What is up with my gums?

August 11, 2016 10:30 AM

Does anyone else here have gum disease that just keeps getting worse and worse no matter what you try? Has anything stopped it in its tracks?

For the last several months, my gums have been frequently red and puffy for no outward reason that I can see. They are also receding like mad. I'm scheduling an appointment with a periodontist, because my regular dentist has been totally unhelpful other than to tell me that I should brush more gently.

In the meantime, though, is there anything that might be clearly causing this, given the following conditions:

I brush suuuuper gently (the dentist doesn't seem to believe this). I literally hold the toothbrush with a thumb and one finger to avoid pressing down too hard. I brush up and down and not back and forth. I use a soft brush. The gum problems are there regardless of the type of toothbrush--I have also used a Sonicare brush as well as (briefly) an Oral-B rotating head brush.

I use classic, old-fashioned Crest toothpaste.

I used to floss every day but have backed off to every second or third day given the recent revelations that it doesn't necessarily have any benefit: http://www.nytimes.com/2016/08/03/health/flossing-teeth-cavities.html

I eat pretty healthy. No sugar, ever. I'm sensitive to carbohydrates so I try to keep them at a moderate level. I can tell when my blood sugar is too high and I try to avoid that feeling no matter what. I'm about 95 percent vegan. I enjoy small amounts of lemon juice as a seasoning on food, but I don't, like, drink the stuff.

I have low ferritin levels. I've been taking an iron supplement and a zinc supplement for awhile now and no change in the gums.

Menopause is a few years off and I think my hormones have been wonky as of late--I've also had some unexplained hair loss (the dr. ran tests that showed my thyroid and testosterone were normal, ferritin was low and B12 was high. The B12 could be because I'd just eaten a ton of nutritional yeast before going in to my appointment.)

I grind my teeth at night.

My teeth started shifting like crazy last year--bottom teeth have gotten crowded. My dentist said a top and bottom retainer on my front teeth at night would prevent grinding and keep them from shifting more. She said it should not affect my gums. I had the retainers made and have been wearing them for a few weeks now.

That's all I can think of for now having to do with the teeth. It's very alarming to look in the mirror and see these red, puffy gums and long, exposed roots on my teeth. Has anyone else dealt with this? Is it the result of some habit that I can easily change?

Thanks!

posted by whistle pig to Health & Fitness (30 answers total)

Are you on any medications? Some of them are known to cause gum disease as a side effect. I noticed that my gums seemed tender and more prone to bleeding on gabapentin, and there are internet anecdotes of worse effects from it.
posted by mister pointy at 10:42 AM on August 11, 2016 [2 favorites]

Could it be a viral or bacterial infection?
posted by littlewater at 10:44 AM on August 11, 2016

Have you been using Listerine? The real, antibacterial stuff, not knockoff "calcium rinses" or whatever.

There is also a potential link between low vitamin D and increased risk of periodontal disease. Conservative supplementation is unlikely to do you any harm (even if it does no good) and vitamin D pills aren't too expensive.
posted by praemunire at 10:49 AM on August 11, 2016 [4 favorites]

The grinding will 100% contribute to gum recession and other gum problems, as well as cavities and enamel loss. Do you wear a nightguard? After I started wearing mine, I had so many fewer issues with my gums.

Also, please keep in mind that the recent news about flossing is about the lack of a long-term, randomized control trial needed to reach a level of evidence for a recommendation by the department of health. It's not evidence that flossing doesn't work - it's a lack of good evidence it does. In light of this, you should follow your dentist's recommendations, and I would guess that they would still recommend it.
posted by Lutoslawski at 10:51 AM on August 11, 2016 [17 favorites]

Try a different toothpaste brand - especially one that doesn't have sodium laureth sulfate. Crest and Colgate in particular really irritate my gums.

And also yes mouthguard helps.
posted by umwhat at 10:57 AM on August 11, 2016 [2 favorites]

Ideas:

*New dentist
*mouth guard
*Maybe ask about this toothpaste -- my dentist prescribed it for me for recession/decay prevention and things are now stable.
posted by *s at 11:02 AM on August 11, 2016 [1 favorite]

You didn't mention it, but do you have acid reflux? My gums were quite painful until i was put on acid reflux medication and I didn't realize that was what was causing the inflammation.

I find it also helps to use warm water when brushing teeth...it's a little more gentle on the gums.
posted by fourpotatoes at 11:06 AM on August 11, 2016

My gum issues don't seem quite as severe as yours, but here's what has worked for me: stopped using an electric toothbrush and stick was a soft-bristle manual brush. For some people, electric toothbrushes are just too damn rough on gums.

I use Parodontax, a European herbal toothpaste that specifcally helps with bleeding gums. I order it on Amazon, it's expensive and sometimes takes weeks to arrive from a random seller in Poland. But it really works for me.
posted by gnutron at 11:07 AM on August 11, 2016 [1 favorite]

Maybe look into coconut oil pulling?
posted by Dressed to Kill at 11:28 AM on August 11, 2016 [1 favorite]

The dentists say that when your gums are tender and puffy and they bleed a lot when you floss them, you should just keep at it, and the flossing will clean out the gunk that was causing the irritation, and the gums will heal, and you will bleed less, but you have to keep flossing. This wasn't working for my husband, so they went in and did a below-gumline deep cleaning, they had to numb him like for a cavity to do this cleaning, and did it in two halves on tow different days. Gums are no longer red and puffy, and don't bleed when he flosses.

He also started wearing a night guard.
posted by aimedwander at 12:03 PM on August 11, 2016 [1 favorite]

I had this problem at one point and discovered that Listerine does nothing to help me when I have a gum infection, but tea tree oil mouthwash knocks it out. Maybe it's something to try?
posted by corey flood at 12:16 PM on August 11, 2016 [2 favorites]

You may need more precise info on your blood sugar; perhaps time to get a meter. See BloodSugar101 website for efficient testing strategy.

I saw improvements with oral probiotics. I was also eating fermented foods, so that confounds the variables.

Hormonal fluctuations can definitely impact your gums. From the NYT Health Guide:

"Before Menstruation. Gingivitis may flare up in some women a few days before they menstruate when progesterone levels are high. Gum inflammation may also occur during ovulation. Progesterone dilates blood vessels causing inflammation, and blocks the repair of collagen, the structural protein that supports the gums."

posted by egk at 12:24 PM on August 11, 2016 [1 favorite]

I had a scaling and root planing (which was unpleasant) followed by a daily rinse of paroex and that's helped immensely. Gums stopped being puffy and receding and pockets in some cases tightened up and stopped becoming deeper.
posted by Karaage at 12:26 PM on August 11, 2016 [1 favorite]

It's not that flossing doesn't have benefits, that story was simply that benefits haven't been proven. I get my dentistry at a local top dental school and I specifically asked my student dentist if they had to choose between flossing and brushing which would they do, and they said flossing. Whatever you may think about the quality of dental school care, they are learning the most current practices. So, now I floss a lot more.
posted by rhizome at 12:49 PM on August 11, 2016 [4 favorites]

I, too, had the scaling and root planing, and my puffy gums are healing well. I also had a round of antibiotics (for a different thing), and that gave me some immediate relief.
posted by feste at 12:55 PM on August 11, 2016

My gum disease got worse when I gained weight & started snoring, the mouth breathing was drying out my mouth at night. Is there some reason you may have started mouth breathing, even something as simple as allergies can set my snoring off.
posted by wwax at 1:09 PM on August 11, 2016

I second that you need a new dentist. A guard for the grinding is a good idea too if you aren't wearing one.

My dental hygienist is a science nerd and always talks about how by flossing you're "disrupting bacterial colonies" and the latest stuff she's learned at conferences, etc. She says that for people with gum disease they prescribe xylitol gum or candies. I'm paraphrasing my understanding here but xylitol (a sugar substitute derived from some plant) destroys the walls of bacteria that cause gum disease. Here's an article about it from dental hygienists. Here's a study.

She's given me samples of Spry gum. The article recommends 6-10 g of xylitol a day. I'd ramp it up slowly because it can also make your stomach a little grumpy. Worth a try IMO.

(The other thing that comes to mind is autoimmune disease if none of these things work.)
posted by purple_bird at 1:29 PM on August 11, 2016

Nthing looking at tooth grinding, and possible acid reflux and/or mouth breathing at night.

My dad's gums improved immensely when he was treated for his terrible, terrible reflux. My gums improved immensely when I was given a CPAP for sleep apnea, which caused me to breathe with my mouth open at night.

A scaling and root planing helped as well, but now that I'm not breathing through my mouth in my sleep, my gums are staying much healthier after that root planing/scaling.
posted by Rosie M. Banks at 1:35 PM on August 11, 2016

Response by poster: Thank you all for your answers! To address some of them:

I probably do breathe through my mouth at night...because of the retainer the current dentist prescribed (she said it would stop the grinding).

I currently swish with xylitol several times a day.

I was a once-daily flosser until last week, so don't think lack of flossing is the problem.

I'm not aware of any problems with acid reflux.

Not currently on any medication other than occasional painkiller.

I'll definitely check out other types of toothpaste, as well as several of the other recommendations here.

Thanks again!
posted by whistle pig at 1:39 PM on August 11, 2016

Even with a nightguard, my gums recede, but much less quickly than they would without it. Also, under the advisement of my dentist, I switched from string floss to a water flosser (Waterpik) and my gum health has improved markedly. My gums are noticeably stronger (less spongey, no bleeding, and no redness) and the gum pockets are measuring smaller and recession has slowed. I had no idea that switching from daily string flossing to water flossing could make such a difference, but it's been a great move for me.
posted by quince at 1:41 PM on August 11, 2016 [3 favorites]

I would have died from menopause if I hadn't started taking fish oil. I take 6 of the big caps a day and it staves off the gum issues but just barely. Caution, you can overdose on fish oil. Go over dosage amounts with your health practitioner. But I swear that fish oil is a cure.
I would switch toothpastes.
Now that I am through menopause it has lessened considerably, verifying for myself at least that the hormones of menopause wreak havoc on some people's gums.
I also swish with hydrogen peroxide when it gets bad which always helps.
posted by cda at 1:44 PM on August 11, 2016

Prescription mouthwash containing chlorhexidine. Used it for a month, at my dentist's recommendation - it seriously messed up my sense of taste for that month, but really improved my gums and overall oral health.
posted by jferg at 2:17 PM on August 11, 2016 [1 favorite]

I have had far fewer gum troubles since I started using Closys mouthwash. It doesn't contain alcohol, there is no sting and it tastes like nothing unless you prefer to add drops of the peppermint oil that is included.

I was introduced to it as a part of Dr. Ellie's Mouth Care System. The whole system comes across as a bit corny but a trusted friend saw a huge, life changing, difference once she started it. Notably it doesn't involve flossing, though of course it's still a good idea to include. Closys or the Dr. Ellie's system might be worth giving a try.
posted by Miss Matheson at 3:21 PM on August 11, 2016 [1 favorite]

So... No deep cleaning from your dentist?

Fire your dentist.

Get a proper deep cleaning. Follow instructions for after-care - keep flossing, brushing, I use a little toothpaste with baking soda.

Regular cleanings every 3 months. They should check the pockets in your guns with an instrument. If you're doing it right, within a year, your gums may even grow back some.

The perio should recommend this or similar. Double check on causes like your diet and blood work. Basically, your gums are infected and your doctor should have given you a deep cleaning. I suspect your diet is at play and you might need supplements, but for real, a deep cleaning on all 4 quadrants does wonders.

Geezus I'm sorry about your shitty dentist. If the perio and dentist are related, think about finding another recommendation.
posted by jbenben at 4:25 PM on August 11, 2016 [3 favorites]

You know I actually bought some norwegian cod liver oil for an unrelated issue and I noticed a few reviews mentioning healthier gums and teeth (as well as a trove of various other improvements in a myriad of health issues so who knows). But it tastes pretty good and has a light lemony flavor as well as providing a disgusting amount of vitamin D. Maybe you could check it out.
posted by wilywabbit at 5:06 PM on August 11, 2016

Deep cleaning plus prescription mouthwash (a temporary measure) has done wonders for my gums after only a week and a half (and after far too many years of avoiding the dentist)—no more bleeding at all—and I still have the second half of that deep cleaning left to go next week. In rough terms, what the dental hygienist explained to me is that if your gums are bleeding, that is essentially the result of a bacterial infection. Deep cleaning gets rid of the calcification, and the mouthwash kills the bacteria off. I also had to essentially re-learn how to brush and floss properly (okay, let's face it—I wasn't flossing much in the first place because my gums hurt too much); doing that and having regular cleanings should help prevent all of that junk from coming back.

Not sure where you are located, but if you're in Western MA and want a recommendation for a fantastic dental office, feel free to MeMail me.
posted by cellar door at 5:18 PM on August 11, 2016 [2 favorites]

I started to have issues about 10 years ago. I've been through three scaling and root planings and then a gum graft. For the last 10 years I've brushed (softly!) with the sensitive head on an electric toothbrush, flossed and used an interdental brush daily. I don't use abrasive toothpaste. I also regularly use a waterpik with salt water or cinnamon oil/water. On the advice of my dentist I have a night guard that I fill with MiPaste and wear overnight once a week. The thing that has made the biggest difference for me is that about three years ago I started getting professional cleanings every three months - every six months with my dentist and every six months with my periodontist. If I could go back in time I would have seen a periodontist earlier and started the three month cleanings earlier. Things are more or less stable now, though my gums do continue their slow recession.

BTW both my dentist and periodontist shrug and say "genetics" to explain my issues, even though gum disease isn't a thing in my family. I'm otherwise in excellent health.
posted by Cuke at 7:16 PM on August 11, 2016 [1 favorite]

I had receding gums (stress, mouth breathing, not brushing enough - all reasons why) - the dentist did some wacky laser treatment on them, gave me some swishy liquid for a few weeks, and I switched to sonicate toothbrush (sorry I can't be more specific about the treatment - I'm assuming whatever they did, it was pretty standard) . It's four years since then, and my gums feel great - all better :D

I'm glad you are seeing a periodontist, s/he should be able to help out. Good luck!
posted by Toddles at 9:32 PM on August 11, 2016

Don't forget to try saline. It makes a big difference to some people with gum problems and is inexpensive and something you can start today.
posted by Jane the Brown at 11:53 AM on August 12, 2016

Oh, I forgot about Cloysys; I did think that helped a lot.
posted by egk at 8:29 AM on August 13, 2016