Bleeding Gums?

PREM KUMAR (name changed on request), 26, is a software consultant with a leading firm in Bangalore. One morning, as he was brushing his teeth, he noticed blood on the toothbrush. He ignored it as it wasn’t in the least painful. This continued for about 3 weeks or so when he decided to visit a dentist. The problem of bad breath also had been troubling him although he was brushing his teeth twice a day.

Prem Kumar is not alone in his plight, bleeding gums affects a vast majority of the population and is one of the most commonly neglected conditions too. Generally, one or two days of no oral hygiene measures leads to the formation if a thin white, garyish or yellow biofilm called plaque that comprises primarily of microorganisms on the surface of teeth and may be readily visualized. The location and rate of plaque formation very among individuals, and determining factors include oral hygiene diet and salivary composition and flow rate.

The soft plaque is hardened by precipitation of mineral salts, which usually starts between the first and 14th day of plaque formation. It is now called calculus or most commonly tartar and is 50 percent mineralized in 2 days and 60-90% mineralized in 12 days Calculus implants on the gums (technically termed gingiva), moves deeper into them causing them to loosen and bleed on touch brushing. This condition of the gums is gingiotes. There is redness in the gums, sponginess and appear swollen. If neglected further, the infection moves on to the bones altering the support to the teeth making them loose over a period of time. This stage is called periodontitis (commonly know as pyorshea) which is many types and affects a wide range age groups.

Simple measures help maintain good oral hygiene and aid in plaque control.

Tooth brushing is ideally recommended after every meal. Since it may not be feasible, twice a day, in the morning and at night before bed time is advised.

A soft or medium toothbrush is best and should be changed every 3 months.

The toothbrush, regardless of the method used, does not completely remove inter dental (in between teeth plaque. Tooth brushing is therefore supplemented with specific aid for inter-dental cleaning.

Dental flossing is cleaning surfaces between two teeth with a multifilament nylon yarn and can be done manually or with a floss holder.

Inter-dental brushes are cone-shaped brushes mounted on a handle suitable for cleaning large irregular or concave tooth surfaces.
A good mouthwash has shown to be effective for plaque reduction but is not a replacement for mechanical plaque control methods like the ones mentioned above. Chlor hexidine has shown the most postive results with a plaque reduction of 45-61 per cent and gingivitis reduction of 27-67 per cent.