to get your teeth cleaned regularly, to remove the dead bacteria that you have missed. During these cleanings, cavities are also found EARLY, before they can grow too large.
Maintenance cleanings are a win-win…and a necessity for our own good.
For fun, here is a before and after picture of tartar that has been removed.
So what happens if I don’t brush well, don’t floss well, AND don’t get my teeth cleaned?
If you notice your gums are bleeding when you brush or floss.
If you then don’t START brushing thoroughly and flossing thoroughly.
If you haven’t gone to get a good, thorough dental cleaning at your honest dental office, to scrape off those “barnacles,”… this is what will happen:
The gum disease THAT YOU HAVE will travel down into your bone underneath and it will start to eat your bone away! This bone is what holds your teeth in your head! If this process is not stopped, your teeth will eventually fall out.
We had a patient who waited so long to get his teeth cleaned, that by the time he did, the hygienist cleaned the tartar off of his lower front teeth..and the teeth could be pulled out with their fingers. The tartar was actually holding the teeth in his mouth. He had no pain to warn him. Bad breath was his only symptom. The disease just silently ate his bone away.
If your teeth are loosening on their own, periodontitis is the culprit. Bone has been eaten away by the bacteria.
Please don’t be too scared to go get help, though. This disease is not good for your body to keep fighting.
It is better to get it under control than to let it keep going.
It’s a silent disease that only your honest dentist can find and diagnose for you. So PLEASE, we beg of you…Get your teeth cleaned regularly, so your mouth is maintained and monitored closely.
When your bone is being affected… You now have Periodontal disease
As we said above, once the disease starts to affect your bone, it is then called Periodontal disease. “Perio” is MUCH harder to control than gum disease is.
It’s undeniably necessary to brush and floss at this point. Periodontal patients even floss with YARN dipped in prescription mouthwash instead. So, flossing is inevitable.
The sooner we start making our dental cleanings, brushing, and flossing a routine, the better off we will be.
If everyone did what they were supposed to do, we hygienists would be out of a job. Be one of those people who barely needs us.
Periodontal pockets form when bone loss occurs.
When Periodontal disease is happening, and your bone is being eaten away underneath, your gum level stays in the same place. So, when you hear us talk about a “pocket,” this is what we are referring to.
A pocket is created under your gums. Your gums stay in their same place, and the pocket gets deeper as more bone is eaten away. The deeper the pocket gets, the harder it is to clean.
We measure these pockets with a dental “probing instrument.” In the picture below, each alternating dark and light area accounts for 3 millimeters. So, 3-6-9-12mm and so on. A healthy depth is 4mm and below. As more bone gets eaten away by the bacteria, that probing instrument will go further down under the gums and into the pocket. The measurement will read higher and higher. Here is a picture to help you visualize this.
Picture the pocket of your pants going all the way down to your ankle. Now picture trying to get a piece of lint out of the bottom corner of it. It would be much more difficult to reach the bottom of that pocket than it would be to reach the bottom of a regular pocket, right? The same goes with the plaque at the bottom of a “periodontal pocket.”
As the pockets get deeper, even your dental hygienist isn’t able to reach and clean the plaque out of the bottom of it thoroughly. If the hygienist can’t get it, you sure as heck can’t get it.
Unfortunately, the bone will just keep getting eaten away. The disease is destined to continue. Your only option is to go see a Periodontist, and it’s very important that you do.
If you lose too much bone, you begin to limit the options for tooth replacement.
If you’re hoping for a dental implant, there needs to be bone left to place an implant in.
If you think you may just go the denture route, you need an arch of bone structure for a denture to hold on well.
So please see a periodontist if that has been recommended to you. They are there to help save your bone and your teeth.
The periodontist will do a “procedure” where they “move” your gum line back to where your bone level has been eaten away to.
It’s a small surgery, yes, but it’s worth it. Many people have it done. You HAVE to get that periodontal pocket back to a healthy, “cleanable” depth so it can be maintained to prevent further bone loss.
Okay, so how do I know if I’ve lost bone? How do I know if I have Periodontal disease?
Your honest dentist or honest dental hygienist can tell if you have lost bone by looking at your x-rays, and by measuring the depth of your “pockets” with that probing instrument.
To measure these depths, they place the instrument under your gum line and gently push it up into, or down into, the pocket area. They run it right alongside the root of your tooth. The instrument will stop where your bone level is.
The measurement is then read from the base of that pocket to the edge of your gum line. It is measured in millimeters. Healthy gums should have readings of 3mm-4mm or less.
