In June 2009 a dentist performed the advanced cleaning procedure they
identified as a full mouth debridement. The dentist also measured the
distance between the bottom of the enamel and the top of the gum. This was
painful as the measurement device pressed into what I assume was soft enamel
or dentin.

The reason for my concern and my question here follows. Before the cleaning,
my gums completely filled the gaps between my maxilla 7, 8, 9 and 10(top front teeth). After
the cleaning, between 9 and 10, a 1.5 millimeter gap exists. And, between 9
and 8, and between 8 and 7, a 0.5 mm gap exists. In other words it appears
that the dentist created gaps during the cleaning process. I definitely had
a lot of blood when I rinses after the cleaning. Did the dentist make a
mistake?

The dentist recommended that I come back for the second part of the cleaning
including having the undersides of my gums cleaned. Another dentist during
another previous appointment recommended the same. Based on the apparent
damage to my gums, I have ignored this. I have not had my teeth cleaning
since.

Answer:

Wow, your ability to relay the information in dental terminology is quite impressive

So first we will explain exactly what happened and then we will explain the reaction of your gums to the procedure.

Full Mouth Debridement

A full mouth debridement is an extensive cleaning procedure that involves cleaning the surfaces of your teeth including the tooth surfaces (root) located under the gums.  A dentist performs a periodontal probing to determine if a patient needs a debridement.  Based off of your information, it looks like the dentist recorded your probing depths, meaning he used a probe to measure the depths of the pockets around your teeth.  This information tells us whether or not your gums are inflamed, meaning that you are experiencing gingivitis (please see our article here for more information on gingivitis).

Signs of Gingivitis

It looks like you had inflammation of your gums.  The major factors in your situation that point us in this direction are the following:

• Bleeding during a cleaning or probing indicates inflammation of gums/gingivitis
• Shrinkage of the gums after the cleaning was performed indicates that the gums were inflamed and are now healing

Healing After Full Mouth Debridement

So now, the dentist performed the debridement and you see spaces that didn’t exist before.  Let’s explain fully why this occurred.

• There is a possibility that you had calculus deposits.  Calculus is a hardened buildup that can accumulate, over time, on teeth.  Sometimes, it appears as tooth structure, but is actually harmful to the teeth.  Calculus usually accumulates around the gumline.  If the dentist removed calculus, spaces can now appear in those newly cleaned areas.
• Your gums are now healing.  Before your gums were inflamed.  Gums become inflamed when there are bacteria, food deposits, plaque, or calculus that remains on the teeth near the gums.  The body’s defense system attempts to fight the foreign invaders resulting in inflammation and tenderness of the gums.  Some signs of inflammation include the following:
  • Red gums
  • Puffy gums
  • Gums that bleed when flossing

Healthy gums should appear coral pink (or slightly pigmented based on ethnicity), firm and tight.

So don’t worry, the dentist definitely didn’t mess up.  Your gums are now healing after the extensive cleaning was performed.  If the spaces in your teeth concern you, return to your dentist and he/she will be able to better assess the situation from this point.  More than likely, once the gums return to full health, the spaces will resolve.  Or, if you had periodontitis, meaning bone loss accompanied the gum inflammation, there are procedures the dentist can use to solve the problem.

Hope this helps and good luck,

Save My Smile Team

I am having pain and bleeding from a tooth.  Also, anything that I eat sticks between by teeth.  Do you have any advice or suggestions for medications?

Answer:

Based off of your description, it looks like you are suffering from pain from your gingiva (gums) and not your actual tooth.  However, please read our article on Toothaches to further assess the situation involving the actual tooth itself.

Inflammation of the Gums = Gingivitis

Usually, when food, bacteria, plaque, calculus, or anything else accumulates around our gums it causes an inflammatory response.  This means that the gums are sensitive, red, puffy, swollen, and bleed very easily.  It sounds like your gums are inflamed, thus causing the bleeding and pain.  This condition is called gingivitis.  A more advanced form of this ailment is called periodontitis if bone loss is involved.

How to Treat Gingivitis

So how can you treat this?  Well, your best bet is to visit your dentist for a thorough cleaning.  If severe, he/she may prescribe you antibiotics to help solve the problem.  However, here are some suggestions to help you with the situation now.

• Rinse with warm salt water to deal with the pain and sensitivity
• Use a mouthwash with chlorohexidine gluconate.  This is a mild antiseptic that is used to kill harmful bacteria in the mouth thus helping to eliminate plaque, calculus, and gingivitis.
• FLOSS EVERY DAY.  This is key to maintaining the health of your gums/gingiva.  Flossing eliminates the bacteria or food trapped under the gums.  This step is also very important for you being that food packs between your teeth.  In areas such as that, you must be sure to brush thoroughly and floss to remove all irritants.

Hope these tips help out and good luck,

SaveMySmile Team

Why does [the gum push down away from my tooth]? It looks like there won’t be support to my tooth if it [keeps] on happening. Is there any solution for it?

Answer:

It sounds like what you’re describing is a severe case of gingival recession.

