teach me how to keep my smile healthy 'til I'm old

October 9, 2010 6:38 PM

For the past couple days, when I have been brushing my teeth, my gums have bled. The Internet is promising me DOOM to my mouth if I don't shape up, but I can't find much on everything specific that I should be doing. Help me help my gums.

Relevant details:
*I went to the dentist a couple months ago and they told me I have a few 4 pockets in my gums.
*I'm 27, female, vegetarian, not pregnant, generally healthy.
*I switched to a different toothpaste after the visit to the dentist.
*I will eat more greens in the future. I haven't in the past. I eat a lot of rice or potatoes, and dairy (including eggs). I cycle between eating vast amounts of fruit and candy/chocolate/ice cream.
*I brush my teeth at least daily and floss 2-3x/week.
*I use a soft-bristle brush.
*I changed toothpastes a few months ago.


Specifically:
*What are the best nutrients for gum health? Which foods can I find them in? I am willing to eat nearly anything vegetarian.

*What else can I do, besides editing my eating habits? Is there anything besides brushing and flossing? I don't like mouth rinses because they taste like alcohol, but I'd love to hear about effective home remedies.

*Please help me pick a toothpaste. It looks like some people think SLSs are bad things, and some people think fluoride is a bad thing. Me, I don't want artificial sweetners in my toothpaste. What do *YOU* think is the best toothpaste option for preventing cavities and plaque?

*Will this gum bleeding go away, how do I speed up the process? Should I keep brushing my gums even though it makes them bleed?

posted by lover to Health & Fitness (34 answers total)

It may not be any of the things you cite above. You may be brushing too hard and wearing the gum line away. Or you may have gingivitis. Do you floss regularly?
posted by dfriedman at 6:43 PM on October 9, 2010

Best answer: *I brush my teeth at least daily and floss 2-3x/week.

Therein lies your problem. I predict that if you brush your teeth 2X daily and floss daily, your gums will vastly improve (it worked for me).

Just use a toothpaste you like - I even know someone who doesn't even use toothpaste when he brushes and his teeth/gums are fine.
posted by walleeguy at 6:51 PM on October 9, 2010 [6 favorites]

Some people, unfortunately, just have bad gums - you may be one (or not! hopefully this is only a short-term fluke). My husband, for example, never, ever flosses and only brushes once a day, and he has no 4 pockets. I have 4 pockets every single time I visit the dentist, and my mouthcare regimen is impeccable. We have very similar (mostly) vegetarian diets, neither of us drinks soda...so, it's a mystery. Poor genes on my part, I suppose.

I can't address all your questions (no idea on the toothpaste recommendation), but here are some ideas:

- Have you considered a Waterpik? They're amazing, inexpensive, easy to use, and mess-free if used in the shower. My dentist recommended one to me when daily brushing (3x/day), flossing (2x/day), and mouth rinse (3+x/day) did not help.
- Are you a mouth breather at night? My top gums were taking a beating every night because I sleep with my mouth wide open. I rub a very thin layer of Vaseline on the gums over my front 4 teeth (upper row only) each night. Yeah, it's kinda gross, but it's saved me pain & bleeding.
- Did you recently start using hormonal birth control? This can cause gum problems.
- Finally, you might want to consider seeing your dentist 3 times a year rather than twice a year if the problem continues. I started doing this last year. I have to pay for one visit a year out of pocket, but it's worth it to me.
posted by pecanpies at 6:53 PM on October 9, 2010 [1 favorite]

Best answer: I brush my teeth at least daily and floss 2-3x/week.

You should brush your teeth at least twice daily and floss every day. I realize not everyone does this (though they should), but especially since you're having problems you need to just suck it up and do it. At the very least, make sure that you're brushing before bedtime. You don't floss more often because it's a pain in the ass, consider using a flosser. The full-size ones from Reach are really good. People will say that flossing with a flosser isn't as good as flossing with floss (you don't reach all surfaces of the tooth), but flossing every day with a flosser is better than flossing only intermittently with regular floss.

However soft your toothbrush is, you should probably be using a softer one. I am a big-big fan of the Colgate 360 extra soft toothbrush. It was recommended to me by my dentist (who I am also related to) for being especially gentle/effective on the gums.

