Bleeding gums? Smelly breath?

Remember this ad? 

You wouldn't ignore it if this happens to any other part of your body, so why do you ignore it when it happens to your gums?

This was an ad for Corsodyl mouthwash, and I thought was brilliant. Even though my gums were bleeding at the time, and I still didn't do anything about it. 

People fuss about hair or make up, take a wash every day, etc. etc.

But many don’t think about their teeth when they think about their appearance. Probably because they are a bit of a fiddle and a chore to clean. 

We all know it’s important to brush our teeth, but how many of us really think about what happens if you don’t clean them properly? How many of us only clean our teeth just to avoid making people cringe when you open your mouth?

What is the big deal with having to clean them every single day anyway?

Bacteria!!! Bacteria own us. From the moment we are born till we die every part of our body is waging a war to keep bacterial growth in check.

* One of the most important ways it does this is by shedding cells, e.g. our skin is constantly shedding and regenerating.* However teeth surfaces are not able to shed and regenerate, as they are made of bone. So bacteria accumulate on teeth in a way they are simply unable to do anywhere else on the body.

What does accumulated bacteria look like?

They form a biofilm (plaque) covering your teeth (even between your teeth, even under your gum line!). When the biofilm becomes dense enough (only a matter of days), it becomes hard. Eeek! Hardened plaque is called tartar (calculus). Biofilm can be removed by brushing. Tartar can not. Think of cement, after its set. It has to be scraped off by a dentist/hygienist. The bacteria within the hard tartar are dead. If it is not removed, the tartar will continue to grow and thicken, imagine what that will do to your poor gums over time.  

Here the tartar (calculus) is practically pushing the gums back

What do bacteria do to your teeth?

They secrete enzymes and acid which corrode your teeth, when exposed to food and especially sugar. The only natural defence teeth have against the acids is saliva. Saliva contains water which dilutes and neutralizes acids. It is also antiseptic.

Corrosion of teeth/bone causes:

• Cavities (caries) 
• Detachment from the gums - The surface of the teeth (enamel) needs to be intact in order to attach to your gums the way they were intended to.

What do bacteria do to your gums?

Nobody thinks about their gums. Your gums are delicate soft tissue which hold your teeth in place. Continuous build up of tartar can physically rub against and irritate the gums, and push them back.

Bacterial assault causes inflammation. Inflammation means redness, swelling, soreness, and in the case of your gums, bleeding. And your mouth will smell. 

If this is happening to you, your gums are infected - you have gum disease. Go see a dentist.

There are two stages of gum disease: gingivitis and periodontitis. When gingivitis becomes advanced this leads to periodontitis, where there is bone loss and serious detachment going on.

What happens when gums detach from teeth?

Gums only detach from parts of the teeth which have been permanently damaged by plaque acids or aggressive brushing.

Detachment caused by aggressive brushing leads to receding gums.

Detachment caused by plaque acids can lead to pockets, gaps between the gum and the tooth where there shouldn’t be, as well as receding gums. And of course in extreme cases loss of the tooth.

Gums have receded, exposing the lower part of the tooth making it look longer

Gum has detached from tooth, forming a pocket

Receded gums and pockets are irreversible. You can stop them from getting worse, but you can’t make them rejoin the tooth again (apart from with surgery).

You end up having more teeth surfaces to clean, and (for example in the case of pockets,) more difficult to clean as well.

Your teeth become sensitive. Only the bottom part of the tooth which is normally supposed to be covered by your gums is sensitive.

When your gums recede, cosmetically your teeth will look longer. This is actually very aging. And not very attractive!

Tooth loss is very common in the older generations, dental hygiene awareness is more advanced now.

Tips for effective dental hygiene

• Brush AND FLOSS your teeth every single day. Twice a day is the gold standard, but your teeth will still fly by on once a day cleaning. Dentists will accept once a day, they won’t want to hear it, but they accept it. Once a day is enough to break up bacterial colonies to slow down the creep of tartar.
• If you clean only once a day, then do it at night before bed time. Saliva provides your teeth with some protection against bacterial assault, but dries up when you are asleep.
• Flossing is just as, if not even more so, important as brushing. No brush is going to be able to between the teeth. Leaving those parts uncleaned is basically not cleaning half your teeth. Imagine kind of just brushing half your mouth, doesn’t make sense.Also with floss you are able to partially clean underneath the gum line, which is pretty cool. A lot of people will brush but don't floss, previous me included. So I'm going to go into flossing again at the end. 
• Get your teeth cleaned professionally at least twice a year. Even if you brush and floss religiously twice a day every day, there is just no way you are going to clean completely beneath the gum line, not without the professional tools. And please don’t try either, you might end up damaging your gums. They can also remove stains, which you can’t do with just brushing. Stains on the teeth really age you. 
• From personal experience, a hygienist will give you more help with your brushing and flossing technique than a dentist will. 
• Use an electric toothbrush. They are more efficient at removing bacteria from your teeth than a conventional toothbrush. Use a mirror, make sure you are covering all the surfaces properly.
• Don’t brush your teeth too hard. You’ll damage your teeth enamel and make your gums recede permanently. You’ll know if you’re brushing too hard if your tooth brush is splaying within 3 months of use. I used to make my brush splay within a week, crazy.
• It is worth spending the money and time on your teeth. Think of how much money you spend on a haircut, or shoes. People notice your teeth, nice teeth make a huge difference to your appearance. Nice smelling breath is practically priceless.