What Causes Gingival Recession

Severe recession usually results from gingivitis or periodontitis.  Gingivitis is the inflammation of the gums around the tooth.  Periodontitis is similar to gingivitis, except it also includes loss of bone around the tooth and shrinkage of the gum tissues away from the tooth.

How to Prevent Gingivitis/Gum Recession

You want to try your best to preserve the tooth and its surrounding structures.  The gums (gingiva) usually shrink away from the teeth because bacteria have accumulated in areas around the tooth.  The bacteria cause our immune system to react in several ways to fight it off.  A combination of our immune system reactions and the harmful toxins released from the bacteria lead up to periodontitis (the gums shrinking away from the tooth).

The best way to treat this is to FLOSS EVERYDAY especially around this tooth and be sure to brush thoroughly all surfaces of your teeth.  If not, bacteria will continue to accumulate around your gumline and continue to add to your condition.

Is the tooth loose?  If so, you may need to visit your dentist for further evaluation.

Is there plaque or calculus around the tooth?  If yes, you will need a dental cleaning in order to effectively remove all of the bacteria from this area.

If the gum recession is severe, you can always visit your dentist for a periodontal graft to assist in replacing the tissue.

As a reminder, be sure to begin to take steps to treat this situation now.  If allowed to worsen, the tooth could eventually become loose and even fall out.  View our articles on Brushing and Flossing for more details on how to properly clean your teeth.

Good luck,

SaveMySmile Team

My teeth bleed every time that I brush.  What should I do in this case?  And also, my mouth is hurt each time I use antiseptic to rinse.

Answer:

How often do you floss? From what you’re telling me you may have some minor inflammation on your gums. This often happens if you don’t floss regularly. Minor inflammation is called gingivitis and is usually easily cured if you start flossing more often or visit your dentist for a cleaning. If you continue not to floss, gingivitis can turn into periodontitis which can lead to a host of other problems including bone recession, loose teeth, etc.

Now remember when you start flossing you will definitely see bleeding. This goes away as you floss more often. Being that your gums are inflammed, your immune system is sensitive in that area and can easily become aggravated. However, you need to be able to clean away the bacteria below your gumline so please continue to floss.

Hope this helps

SaveMySmile Team

Signs of Gingivitis

• Swollen gums
• Bleeding gums (especially when brushing or flossing)
• Shiny or red gums
• Associated pain
• Bad breath or foul smelling gums
• Gum recession (teeth appear longer)

Causes of Gingivitis

• Most often caused by plaque accumulation and poor oral hygiene habits
• Hormonal changes (i.e. pregnancy)
• Certain medications that may suppress the immune system

Gingivitis is a mild form of inflammation.  Unlike it’s more serious form, periodontitis, gingivitis can be treated quickly and easily if addressed in a timely fashion.

Treatment for Gingivitis

• Improve oral hygiene habits – Brush after each meal and floss every day.  If this regimen is followed precisely, the bleeding will eventually stop.
• Incorporate a mouth rinse, preferably with chlorohexidine, into your daily routine.  This can assist with the removal of unwanted bacteria.
• Visit the dentist and get a cleaning – The dentist will be able to effectively remove plaque and calculus, the main causes of gingivitis.  However, it’s up to you to maintain the plaque free mouth after this point.
• Antibiotics – If serious, the dentist may prescribe antibiotics to control the bacterial invasion.

All in all, gingivitis can easily be managed if addressed early.  Take the right steps in keeping up with your oral hygiene to maintain a healthy smile.

Have more questions?  Feel free to leave a commit or submit a question to be included in our FAQ’s.

So why floss your teeth?

• Mouthwash and a toothbrush can’t reach every surface of your teeth! Flossing removes the food buildup and bacteria that is located between your teeth.
• Most cavities arise from bacteria located between the teeth – This area is often overlooked. Many feel that if they can’t see it, then it isn’t a problem. However, if given the chance, microscopic bacteria can and will accumulate and begin the demineralization process of enamel slowly leading to cavities, pain, and bacterial invasion.
• You don’t want bleeding gums do you? – Bleeding gums is a sign of inflammation! If you don’t floss regularly, you can expect some minor bleeding when you start out. But don’t quit. Bleeding gums indicates gingivitis, and even worse periodontitis. If severe enough, this will lead to recession of the gums and loose teeth. Flossing removes irritating bacteria from being allowed to infiltrate your gums and cause infection.

Proper steps to flossing

• Start off with a long strand of floss (around 15 inches or so) and wrap it around each middle finger
• Use your index finger to guide the floss between your teeth
• Once the strand of floss is between your teeth, follow the curvature of each tooth in an up and down motion about 2-3 times. Don’t be afraid to push the floss under the gums, this is a critical area that needs to be cleaned.
• Remove floss and repeat with each tooth, making sure to use a clean section of the floss each time.

How often should I floss?

It’s best to floss a minimum of once a day

I tried to floss and my gums started bleeding, should I stop?  Is something wrong?

Do not stop.  This is a sign of inflammation and indicates that you haven’t flossed in awhile.  Continue to floss everyday and the bleeding will stop.

Have more questions?  Feel free to leave a commit or submit a question to be included in our FAQ’s.

Happy Flossing!