A reading of 4mm, or even 5mm, in the back teeth DOES NOT always mean that you need a deep cleaning, as the DISHONEST dental types like to tell everyone. It does not necessarily mean that you need antibiotics placed under the gum line for a hefty fee per site either.
4-5mm in the back teeth can simply mean that your gums are a little puffy and inflamed because you haven’t been great at flossing and brushing. It can mean that you need a good, THOROUGH dental cleaning. It does not necessarily mean that you need a deep cleaning with root planing and the works.
Gum inflammation can go down 1-2 millimeters with a good, thorough dental cleaning done by your honest hygienist, combined with the correct brushing/flossing/mouthwash routine. It takes just a week or two to see the results of that.
Talk with an honest dentist about trying this FIRST if you’re in the 4-5mm range in the posterior teeth.
4-5mm in front teeth is another story and a bit more worrisome.
Probe readings of 6mm or higher in the posterior teeth or 4mm or higher in the anterior teeth are numbers to be more concerned about, ESPECIALLY if there are multiple readings like this around your entire mouth.
One or two of them are more controllable by you and your honest dentist/hygienist, but an entire mouth of deep pocket readings means that it would be best to be seen by a periodontist. They are the gum and bone specialists. At this point you most likely have periodontal disease beginning.
Our probing instruments go up to 12mm. We’ve had to guess at numbers after that even. Please don’t let yourself get to this point.
If you do believe you HAVE reached this point, please don’t give up. It’s important that you take care of it and get that infection out of there. The health of your entire body is at its mercy. You need to get back to health. Your body is fighting that infection daily.
Periodontal Disease causes an increased risk for heart attacks and strokes
If your mouth is not healthy, it will affect the health of your body.
Your immune system will constantly be trying to fight off that infection. The plaque in your mouth can get into your bloodstream when your gums bleed. This means your arteries.
The American Dental Association and the American Heart Association have both acknowledged the correlation between Periodontal Disease and atherosclerosis, affecting cardiovascular arteries. Plaque and inflammation in your arteries.
Periodontitis and Diabetes
People with Diabetes are more at risk of developing Periodontal disease due to the higher sugar levels in the saliva. The bacteria in your mouth grows and releases more acid when it’s fed more sugar. So it is extra important for patients with Diabetes to brush, floss, and get regular dental cleanings.
Gingivitis, Periodontitis, and Pregnancy
Due to the changes in hormone levels, pregnant women develop gingivitis more easily. They are, therefore, at a higher risk of developing Periodontitis if they don’t floss, brush, and get their regular cleanings.
There is actually a name for it. It is called “Pregnancy Gingivitis.” Go figure!
It has been noted that extreme cases have been linked to miscarriage or premature birth as well, but stress can also do the same. So, the best advice we give our mothers-to-be is… don’t stress. Just go home and start flossing and brushing like you have never done before. Keep that mouth healthy for that baby!
So, periodontal disease doesn’t hurt? I won’t even know that I have it?
Periodontitis DOES NOT HURT in the beginning. The “nothing hurts or bothers me” statement does not apply to dentistry like everyone thinks it does. You’ll notice the bleeding and tender gums like with gingivitis, but that’s about it. Many people pay no attention to those things.
Periodontal disease is basically silent to the average person.
The main noticeable symptom is bad breath.
Periodontal disease actually has a VERY distinctive smell, to professionals who are familiar with it. Average people who don’t know what they are smelling, though will just go through the mouthwash like crazy trying to mask it.
Another indefinite symptom is bleeding gums.
Waaaaaay too many people think bleeding gums are normal, or that they are hurting themselves with the brush or the floss.
All too often, they actually STOP brushing and flossing when they see bleeding, when what they really need to be doing is brushing and flossing MORE!
Late-stage Periodontal symptoms include loose teeth and forming periodontal abscesses. This is usually accompanied by extreme breath because the bone is rotting away in your mouth. Once the teeth are loose and abscessing periodontally, it’s much less likely that your honest dentist or periodontist can save the affected teeth. It is much less likely that there will be enough bone left to replace that tooth with a dental implant, as well.
Here is a picture of what severe periodontitis looks like. There is very heavy tartar all along the gum lines. The gums have moved away from the healthy place where they were supposed to lay. The roots of the teeth are showing. There are now more spaces in between the teeth where the healthy gums used to fill it in.
This is not the best position to be in, but it’s not too late. Your honest dentist and periodontist can still help. Please let them help to get that infection out of your body. Please make yourself a priority. You’re worth it.
For this reason, it’s extremely important to get your teeth cleaned regularly!
