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