When you brush, you should be brushing the entire tooth including the gum line (not the gums themselves, unless your dentist has advised you otherwise). When you brush the gum line, you should do it with the intensity you would use if you wanted to remove a crayon mark from a raw egg. Gentle and deliberate. And brush in tiny circles.
posted by phunniemee at 6:54 PM on October 9, 2010 [3 favorites]

Yeah, brush twice daily and floss every day. Consider adding an ADA-approved rinse such as regular Listerine twice daily as well.
posted by jedicus at 7:06 PM on October 9, 2010

Floss. Floss is your friend. Your new best friend. Seriously, I had some deep pockets in my gums at a young age. I have kept them under control only with daily flossing. I've realized now that I'm just one of those people who is prone to gum disease, and I'll have to floss daily for the rest of my life. I always thought before that flossing was such a pain, but, truthfully, I've gotten used to it and now it's just part of my daily routine.

But, this is good news! Because all you need to do to keep gum disease under control is regular cleanings every 6 months and daily brushing and flossing. At least, that's what has worked for me.
posted by shannonigans at 7:12 PM on October 9, 2010

The pockets encourage bacteria to grow. In my experience, flossing didn't really reach the pockets. I second a Waterpik once a day -- brush your teeth first. You can add baking soda to the Waterpik's tank, or pour a bit of anti-bacterial rinse in there. After one week, I'd almost bet your problem will be gone (if it's not a more serious dental issue). Also, your dentist can give you an antibacterial cleaning -- might cost more.
posted by thinkpiece at 7:29 PM on October 9, 2010

Waterpik! First time I used one was buhluhdy. But next day back on normal brushing--and no red appeared! I've since learned that a salt water mouthwash after (not in) the waterpik helps if there is bleeding. Now I alternate waterpik and flossing. Result: no bleeding, no gum pockets . YMMV, but this was qbout the best $33 I've spent.
posted by gregoreo at 7:31 PM on October 9, 2010

Bleeding gums are an indication that the area hasn't been getting regularly cleaned well when brushing/flossing. Do not let up in the area because you think you are causing harm by making it bleed, rather take it as a sign to stimulate the area more. Bleeding when brushing/flossing will stop within a couple of days of stepping up your routine.

Did the dentist or hygienist give you instructions on how to properly use the toothbrush? You need to angle it into the gumline and very gently, make little circles, allowing the bristles to sweep into the pockets. Flossing is critical, brand of such not so much important. You want a floss that doesn't shred and drive you crazy and frustrate you so you don't use it? Glide or Reach Total Care are great products for not breaking/shredding.

Always use soft bristles, if you were to go to a mechanical brush, I can't recommend any other than Sonicaire. I think it's a terrific brush, and the only one I think that can do better than a normally dextrous human can with a hand brush.

The brand of toothpaste isn't such a big deal. Yes, fluoride is important, but it is for anti-cavity purposes, doesn't do much for gum health. Crest/Colgate/Tom's... use what tastes good, you are going to clean your teeth and gums with the bristles of your brush, toothpaste is what helps us like to do it more because it tastes good/refreshes breath.

Listerine mouthrinses are great for knocking down the bacteria count in your mouth...they have just come out with a non-alcohol containing formula. Listerine Zero... hopefully not as severe tasting/burning feeling.
posted by Jazz Hands at 7:34 PM on October 9, 2010

Listerine, the original one (yellow color). It tastes horrible, but having gums is so very nice. In a week or so, you get over the taste shock.
posted by Houstonian at 7:44 PM on October 9, 2010

I've heard good and bad about waterpiks, but my personal experience has been VERY good. I put water, mouthwash and hydrogen peroxide in mine and, be prepared for the first time to be U G L Y and maybe even painful. It gets better. At the very least, in the morning and before bed, you should be brushing. Sleeping is rough on gums because you dry out and the bacteria have no competition.
posted by Redhush at 7:49 PM on October 9, 2010

Best answer: As someone who has already run into the doom that is just hypothetically in your future, here is my evening drill:

1) Brush with an electric toothbrush. Seriously, you will wonder how you ever got along without one.
2) Then floss.
3) Then use an interdental toothbrush in all the spaces you can. You will be embarrassed how much crap you missed while you flossed.
4) Then Listerine.

In the mornings I just brush.

It's a pain, but trust me, the alternative is worse.
posted by dfan at 7:58 PM on October 9, 2010 [1 favorite]

Houstonian, I believe (many of) the other flavors of Listerine still have the same active ingredients. Why the horrid original flavor?
posted by needs more cowbell at 8:03 PM on October 9, 2010

I have no idea why the original flavor is preferred -- this comes from my dentist, and I didn't ask.
posted by Houstonian at 8:07 PM on October 9, 2010

Best answer: My mother-in-law is a dental hygienist. My husband has never had a cavity, not in 41 years of life. Here's what you need to do, minimum:

-get a soft-bristled toothbrush (SOFT), manual or electric (electric is great for people who don't like to brush)
-brush at least twice a day
-floss every day

Before I started doing this, I was having gum issues. When I started the regimen, I stopped having gum issues.
posted by cooker girl at 8:09 PM on October 9, 2010

Floss every day.

No change I have ever made in my dental hygiene have ever made as big an improvement as flossing every single day. Not even going from brushing once a day to twice a day.
posted by Ookseer at 8:59 PM on October 9, 2010

Joining the chorus: Floss. Every. Day. At night, so the stuff doesn't sit there all night moldering away.

And the Magic Solution: a Sonicare toothbrush. I have awful teeth, my gums bled all the time (yes, even with dailyx2 brushing and daily flossing). My dentist started using a Sonicare, became a believer, offered to underwrite one for me if I couldn't afford it. I've been using it for at least 7 years. Perfect gums! Teeth cleaning a piece of cake! (rice cake) A couple of prods with the pointy thing and another "You're doing everything right. See you next year." Seriously, I'd give up my flush toilet before I'd give up my Sonicare.

I imagine there are many other brand names, but I go with what healed my gums. Just make sure the brush is small and soft, and it has a little timer to tell you after 30 seconds. Then just gently back and forth, massaging your gums, 30 seconds for each quadrant, and you're done.


posted by kestralwing at 9:06 PM on October 9, 2010

Nthing flossing. I used to have problems with my gums bleeding with daily, and my dentist recommended I floss twice a day, which I did for a while until it cleared up, then I went back to once a day. Very occasionally now (once every couple of years) I'll get bleedy gums again, and I just kick up my flossing back to 2x a day and it goes away. It's not the most pleasant thing to do when you already have bleeding gums, but it really, really, really helps. And by the way I use (Glide) dental TAPE which is thicker than regular floss!

All that said, you should certainly go back to the dentist. IANADentist but I imagine there are conditions that cause bleeding gums that would be exacerbated by flossing or extra flossing.
posted by hansbrough at 9:13 PM on October 9, 2010

Best answer: I used to have this problem, and don't have it anymore.

Here is my bedtime dental routine.

1. Brush with Sonicare toothbrush.

2. Floss (and I don't just floss at night -- I tend to floss after every meal and snack, at least to get the areas where I know food tends to collect).

3. Listerine.

4. And no one has mentioned this, I don't think... but a fluoride rinse last thing at night is a great thing. ACT is the most common brand. Swish it around as long as you can stand (seriously, like a few minutes if you can) and then don't eat or drink anything until morning -- not even water if you can help it.

In the morning I just brush.
posted by rabbitrabbit at 9:24 PM on October 9, 2010

I've had bleeding gums all of my life even with brushing 3 times a day until I started following this regimen.

Even my dental hygienist was impressed!
posted by a22lamia at 9:24 PM on October 9, 2010

Best answer: Floss, floss, lovely floss
Nothing quite like it for removing the moss
So follow me, follow
Down to the hollow
And there let us not swallow
The glorious floss

(With apologies to Flanders and Swan, and I'm not clever enough for this stuff anyway, but floss really is what you need. My dentist, like many others, says only to floss the teeth you want to keep.)
posted by anadem at 9:36 PM on October 9, 2010 [2 favorites]

Best answer: You sound like you need Vitamin C.

I would get some high-dose (500mg or more) chewable tablets from a Trader Joe's or your local health food store and see how you do over the next few days. Vit C is critical for our bodies (especially our mouths) when it comes to healing and fighting against infection (ie gingivitis). You can honestly take up to 3-5 grams of Vit C if you want to give yourself a real boost, because Vit C is water soluble, but if you're not used to it you could bring about some tummy sensitivity.

Add at least 500mg to your daily routine, and gently introduce the B complex to your diet. Both C and the B complexes (50, 12, etc) can reduce painful gums and get you back into working order. I also rinse with salt water and massage my gums gently whenever this happens. Feel better!
posted by patronuscharms at 9:37 PM on October 9, 2010

Best answer: PS: I'm a life-long vegetarian. :) It's crazy how sometimes our diets can get a little funky sometimes. Maybe add some spinach/dark greens and some squashes to your diet as an added buffer. The dark greens will add to your iron levels, and the squashes will bring you Vitamins A, B, and C. Couldn't hurt!
posted by patronuscharms at 9:39 PM on October 9, 2010

Listerine can be hard to tolerate... my dentist told me to use the no-alcohol ACT with fluoride.

