My Gums Hurt

November 27, 2012 11:55 AM

I haven't been to the dentist in four years. Yes, I know, BAD. I finally scheduled an appointment for Monday, but the gums below my lower front teeth are of sore and inflamed at the moment - which is basically what prompted me to finally get over myself and schedule the appointment. YANMDentist, but does anyone have any suggestions for what I can do between now and Monday to calm my gums down?

Background info if relevant: I am female, late 20s. I brush twice a day. I'm a very thorough brusher. My gums do not bleed when I brush my teeth. I floss whenever I remember to - maybe once every 3-4 days. I know I should floss more often. My gums sometimes bleed when I floss, but not copiously. There is no gushing of blood, just some red tinging on the floss, usually in the rear molar area, not the front teeth where my gums are sore now. I've only ever had one cavity, and that was over 15 years ago. I don't drink soda or eat craploads of candy and sugary stuff. I do drink coffee, but only 1 cup a day. I am a reformed cigarette smoker.

My last dentist was doing the root scaling/planing/deep cleaning/scraping/shoving poky things into my gums every three months or so for me because I had deep pockets in some areas. This, however, was four years ago. I know inflamed gums are usually a sign of gum disease. I am currently without dental insurance, which is why I've been so negligent all this time, but the sore gums have freaked me out enough that I'm going to bite the bullet and pay out of pocket for a checkup. How much will a dental checkup cost? Money is tight right now as I am between jobs and the unemployment check barely covers my normal bills.

Can anyone point me towards a home remedy that might soothe my gums over the next week till I can see the dentist?

I was the author of the PLANTAR WART OF DOOM question a couple of weeks ago. So now my foot hurts and my gums hurt. Figures that my body started falling apart AFTER my last contract job ended so I have no money to pay for anything. Sigh.

posted by thereemix to health & fitness (20 answers total)

Salt water rinses can help reduce inflammation in the short term. It may sting the first couple of times, but then it helps a lot.
posted by xingcat at 12:06 PM on November 27, 2012 [1 favorite]

Home remedy: rinse with warm salt water. This site recommends one tablespoon of salt in a pint of water, which seems about right to me. Use sea salt or some kind of salt that doesn't have anti-caking agents in it if you can (check the ingredients on the box).

Ask the dentist how much the checkup will cost, and shop around. Most people don't have dental insurance. Dental insurance is more like a discount program (or a way of getting your employer to shoulder some of your dental costs) than real insurance.

It will be fine! You'll feel so much better once you go!
posted by mskyle at 12:08 PM on November 27, 2012 [1 favorite]

Start flossing daily (and gently) with that floss that is soft and springy. I don't know what it's called, but it's more like a small bundle of cotton than a piece of tape. It's effective and less...aggressive.

And most definitely seconding the warm salt water rinses.
posted by phunniemee at 12:09 PM on November 27, 2012

Take vitamin C. Try taking 1,000mg a day. If that doesn't upset you, take 2,000.
posted by mareli at 12:17 PM on November 27, 2012

Flossing daily for a couple of weeks before you go to the dentist will go a long way towards making the visit less painful. I realize you don't have a couple of weeks, but flossing daily in the time you have left will still help.
posted by alms at 12:24 PM on November 27, 2012 [1 favorite]

Floss twice a day until your appointment and rinse with salt water.
posted by cooker girl at 12:32 PM on November 27, 2012

First: Do whatever you have to to keep those teeth cleaned. See if a dental hygiene school is nearby or find out what kind of aid your state might have. I lost my lower front teeth due to a combination of genetics -- not having great bone structure -- and insufficient preventive care. I do have a partial plate, but it is not the same. I am very sensitive and if I am feeling at all queasy, it is all I can do to keep my teeth in without gagging.

Second, in addition to the salt water rinses, you can rub your gums with plain old ground cloves. It is both an anesthetic and an antibiotic. This was a lifesaver for me not long ago when I was in excruciating pain. Just make sure to rinse thoroughly and floss so that you do not leave any of the cloves trapped.
posted by Altomentis at 1:11 PM on November 27, 2012

There is a product for this: Colgate Peroxyl mouthwash. It's minty-flavored hydrogen peroxide, diluted to the level you want for your mouth. It's an antiseptic and it does help with gum problems, and makes them feel a little better too. You can get it at the drugstore.
posted by Houstonian at 1:23 PM on November 27, 2012 [1 favorite]

Be GENTLE with your mouth. You say you're a thorough brusher, and you floss way more than... some people I know :P So be a little less thorough. Don't brush so hard or so long. Get a softer toothbrush if you can. Sometimes being overzealous can actually hurt more than being lax about it.

