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The reason your gums are bleeding

You may consider bleeding gums a minor nuisance, but they can be associated with many much more serious diseases. How can you prevent gum disease and why should you do this? We ask the experts.

What bleeding gums mean

Most of us are familiar with bleeding gums; it's most obvious when we brush our teeth. Although bleeding gums are extremely common, it's not something we should accept. Dr Uchenna Okoye, clinical director at London Smiling and a British Dental Association spokesperson says:

"Bleeding gums are not normal. They are the first sign of gum disease. They can also occasionally be a sign of more serious disease like leukaemia or vitamin C deficiency."

How does it occur?

Okoye explains: "Bacteria from plaque release toxins which damage the gum tissue, causing inflammation and then bleeding."

In its early stage, mild gum disease, known as gingivitis, is relatively easy to treat. But a later stage called periodontitis is more serious.

"The bone gets destroyed and, with time, teeth become loose and painful," she adds.

Gum disease, rather than tooth decay, is the leading cause of loss of teeth.

Who is more at risk?

Women are more susceptible to gum disease because of hormonal fluctuations. During puberty, increased blood flow to the gums can change how they react to plaque. Hormonal changes during pregnancy and the menopause can affect gums too. Loss of oestrogen caused by the menopause can result in bone loss in the jaw.

Anyone who has a dry mouth with reduced saliva flow can be more at risk because saliva helps cleanse the gums. Some drugs for other illnesses can cause dry mouth. Everyone who doesn't have good oral hygiene or who eats a poor diet with too much sugar is at risk of gum disease.

The link to other diseases

You may think that bleeding gums are a nuisance, but research shows they can potentially be more serious.

Dr Okoye says: "Gum disease is now linked to many health issues, including heart disease, cancer, type 2 diabetes, premature birth and erectile dysfunction."

Elaine Tilling, dental hygienist and clinical head of education at TePe explains: "Gum disease is associated with other diseases that share an inflammatory pathway. Research into this is relatively new, which is why many people are unaware of the association. We know that the bacteria associated with gum disease are implicated in the formation of arteriosclerosis (furring up of the main arteries) and are found in the heart tissues of people with heart disease."

This low level of inflammation caused by bacteria from plaque is also associated with the development of cancer and type 2 diabetes.

Tilling adds: "Gum disease means you may have an area of inflammation in your mouth the size of the palm of your hand, so it's easy to see how bacteria can enter the body quickly this way. We know that patients with gum disease are more likely to have poor blood sugar control and either have, or are at risk from, type 2 diabetes."

Because gum disease rarely causes pain until it's more advanced, it is easy to ignore it and be unaware of how it can impact on other areas of the body.

Prevent gum disease

Gum disease is preventable and reversible with good oral hygiene, although you can't reverse bone loss or lost teeth when it is advanced. The best way to keep gums healthy is to clean your teeth at least twice a day - in the morning and before bed.

The right toothbrush helps. Dr Okoye suggests a gentle action, round-headed electric toothbrush if you already use an electric brush. It's important to clean right down to the gum line, even if your gums are already inflamed and bleeding.

"If any area of your mouth bleeds," Dr Okoye says, "You need to focus on it more to get rid of the bacteria. Most people tend to take a step back, but that's the opposite of what you should do."

Tilling advises: "Clean in between your teeth too, either with floss or small brushes. This will clean 40% of the tooth's surface that is missed by using a brush alone."

In addition, you can use a mouth wash or an antibacterial gel on the sore areas of gums. If you suffer from dry mouth, maybe because of drugs you take, sugar-free chewing gum can create more saliva and help cleanse your mouth.

Reducing your sugar intake, especially sweet foods and drinks in between meals, will help reduce plaque and bacteria. Eating foods containing vitamin C will also help gum health.

How your dentist can help you

Regular dental check-ups are also important. How often you need to see your dentist varies, Tilling says.

"If you have good oral hygiene you may only need to be seen every year or two. But if you are susceptible to gum disease, you may need to see a hygienist every 3-6 months."

A hygienist will remove the hard plaque which has built up and which cannot be removed by brushing. If this is not removed bacteria will flourish and your gums will become inflamed. Although all gum disease can be treated, the periodontitis stage can require more radical treatment, usually with oral antibiotics as part of the treatment.

The advice is, don't ignore your bleeding gums because the sooner you take steps to manage it, the less treatment you will need and the lower your risk of other disease.

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