Gum Disease, You’ve Got 72 Hours Until It Strikes Again.
Contrary to popular marketing, the long term solution to gum disease does not reside in the latest toothpaste, gadget or mouthwash. The trick to preventing gum disease is learning what it is, how it works and most importantly how you can diagnose it at home in order to kill it. Gum disease can form in 72 hours and considering dental visits are spaced six months apart the self-diagnosis component is key.
Firstly, Gum disease comes in two flavors. Gingivitis is an inflammation of the gums only and will show up as red, swollen, bleeding gums. Gingivitis can be very subtle and requires a keen eye to spot. If you don’t know what to look for it can be easy to miss. Alternatively, Periodontitis is the big brother to gingivitis and is where the gum and bone start to break down due to sustained inflammation. Essentially the gingivitis wasn’t corrected and morphed into periodontitis. Both forms of this disease are caused by the incomplete removal of bacteria from below the gum line.
The Gum Pocket – ground zero
The point where you see the gum and the tooth meet is NOT where they meet. In a normal situation, the gums will physically attach to the tooth about 3mm below what you would identify as the gum line. This difference creates a small pocket around every tooth or what we in the dental community call a sulcus.
If there is a flaw in the human body, the sulcus is it. The natural anatomy of this pocket causes it to fill up bacteria when we eat. If not cleaned out daily via brushing and flossing this dental plaque will trigger inflammation which will lead to our old friend gum disease.
I tell my patients that this little pocket is like an O-ring that prevents bacterial bugs from the outside world from invading the inside of our body. Everything remains cool as long as the O-ring is tight and healthy. However if you slap a bunch of dental plaque on it and wait three days, not only will you have an inflamed O-ring that we can call gingivitis, but you’ll also have an open pathway for bacteria to directly enter your bloodstream, and that’s not good. When gums turn red and start to bleed it means bacteria can enter the blood. Healthy gums will not bleed.
So What does gingivitis look like?
Take a look at the picture below. 5 teeth on the top and 4 teeth on the bottom have gingivitis. Can you see the difference? The teeth that have gingivitis have a small red halo right at the gum line. This is caused by bacteria living just below the gum line inside the sulcus. The body has recognized the bacteria as a threat and has increased the blood flow to the affected areas in an effort to kill the bacteria with white blood cells. The increased blood flow is what’s causing the gums to turn red. Furthermore, brushing these areas will cause the gums to bleed. Now pay attention. Bleeding gums do not mean that you have caused trauma or damaged your gums in some way. It means you’ve discovered an area that was already inflamed due to a bacterial presence. As the gums become engorged with blood the blood vessels will enlarge and expand close to the surface. Brushing this area will break some of these vessels and cause bleeding. Too often we incorrectly assume that blood means we should stop brushing the area when just the opposite is true. The gums have become fragile and inflamed but continued cleansing of the areas will remove the bacteria thereby eliminating the need for inflammation. Don’t kill yourself with the brush, just ensure sure you make good contact at a 45-degree angle and the gums will heal.
The type of gum disease (gingivitis) pictured above is the most common form. When you see statistics about 50% of individuals over the age of 30 having it, this is what is meant. This is a mild form of the disease but still allows bacteria to enter the bloodstream which increases the risk of developing heart disease, diabetes, stroke, Alzheimer’s and certain forms of cancer. However, with good brushing and moderate flossing, it can be removed in 72 hours. Alternatively, it can return in 72 hours. We never really win the war with gum disease. Our main objective is to keep the bacterial count low so the body doesn’t have to initiate an inflammatory response. The inflamed state is what allows the bacteria to enter the bloodstream. On average and depending on your level of health it takes 72 hours for bacteria living inside the sulcus to create a toxicity level that’s sufficient to trigger an inflammatory response.
If you notice areas in your mouth that look like the picture above or have gums that frequently bleed, it’s time to make a change.
- Brush your teeth. The type of toothpaste you use is irrelevant but HOW you brush is CRITICAL. If you’re brushing your teeth the same way you did back in the third grade ( up and down or circles) you need to change. These techniques clean the surfaces of the teeth but not the sulcus. Additionally, if your gums bleed when you brush or floss you need to change. I recommend the MD Brush which places you at the correct 45 Degree angle to clean out the sulcus where bacteria love to grow. Gum disease is really a disease of brushing mechanics that’s created when we first learn to brush. The MD Brush improves the behavior of brushing by addressing stroke and angle of attack which then improves the muscle memory associated with brushing. This kind of change can have lasting benefits for your health. Sonic brushes are OK but they tend to provide a false sense of security, cause sensitivity and can be expensive. You should ONLY brush in circles if advised to do so by your dentist which they will do if you have a lot of gum recession.
- Floss. Remember you are trying to scrape the goop off the sides of the teeth, so make sure to pull and push against the teeth as you slide the floss down in-between. Simply popping the floss in and out is not enough. Floss and repeat until the floss don’t stink. Floss in the shower so you don’t forget to do it, and use a new piece of floss for each area. I do not recommend those floss pick wishbone things since they only transfer bacteria from one place to another. Once you floss an area you must use a new piece of floss for the next area.
- Brush again, but this time instead of using toothpaste, use Listerine mouthwash. You’ll be brushing with a liquid so it will be running down your arm and making a mess. NOTE: ONCE YOU SPIT, DO NOT RINSE THE LISTERINE OUT, just let it linger. It will continue to kill bacteria for up to 5 hours provided you don’t rinse or drink anything. Performing your home care like this will yield immediate results, but remember, bacteria will never take a vacation, call in sick, or quit. All they do is grow, multiply, and release toxins, so gingivitis can return within 72 hours.
Written by, Mike Davidson – Maverick Dental Hygienist, CEO MD Brush, LLC