One week of wussing out isn't going to make a huge difference in your overall oral health. Flossing gently, with that tape floss, will be helpful, but don't go overboard.

Take some ibuprofen. A wet tea bag (actual tea, not herbal) pressed against your gums uses tannins to calm your gums down. If you can go to your local pharmacy, Anbesol/Orajel can numb it up; if you prefer the natural route, your local natural foods place typically has some sort of... hmmm... clove drops, I think?

Basically, you should just focus on getting to the appointment. Your dentist will then tell you specifically what to do, from daily stuff/maintenance to getting down and dirty in the tissue.

In terms of money and future appointments (tl;dr warning):
I can't access my statements right now, but I think a regular cleaning for me has a list price of something like $80 (I have insurance, but I have to pay out of pocket for more than three cleanings per year). I go to a standalone office in a mid-sized city. If I were to guess, I'd say that baseline appointment (which may or may not have included the cleaning at the next visit) was $120-150?

Obviously you're paying for everything, routine or not. Things that will cost more money down the line:
--Fluoride treatment (I think mine is like $25 or $35 and is not covered by insurance)
--Prescription mouthwash they will almost certainly give you to help out your gums (I want to say it's $15, but they only want you to use it for a few weeks and it'll last forever)
--Fixing or applying sealants
--Fixing or replacing old fillings
--Anything that requires more than a cursory visit from the dentist him or herself, as opposed to hygienist-only treatment.

Your dentist should be able to offer you options for a first visit. You're probably past the "free consultation" stage, but you should be able to say, "I would prefer you focus specifically on the more acute stuff" or "Please be comprehensive so I can think about reestablishing regular treatment." Your dentist should also have payment plans available. Aside from just setting up a schedule of payments, there are specific credit/financing plans that the office may offer, kind of like what you'd get if you want to buy a laptop. But that may be only for coverage over a certain dollar amount (e.g., cosmetic procedures, Invisalign, whatever).

I hate to tell you that it'll cost more than you've anticipated, but this first visit will be quite a bit more comprehensive and will likely lead to additional visits down the road. Part of that is because the time and, frankly, pain and poking they put in to establish where you are isn't typically doable in a single visit. (You can obviously tell your dentist that you're not sure how often you can get professional care from here on out, to which your dentist will almost certainly say, "But oral health is so important to your whole body!" -- which it is -- and then hopefully give you some strategies.)

I hadn't been for five years or something because of various insurance issues. Here's how it went with me:
I went in and they did a 90-minute appointment (as opposed to the usual hour) that they may have referred to as a "baseline" or something similar. They took x-rays, talked to me about my general health and history, then did this thing where they looked at the gumline around every tooth and measured the millimeters of gum at both edges and the middle. It'll sound like "2-3-2" or "5-6-5" or something; a higher number is worse (that means more swelling), but it's definitely something that can improve quickly. This will make your mouth hurt and bleed, especially if you're already tender. It will also take a while now, but if you go back it'll take less time.

They will most likely not clean your teeth at this appointment. They may or may not include this first cleaning in the baseline appointment cost. They will probably tell you to come back in two weeks after you've been rinsing with prescription mouthwash (see below). After that, they will schedule you for appointments to address any problems they found in the first appointment. I had (I think) three cavities or filling replacements, and we did that in two appointments.

I am here to tell you that dental health really DOES have an impact on the rest of your body, and can have some very real connections to things like your cardiovascular health. This is definitely a use it or lose it situation; you'll be much better off to find any way possible to keep things under control now and not lose teeth/require more extensive work later.
posted by Madamina at 1:29 PM on November 27, 2012 [3 favorites]

If you've had one cavity in your life and you're in your late 20s, you don't need fluoride application. Also, if you ONLY have gingivitis, then the Rx mouth rinse will help.
posted by Cuspidx at 1:56 PM on November 27, 2012

My mouth is dry, especially when I sleep, so my gums are really vulnerable. I use and over-the-counter rinse called CloSys, which helps if I use it daily. Regular Listerine helped even more, but it stung the inside of my mouth too much -- that's not a problem for everyone.
posted by wryly at 2:09 PM on November 27, 2012

How much will a dental checkup cost?

Call the dental clinic and ask! Dentists are generally much more transparent about prices than many medical clinics and hospitals can be. You can also call around to compare prices.

Ask if x-rays are really necessary right now, you can expect them to be a good chunk of the cost of a checkup.

If the dentist recommends treatments past the basic checkup, don't be shy of asking about prices, or about what time frame you need to follow.
posted by yohko at 2:19 PM on November 27, 2012

Warm salt water, or as said before too, a peroxide based mouthwash. I like Crest 3D White. Helps me with all sorts of mouth boo-boos(I tend to have tortilla chip incidents on a regular basis). Plus it makes my teeth feel great and has improved the whiteness a bit.
Floss lightly, brush your teeth then use the rinse or mouthwash. Later when your gums feel better you can use a flouride rinse such as ACT every once in a while.
I also know dentists that think deep cleanings are the stuff, and some that think its a big money maker. Me, I think its, yep, their way of making big money.
posted by PJMoore at 3:04 PM on November 27, 2012

I do mild salt water rinses when my gums get irritated, a thing that happens sometimes (it can be hormonal, incidentally). So if my gums get irritated I do a few days of that.

If you are having gum troubles you might consider doing dental visits every four months.

I know you're thinking, 'How awesome!' but it kind of helps those of us whose genes have not been kind in dental terms, and even if you don't have insurance, if you pay out of pocket four times a year, in the end it's cheaper than four root canals, four crowns and an implant. Ask me how I know.

Incidentally, some people just have bad genes in this way -- I'm a diligent flosser and user of electric toothbrushes and timers and so on and I still have to live a life of eternal vigilance regarding my teeth, including the aforementioned four-times-per-year dentist visits. It's unfair but in terms of genetic luck I suppose one could do worse.
posted by A Terrible Llama at 3:16 PM on November 27, 2012 [1 favorite]

Get those little floss picks that come in bags of a hundred or so. Buy several bags. Leave one in the car. When you are on your way to work, or way back, or after going out to eat, or wherever, floss. It only takes about 30 seconds. It will be super easy to do several times a day that way. You need to start flossing very gently right now.

Buy some mouthwash that is designed to fight gingivitis, and start using it after you brush every time.

These two things in tandem will go miles towards helping your gums. You won't have perfect gums by next week, but in the long term you will.

I used to have terrible teeth and gums, with tons of bleeding when at the dentist. As soon as I started flossing in the car and using mouthwash after brushing, I haven't had a single problem in years. It really is a night and day difference, and takes almost no extra effort.

Root canals and crowns are expensive. They are also cheap to prevent. Take the advice from someone who waited to learn these things the hard way. Floss and mouthwash will work miracles.
posted by markblasco at 3:29 PM on November 27, 2012

Brush gently. Mom brushed her gums in the front too hard and needed a skin graft in her late 50's. My husband has the same issue so I bought him a super gentle toothbrush called the Nimbus. Brushing very gently takes longer but your gums will be better for it.
posted by Foam Pants at 3:47 PM on November 27, 2012

The floss Phunniemee is talking about is called Reach Gently Gum Care. It's kind of hard to find but is the only kind of floss I use. I also have tender gums. I definitely recommend gently flossing every day. That's what my dentist said to do when I was having tender gums. It may seem counterintuitive but the accumulated gunk attracts bacteria, which will irritate your gums even more. Following up with a saltwater or diluted hydrogen peroxide rinse will help too. You can also make sure your toothbrush is as soft as possible by rinsing it in hot water first.
posted by apricot at 3:47 PM on November 27, 2012 [2 favorites]

No particular advice, but I wanted to drop in to say that I tried to save money by not going to the dentist for a couple of years. My teeth are usually hunky dory, so I didn't think it was that big of a deal. I ended up more $$ out of pocket when I finally DID go back because stuff had to be fixed that wouldn't have gone wrong if I had just paid for the cleanings every 6 months like I was supposed to. Lesson learned.
posted by wwartorff at 5:55 PM on November 27, 2012

Hi folks - thanks a lot for your advice and encouragement. I did a few salt water rinses and things seem to have calmed down a bit, and I bought some of the uber-gentle floss phunniemee and apricot mentioned and am going to step it up with the flossing.

Foam Pants - the Nimbus looks pretty cool. I do feel the bristles on my (soft) toothbrush are a little rough, so I am thinking about purchasing one of those as well.

I also was able to push up my dental appointment to yesterday afternoon - they had a cancellation and I figured why the heck put it off? To my utter relief, the only major things that need to be addressed is a deep cleaning (gum poky time) since it does seem that I have a big of gingivitis around my lower front teeth, plus two fillings - one to replace the worn-out filling from my cavity 15 years ago, and another smaller one for the tooth next to it. THANK GOD I totally thought I was going to be told that they were going to have to root canal every tooth in my head plus give me gum grafts or something like that.

That said, since I am uninsured, a deep cleaning + 2 fillings = $804 out of pocket. Yikes. I applied for CareCredit in the office and was approved, so at least I won't have to drain my bank account dry for this.

Thanks again folks!
posted by thereemix at 10:25 AM on November 30, 2012 [1 favorite]

As a followup, I just got back from the dentist and asked my awesome hygienist a few questions to round out this info. That said, this will probably be the Dr. Captain Obvious Report, since most of it is either common sense or overlaps what I and others said before.

Still, I hope having this info in one place is useful for anyone who looks up this thread later :)

Standard dental practice is to offer three kinds of exams.
Comprehensive: the whole shebang -- x-rays and examination, gum health check, all that.
Limited: a pretty general overview of the whole mouth, except that you'd probably focus on a single topic area: cavities, gum health, etc.
Focused: just that, focusing on the single problem area, such as saying "the area around my two front teeth has been sore all week."
A free initial consult may also be possible.

Again, you are absolutely entitled to say that you only want a certain type of exam, or to only go as far as you've agreed to go. (This is one of those "that's obvious, but you really need to know you can stand up for your needs" things.)

If you are uninsured or have limited finances, consider setting up a comprehensive appointment to figure out what you might need and how you might address it. You'll get a full workup to tell you what's going on, etc., but most importantly you'll get a prioritized treatment plan and probably a good idea of the financial impact.

The first reason this helps is because you can plan the timing, both in terms of finances and goals. "We'll do Big Treatment X sometime in 2013, but we'll deal with Small Treatment Y at the next appointment" is a good start.

But by prioritizing, they will also help you save money, time and pain. If you have two cavities, but one is next to a root, they'll almost always go for the latter first, before it affects the root and necessitates a root canal. Even (especially) if neither of them hurt yet -- if you're waiting until something hurts, that tells you than something's not just wrong but REALLY wrong. (But it always happens, because -- duh -- you don't know it unless you've seen it in an exam.)

It's a really good idea to ask for a consult after the exam, where they can sit you down up front and discuss both the treatment AND the finances. Specifically, ask if they can print out the treatment plan so you can have it all down on paper in front of you. It can be really helpful to visualize all that stuff at once.

CareCredit is great because you can use it for a lot more than just dental work. It covers things like chiropractic care, hearing aids, glasses/contacts, LASIK (I may take them up on that...), dermatology, cosmetic procedures, even veterinary care. Obviously it's still credit that you still have to pay off, but it's a nice option to have.

My cleaning today was $74 out of pocket (I'd already gone past my yearly cleaning limit). When I showed my very experienced hygienist this post, she said, "$804 is an awfully good deal for all of that." She also said because, clearly, you need to hear this from an invisible hygienist 1000 miles away who has never seen your teeth that it sounds like things are going well for you, gum-wise. That "2-3-2" thing I described above is how they find the gum pockets, which then leads to figuring out if you would have needed planing/scaling again -- and you don't!

Yay for you and your mouth!

This is all brought to you by the fine folks at Monroe Street Family Dental, who are uniformly wonderful in unexpected and fabulous ways. If you know someone looking for a dentist in Madison, Wisconsin, you should absolutely check them out. Dr. Farrow, in addition to being a kind and thorough second-generation dentist, has awesome iTunes taste :)
posted by Madamina at 1:17 PM on December 14, 2012 [1 favorite]