More tips! Love it

• Floss before brushing, so that the good stuff in your toothpaste is more able to go between your teeth.
• You can brush partially between each tooth with interdental brushes, which may be worth doing if you have large gaps between your teeth. Maybe wait and ask a dentist or hygienist to show you how to use them though. Some gaps are too tight to use brushes and can only be flossed. Interdental brushes can’t really replace flossing however, floss is able to clean partially below the gum line. You’d need to do both. 

• Avoid brushing straight away after eating. Plaque produces acid which softens the enamel of your teeth. If you brush at this point, you’ll damage the enamel. Wait an hour or so after, or brush before eating, for example before breakfast or lunch.
• If you have very sensitive teeth rub toothpaste for sensitive teeth onto the affected areas and leave.
• If you use mouth wash, don’t use straight away after brushing. This removes the beneficial layer of fluoride left on your teeth from the toothpaste. Recently not rinsing even with water has been suggested, just spit the excess toothpaste out and wipe your mouth.
• I don’t really bother with mouthwash, but I will use Corsodyl (Chlorhexidine) mouthwash if my gums are inflamed, or on ulcers. Chlorhexidine kills bacteria. I wouldn’t use it every day though, I don’t think I need it, plus it stains the teeth. Stains can be removed by a hygienist.  You can also get Corsodyl spray, which enables you to spray onto specific parts of the mouth, rather than sloshing mouthwash all over if you don’t need to.
• Change your toothbrush every 3 or so months, for hygiene reasons if nothing else. 

FLOSSING, and what happened with me

I was never the best with brushing my teeth, but I NEVER flossed. My gums started bleeding when I was young, I think in my teens. And I didn't think anything of it. Kids eh? This was years before that ad with the bleeding eye came out. I remember seeing that poster, and still not thinking anything of it because I'd had it for so long I thought it was normal. It wasn't until I got pregnant and my gums got even worse, and my dental hygienist really rammed the point home - pregnant women are more prone to gum disease and tooth loss. That was when I finally started brushing and flossing daily, for the first time in my life. I was 34.

I had started seeing the hygienist a couple of years earlier, after a particularly bad bout of gum inflammation. She removed all my tartar build up, and I improved my brushing technique and frequency but still only flossed every 2-3 days. Which to me was a big improvement from before. However my gums continued to bleed.

Getting myself to floss every day was a challenge, I seriously was like, can I really do this? It is about retraining yourself, and developing that habit. I would say it took about a month or so before it mentally became less of a chore. And the results were so, so worth it.

The first time my gums did NOT bleed when I brushed was after a couple of months of daily brushing and flossing. My goodness, when that happened, it was like a religious moment. My gums had bled when brushing for so long, I honestly had not realised that they were not supposed to do that. Parts still bled when I flossed, but after a further couple months later, that too stopped. 

As I said, I was 34. The result of years of insufficient dental hygiene and gingivitis: my gums are receded (more due to hard brushing, and not as bad as that photo above), and I have a couple of pockets between my two bottom back teeth on the left side of my mouth. 

The pockets get inflammed a lot, which makes it feel like there's food stuck there and drives me nuts. I have to try and clean them with an interdental brush which I pretty much poke around with and hope for the best. If I don't do this the pockets tends to bleed and smell. It's a hassle, and took a little while for me to realise that I was going to have to do this for the rest of my life. You might be interested to know I only found out about them and how to clean them through the hygienist, and not the dentist.

I have read that gingivitis can be hereditary, my mother had it and has lost several teeth, one of which was during her last pregnancy. Apparently some people are more prone to forming tartar than others, maybe something to do with the strains of bacteria in their mouths. 

My routine now is brushing twice a day and flossing once a day. I tend to floss when I'm watching TV or YouTube, then go into the bathroom in front of the mirror, clean again with an interdental brush, and then finally brush with an electric toothbrush. As I only floss once a day, I do this in the evening, roughly around 9 pm. I used to forget, and then go to sleep with out cleaning, and I went through a spell of setting an alarm clock to remind myself. Nowadays having a routine makes it easier to not forget.

I also have my teeth cleaned professionally every 6 months, or even more. They don't really have hygienists in HK, so I've been getting my teeth cleaned by dentists, and I don't really feel they do as good a job somehow. But for now it'll have to do.

My teeth have a lot of yellowing and stains from tea drinking, so I am now interested in whitening, but that would have to be saved for another post....

You Tube videos

This one is pretty good for showing you what the dentist/hygienist does, and what tartar (calculus) looks like:

This lady is a hygienist and she goes over teeth brushing technique. She has a couple other videos on cleaning between the teeth as well.

Here's the Corsodyl commercial with the powerful image of the girl with the bleeding eye:

That's the end of this post, I hope you found it helpful. 

To good dental health and hygiene!

My teeth now - haha I wish!