People who are prone to getting Periodontal disease are usually NOT as prone to getting cavities. It’s true! We’ve seen it over and over again. It IS commonly a genetic thing and a different type of bacteria that people have in their mouths.
So, guess what happens? They get complacent because they don’t get cavities! They think that because “nothing hurts” in their mouth, they don’t have to go to the dentist.
What they don’t realize, though, is that instead of cavities these “gum and bone disease people” are silently growing those “barnacles.” Tartar is stuck on their teeth like a barnacle to a boat, attracting and harboring MORE live bacteria. The added bacteria will eventually die, too, making the barnacle grow even larger, contributing to MORE disease!
You need your hygienist to pick off those barnacles for you regularly. Once it’s hard, it won’t come off with brushing or flossing at home. If it doesn’t get cleaned off…..gum and bone disease will come soon.
When you go get your teeth cleaned every six months, the barnacles are small, and your hygienist can get rid of all of them quickly and thoroughly.
When you go a long time in between cleanings, don’t floss, don’t brush well, and skip brushing at night; this dead bacteria grows and grows and grows. Your hygienist will have to use more muscle, more time, and sometimes even their ultrasonic scaler, aka “jackhammer,” to help remove it. (Just being funny about the “jackhammer” part. All it does is vibrate with water, but it helps with the larger pieces for sure)
This video shows satisfying the ultrasonic removing of tartar.
Sometimes there are so many “barnacles” that can’t all be cleaned off in one appointment time. Sometimes it has grown so large that it can be seen on the x-rays! Sometimes it’s so deep down in the periodontal pocket that the hygienist can’t even get it all. Sometimes you need a “deep cleaning.”
We’ll say it again and again, though. Once you have a deep cleaning, as long as you continue your routine dental cleanings afterwards, and are good about brushing and flossing, you shouldn’t need a deep cleaning again. Your honest dental hygienist should be able to maintain your mouth with their thorough dental cleanings as long as you are doing your part.
If you don’t help with your part, though, it will be an uphill battle for you. But please think about this, how hard is it to brush, floss, and go get your teeth cleaned a few times a year? It’s much easier than the alternative, don’t you agree?
All of this sounds can sound scary, but…
If a person who is more prone to gum and bone disease would learn early on that flossing, brushing, mouthwash, and regular dental cleanings were their best dental friends, their dental problems would be slim to none in life.
Their normal dental maintenance routine would look like this:
A cleaning twice a year, x-rays once a year (or even two), and an exam once a year. That’s it!
Floss is truthfully their best insurance! Most of these people do fine without dental insurance at all even! They can usually save some money in a side account for the rare event that a cavity happens or they crack a tooth. This insurance trick is only true, of course, IF they take the time to find an honest dentist first.
A dishonest dentist will find a cavity in there, even if there isn’t one.
The KEY to saving your mouth:
The key is…find your HONEST dentist/dental hygienist. Then, believe them and do what they say. If you’re worried that you are being lied to, take the time to get a SECOND opinion somewhere else.
If there is any question in your mind that an office is not being honest with you, get a copy of your x-rays and “pocket numbers” and go get a second opinion with an honest dentist.
If an office tells you that you cannot have a copy of your records, RUN from that office immediately. They should have nothing to hide and should always be willing to give you your records. YOU PAID for them.
An honest dental office will be able to explain everything to you thoroughly, so that you understand them and believe them. Your mouth and wallet are safe there.
In the end…
It would be worth your time to reading the SODA we have spilled on how to floss properly, brush properly, and use mouthwash. It’s important that you do all of those things correctly, so have a click on those links!
You see yourself 365 days a year. Your honest dentist and dental hygienist only see you two days a year. Even if they recommend that you get your teeth cleaned every 3 months, instead of every 6 months, that still adds up to a whopping 4 days per year !!!!!!!
It’s up to you. You need to keep the bacteria that cause these diseases OUT of your mouth consistently, 365 days a year.
So, even though you’re super smart with this knowledge now, please remember that your honest dentist still knows more. Trust them and believe them.
Remember, we can’t diagnose you from cyberspace. You’ll have to go find your honest dentist.
We hope this information answered all of your questions! Though it would be best if we did, we’ll never claim to know it all, all of the time. Nobody knows it all! We do claim honesty, though, and we sincerely want to help as many people as we can! Our patients have maintained beautifully, following our conservative recommendations :)
So, thanks so much for reading and letting us spill our SODA! Remember to take the time to find your HONEST DENTIST, and be sure to browse around our links and follow us on social media for answers to more of your exciting dental questions, like:
