Stop Gap Measures

December 13, 2006 11:08 AM

[Dental Filter] So, my gums are doing an awful lot of bleeding. It will be at least four months before I can go to the dentist. What can I do about this in the mean time?

So, yeah, my mouth is sort of in rough shape. It's become common to wake up needing to spit blood in the morning. Sometimes it even happens when I stay up too late at night. When I brush my teeth, I wind up bleeding into my toothpaste. I realize only a dentist can provide a meaningful solution to this, but I won't have insurance until the spring. So, what can I do in the meantime to reclaim my teeth and gums a bit.

posted by EatTheWeak to health & fitness (28 comments total)

this happened to me years ago.
my dentist didn't have an appointment available for almost 3 months, and i was in horrible pain, and bleeding if i sucked on my teeth too hard (lol).

anyway. i had the dentist call in some antibiotics to my pharmacy, so i could treat the gingivitis while i waited for my appointment to roll around.

i'm assuming you have the same thing, so maybe you could try that route (if your dentist will call in a script without seeing your first).
posted by picture_yellow at 11:11 AM on December 13, 2006

Sounds like gingivitis. Floss every day and rinse with Listerine for 30 seconds twice a day.

If you're female: are you by any chance pregnant? That can cause bleeding gums, too.
posted by amro at 11:11 AM on December 13, 2006

Wash your mouth with hydrogen peroxide frequently.
posted by trip and a half at 11:16 AM on December 13, 2006 [1 favorite has favorites]

Get the antibiotics, then get a Sonicare.
posted by kindall at 11:20 AM on December 13, 2006

Get a Sonicare toothbrush. I had this issue and the stimulation of the gums that a Sonicare provides help to bring blood circulation and cell regeneration to the gumline.
posted by BrodieShadeTree at 11:26 AM on December 13, 2006

third sonicare.

you might want to also try biotene mouthwash and toothpaste. (don't use the biotene toothpaste exclusively, but brush and an 1-2 extra times a day with it.)
posted by milarepa at 11:39 AM on December 13, 2006

Are you flossing?
posted by bshort at 11:45 AM on December 13, 2006

This can quickly become serious, so I'd be careful. When bacteria have a clear route into the blood stream from somewhere as nasty as the mouth, it can result in septicemia. This is potentially deadly.

I'm not suggesting that you're at immediate risk, but keep an eye out for anything unusual, and get prompt medical treatment if you believe that something is amiss.

The hydrogen peroxide and listerine recommended above are pretty much interchangable. All that they're doing is killing bacteria in your mouth. Using either is good advice.
posted by chrisamiller at 11:47 AM on December 13, 2006

I had mild gingivitis a few months ago, but followed my hygienist's advice and have pink, healthy gums now.

I rinse and brush (steps 1-2) in the morning, and rinse, floss, brush and rinse (steps 1-4) in the evening.

1) Rinse and swish thoroughly with a mouthwash that loosens plaque (e.g. Plax) so that plaque all over your teeth, especially at/under the gumline, can be brushed away more easily.

2) Floss before you brush. I'm 45 and I have NEVER flossed more than three days in a row before, but I'm now flossing 5-7 days a week because my hygienist said the magic words: you don't have to be perfect about it. She gave me permission to floss every other day, although once a day is better, and to floss only the areas where my gums were worse (front of my mouth). I now floss almost every evening, and almost all the way through my mouth. (I have a tough time flossing my very back molars, but I do try.)

3) Brush with plaque-fighting toothpaste (e.g. Colgate Total) and a soft or extra soft toothbrush. A Sonicare or similar electric brush is great, but a $2 children's toothbrush from the drugstore is also fine.

First brush down from the gumline/up from the gumline in each section of your mouth. You will bleed. Keep going, rinsing your brush and adding more toothpaste as needed. Remember to brush the interior curve of your teeth, too. This is why a small brush is best.

After you have brushed this way throughout your mouth, rinse your brush again, add a little more toothpaste, and set it against your gumline at a 45 degree angle and GENTLY press and wiggle each section for a few seconds. You will bleed. Spit it out, rinse your brush and add a little toothpaste if needed, and keep going all the way around your mouth.

The gum-wiggling step is important, even though it will temporarily make you bleed, because you need to clean and stimulate the gumline and get those nasty little pockets, havens for bacteria, to go away. SOFT brush. GENTLE wiggling. You're not grating cheese.

4) Rinse with water if you have a lot of blood, then rinse with a GENTLE alcohol-free mouthwash that fights plaque. I use Biotene, which is pricey, but I use it only once a day. You should not eat or drink for 30 minutes after this final rinse.

You're bleeding a lot more than I did, so if you can see a dentist or even a student at a local dental school soon, please do so. As others have mentioned, you may need a complete course of antibiotics if you are bleeding so badly that you have to get up in the middle of the night. And you probably have a lot of tartar accumulated that cannot be removed with gentle brushing and flossing.

(If you see dental tools for sale in your drug store, DON'T buy them. I tried that and almost made my hygienist faint. You can make things a lot worse if you try to remove tartar yourself, especially given the amount of bleeding you're dealing with right now.)
posted by maudlin at 12:01 PM on December 13, 2006 [10 favorites has favorites]

I'm not certain this is a dental problem. It's also a common sign of very low platelets. Bleeding gums from gingivitis is one thing, and if you never brush your teeth and have sore, pink, puffy gums and foul breath, well, that's gingivitis.

But if, heaven forbid, you've come down with something like immunogenic thrombopenic purpura, which can happen after an unnoticed viral illness, your platelet count might be zero. Low platelets can cause painless gum bleeding even if your oral hygiene is very good.

In that case you're at serious risk for death from minor injury. So you might want to consider going to some doc to get a blood count.
posted by ikkyu2 at 12:01 PM on December 13, 2006

OK, steps 1 and 3 are rinse and brush. *sigh*
posted by maudlin at 12:03 PM on December 13, 2006

Call your dentist and see if they can fit you in for a cleaning before the spring. A cleaning is under $100, and it will really help. (Irritation from tartar/plaque buildup can be a huge cause of bleeding)

Flossing is the #1 thing you can do at home to keep bad dental woes at bay.
posted by LobsterMitten at 12:14 PM on December 13, 2006

I too recommend flossing, I had at one point the same symptons you described. I remember being told to floss when I was younger by dentist but I found it too much of a chore to do. Anyway after I ended up paying extra from a deep cleaning, I decided to take more care of my teeth. Flossing is definitely one of the best ways to stop and prevent bleeding gums. I usually floss first then brush my teeth then mouthwash.

After you do a couple of days of flossing you become hooked, or at least I did. Now I feel dirty if I don't floss.
posted by spacesbetween at 12:33 PM on December 13, 2006

I had the same thing for years, and my dentist said sure, keep brushing and flossing, but the only way to really keep this under control is to go in to see him every six months and let him do his super-dooper cleaning thing with his pointed scraper tools( I know, they're yucky but they get the job done).

I also had to get a gingivectomy, but it wasn't too bad because they used a laser.

Don't be shy about asking for novocain, even just for routine cleaning.
posted by frosty_hut at 12:50 PM on December 13, 2006

Flossing will do wonders for your gum health. Seriously. It will suck at first and you will bleed. After a while, it will stop sucking and your gums will stop bleeding. You do not need to spend lots of money on a special toothbrush. Just floss. It is cheap stuff.

If flossing doesn't help, then you do need to see someone sooner rather than later.
posted by caution live frogs at 12:53 PM on December 13, 2006

I occasionally have (had) much more minor gum bleeding when I ovulate. I found that taking more Vitamin C helped, as did getting into the flossing habit. (Yes, I've known college kids with scurvy - do you have scurvy?)

The flossing habit was encouraged by something I think I saw here - keeping it by the computer, so that I floss while I'm reading MeFi or watching some YouTube.
posted by cobaltnine at 1:14 PM on December 13, 2006

Second the scury suspicion. Sounds pretty serious- if the brushing/flossing advice doesn't stop the bleeding problem, I'd fork out the dough to see an M.D. at a walk-in clinic. Also, some dental offices offer a $50 visit (cleaning and check-up) for first time customers, doesn't matter if you don't have insurance. Also check out any dental schools in your area, you might be able to get dirt-cheap if not free care.
posted by emd3737 at 1:36 PM on December 13, 2006

One of the things I also did was that flossing would make my mouth hurt so badly, sometimes starting a headache... so I would, in addition to the brushing/flossing/Listerine, USE ANBESOL or ORAGEL that you use for baby teething pain. I did this for about a week, getting my gums used to the flossing. And now, I can floss and brush painfree and my gums are healthier for it.

It took me a long time to realize that I was avoiding the pain, even thought I WANTED to floss.

Good luck!
posted by raar at 1:58 PM on December 13, 2006

If the issue is not plaque but bacterial infection of the gums: A periodontal surgeon who teaches at NYU Dental School advised me that warm salt water (1/2 teaspoon to 6 oz. water) is more effective than Listerine, etc. As warm as you can reasonably tolerate, but not scalding. At least 5 times a day if you're having problems.
posted by Dave 9 at 2:04 PM on December 13, 2006

All good advice: brush, floss, rinse with peroxide/listerine (mmm! blue flavor!), water pics, sonic toothbrushes, antibiotics. I would also add two more options my dentist has me doing. If the gap between your teeth is large pick up an interdental brush and use that as well. Don't force it in there though. She also has me massaging my gums to increase blood flow.

Please, please: be gentle with all of these operations! And don't forget to replace your brush often. They end up harboring bacteria as they age.

Good luck!
posted by chairface at 2:05 PM on December 13, 2006

Thanks for all the good advice, my friends.

chrisamiller/ikkyu2 - that's terrifying. what are some other signs of these conditions?
posted by EatTheWeak at 2:05 PM on December 13, 2006

I have crappy gums and have gone back to a dentist after a long absence (nothing turns you off dentistry quite like a childhood dentist who you have seen HIT kids and scream at her hygienists - I should write a book, though nobody would believe it) and here's my advice.

Can you spare $200? If so, just go have a preliminary appointment with a dentist and get a cleaning. I assume you've been away for a long time so they'll want to do x-rays and you can tell them nope, gonna have to wait till spring.

However if you've got a lot of tartar buildup because of a long absence and iffy care I think you're going to have limited return on investment if you just start flossing now. If the only choices are do or don't floss, by all means, get into the habit. However I believe - perhaps there's a dentist or hygienist here who can weigh in - that by flossing you're primarily trying to prevent new build-up, your existing plaque (which might be plentiful) is going to need some planing in the dentist's office.

You should just call some dentists and tell them you have no insurance. The reality is that most dental insurance blows goats. Every dentist has experience working with people having to pay out of pocket, in part or in whole, because most dental insurance takes a very short-sighted approach to what they'll pay for.

Case in point: just today I wrote a $120 check for a cleaning because my insurance will only pay for 2 a year, but my horrid gums are such that 4 a year improves my chances of preventing any more recession. They can pay $240 a year for additional cleanings or they can pay thousands for an implant or dentures if I lose teeth because of bone loss. They're choosing the save the $120. *shrug*

To make a long story marginally less long - I think most dentists you call will have a system for working with people who need uncovered care.

I Nth the peroxide suggestion. Lots of people use it as a mouth rinse and so long as you make sure to spit there's no real chance of any negative effect that I'm aware of. Personally I'd stay away from Lysterine given how much alcohol it has in it. Maybe prevent tarter but it has always been hard on my tongue.
posted by phearlez at 2:36 PM on December 13, 2006

Pop 30mg of Vitamin C every day. If your gums improve, you had scurvy. If they don't, you're out maybe two bucks.
posted by flabdablet at 3:19 PM on December 13, 2006

I'm late to the party but hope I can be helpful. I have heriditary recessive gums (several surgeries) and have to be constantly vigilant. If your nerves are exposed it might make an overdue cleaning painful, so maybe an external numbing agent will be in order. You can also ask your dentist to check for any exposuure of the tooth roots through enlarged "pockets" of receded gums.

Yes, floss. Tedious but essential. But also make sure you are doing more than a cursory job by bracing the floss against each side of the two teeth, and pulling the front part of the floss down and slightly in front of the tooth.

Since you may be sensitive while brushing for a while, you mgith want to try Sensodyne toothpaste for a bit. It doesn't taste great, but it's extremely effective.

Good luck.
posted by foxy_hedgehog at 3:23 PM on December 13, 2006

If my gums were bleeding without provocation, seeing a dentist would be my absolute #1 priority in life. Just saying.

Also, apparently using a Waterpik counts as flossing. I wish someone told me this years ago.
posted by trevyn at 4:09 PM on December 13, 2006

Following up on ikkyu2's comment (and your subsequent question), one of the symptoms of Idiopathic Thrombocytopenic Purpura (ITP) is indeed oral bleeding. Other symptoms of ITP include nosebleeds and bruising. You could start with a simple blood test to check your platelet count and rule out ITP or other blood disorders.

The oral hygiene suggestions above are a good idea, no matter what the cause is.
posted by nelvana at 7:55 PM on December 13, 2006

chrisamiller/ikkyu2 - that's terrifying. what are some other signs of these conditions?

If you have septicemia, you'd know it. Since the bacteria are in your bloodstream, you'll get body-wide inflammation, a high-grade fever, increased heart rate, shallow and quick breathing. You'll generally feel like crap and be pretty seriously ill.

That said, a normal, healthy immune system shouldn't have any problem handling the bacteria from some minor bleeding gums. The cases I remember reading about were from people with serious oral problems and compromised immune systems.
posted by chrisamiller at 8:33 PM on December 13, 2006

Since you may be sensitive while brushing for a while, you mgith want to try Sensodyne toothpaste for a bit. It doesn't taste great, but it's extremely effective.

There's several flavors and the blue mint stuff (which always seems hard to find for some reason) seems to me to taste little different than Crest.

My dentist commented to me once that if I was having more sensitivity that in addition to brushing with it I could put a little Sensodyne on my finger and rub it on my gums and leave it on for some more benefit.

As far as pain in the dentist's chair, many dentists are set up for nitrous in all their rooms and don't charge extra for it. You just have to ask.
posted by phearlez at 12:48 PM on December 14, 2006