FWIW you can put salt water through a waterpik, you just have to flush it out with a full container of regular water afterwards. 1/2 a teaspoon of salt per cup of water is fine.
posted by IndigoRain at 10:56 PM on October 9, 2010 [1 favorite]

To summarize what everyone else is saying, forget the fancy quack cures you mentioned in your question -- "effective home remedies", diet, superfoods, nutrients, brand of toothpaste or mouthwash. Flossing every day (even if it bleeds at first -- it won't after a while) and brush your teeth morning and night with flouride toothpaste.
posted by dontjumplarry at 1:26 AM on October 10, 2010 [1 favorite]

I had the same thing (minor bleeding when brushing my teeth), and my dentist told me that it indicates a chronic infection usually resulting from inadequate dental hygiene.

He recommended that I brush more regularly and attentively, and was quite adamant in his recommendation that I begin using ACT fluoride rinse. He suggested the brand specifically, and I like it because it doesn't burn like Listerine.

Anyway, it's about ten years later now, and I still use that brand of mouthwash. My gums no longer bleed :P
posted by teatime at 2:13 AM on October 10, 2010

But I should specify:

* Any flouride rinse should work equally.
* Brushing twice per day etc. is more important than magical fix-it chemicals.
posted by teatime at 2:13 AM on October 10, 2010

...just to offer a different (though not necessarily differing) opinion/POV, my gums have been bleeding when I brush for 10 years (off and on). When I go to the dentist they suggest I floss. I do for a week then throw my hands up and return to not flossing.
It may be true that I am in for something horrible down the road, but I wanted to point out that I have had bleeding gums (with no pain, mind you) for 10 years and I'm still here to tell the tale, so it may not be the national emergency you seem to see it as. I'm just sayin'...
posted by segatakai at 3:08 AM on October 10, 2010

Your diet will make very little difference as far as your gums are concerned (assuming you get all of your basic nutrients, which the great majority of people in the developed world do, without any special effort).

If you're still using a manual brush, stop, and just get a Sonicare already. It's the 21st century, for god's sake, and the difference will be immediate.
posted by halogen at 3:13 AM on October 10, 2010 [1 favorite]

Best answer: The #1 thing that improved my teeth was keeping an extra roll of floss near the computer. I floss randomly while reading long articles. I told my dentist and she was like 'whatever works.'

My dentist had previously recommended a waterpik but after some ridiculous attempts that involved water everywhere but in my gums, including, somehow, in my eyes and across the room, I quit.
posted by cobaltnine at 5:31 AM on October 10, 2010 [1 favorite]

Agree with most of the advice above, especially about flossing. About 10-15 years ago I had the same problem and in addition to flossing was prescibed Peridex prescription mouth rinse. Both of those together cleared things up, but the Peridex not only tastes nasty, it makes everything you eat for a while afterward bitter as well. So I switched to an over the counter antibacterial mouthwash (Listerine or similar) and have had no problems since.

You mention not liking alcohol-containing mouthwash. Listerine has just introduced an alcohol-free version of their mouthwash. I have tried it and don't care for the taste (it tastes like watered-down mint listerine to me) and haven't used it long enough to know if it works for me, but it may be owrth a try for you.
posted by TedW at 7:10 AM on October 10, 2010

Best answer: On toothpaste: My hygienist tells me you don't even need it, because it's the brush's mechanical action that cleans your teeth and gums. But I want a nice minty freshness after brushing so I use toothpaste. But I hatehatehate the taste of saccharin, and every big-brand paste has it. So I spring for Tom's of Maine, which is pricey but doesn't have saccharin. I like it.

For what it's worth, I brushed two or three times a day for years, but didn't floss, or not much, and ended up with sachel-sized pockets and some bleeding, so now I'm flossing religiously and getting professional cleanings every four months. It works. I wish I'd been flossing daily, at least, for all those years.

My takeaway: Whenever you have a choice, the harder one is the one you'll wish you'd made.
posted by fivesavagepalms at 7:56 AM on October 10, 2010 [1 favorite]

Response by poster: My take-away: I'll definitely brush 2x/day and floss daily from now on. I'll add fluoride rinse and waterpick if necessary. It's good to know that the type of toothpaste isn't that important. The advice to "When you brush the gum line, you should do it with the intensity you would use if you wanted to remove a crayon mark from a raw egg" was useful. And I'll always carry floss with me.

Bonus points for anyone who can tell me how to make a fluoride mouth rinse from home.


Thank you for all your advice. I really appreciate it.
posted by lover at 11:02 AM on October 10, 2010

Response by poster: P.S. I will be cooking up a lot of squash and leafy greens in the near future. Leafy greens! Man-oh-man do I need to work those into my diet....
posted by lover at 11:05 AM on October 10, 2010