Dear patient,

The bleeding between teeth can be from local causes like a restoration collecting plaque, deep gum pokcets, poor oral hygiene in the area or it can be something related to your overall health. But again since you said it is only place most probably it is a local reason. Good luck.

Being that it is difficult at best to diagnose without the patient I would offer that there are several things that should be looked at. If you have periodontal pockets of 5mm or more and significant bone loss and/or looseness of teeth then you have advanced periodontal disease and 3 month cleanings, Sonicare and Waterpik use are not going to solve the problem. The loss of enamel and eroding of gums is probably due to excessive force of brushing and possibly grinding (bruxism). If the bleeding is significant or doesn't stop easily you could have an underlying medical problem for which you need to see your physician. In the meantime I would suggest you see a periodontist (gum specialist) as soon as possible for an accurate diagnosis.

All of the responses below are fundamental to eliminating systemic causes of a bleeding disorder (including diabetes). However, if all of those tests are normal or even if they are not you should attend a biological dentist who can take a sample of plague and examine it under a microscope to see for the presence of certain pathogenic bacteria and parasites. Special protocols must be used to eliminate these parasites, Typical oral hygiene efforts often are not effective particularly if re-infection occurs from "mothers, lovers and pets". Check outwww.iaomt.org for a listing of biological dentists in your area. Ask them if they provide non-surgical biological therapy using a microscope.

there are a few questions to clear up first. are you taking any medication like aspirin or nsaids?

have you seen your physician? have you had any "blood work" done? specifically a hematological work up including inr, pt, putt and clotting factors to rule out blood dyscrasias. and have you had radiographs of the area in question? the answer to these questions will narrow the diagnosis. looking forward to answers

Electric tooth brushes on adults that have any form of periodontal disease are ineffective. You need to brush BELOW the gum line as well as above the gum line. If you don't know how to brush below the gum line the problem will persist. Flossing also must be done as deep as possible below the gum line and in one specific way only. A soft, flat toothbrush is all you need. Angle the bristles at 45 degrees to the teeth. Slide the bristles to the gum line then push them gently below the gum line. Wiggle a little and remove. Then brush up and down. Electric tooth brushes do not have the ability to clean below the gum line. If you are in the area stop by for a complimentary demonstration. Invest in a water pic devise as well. avoid simple sugars. Rinse right after eating if you can't brush.

If you need further clarification call me cell 301-367-8268

Peter Merai DDS, FAGD

Causes of Bleeding Gums

Rarely, bleeding gums may be a symptom of other problems pertaining to your mouth or body. While bleeding gums are usually a good signal that you have gum disease, causes of bleeding gums can also result from:

- Brushing too hard

- A vitamin deficiency

- Taking blood thinners or other medications

- Bleeding or clotting disorders

- Hormonal changes during pregnancy, resulting in pregnancy gingivitis

- Dentures that don't fit

- Mouth sores

- Other medical problems, including diabetes, heart disease, leukemia or scurvy

Regardless of your situation, it's important that you don't self diagnose. Only a dentist can determine the causes of bleeding gums and offer the right treatment.

There is a specialty in dentistry called periodontics, they specialize in the care, health and surgical procedures pertaining to gum tissue and bone. Ask for your dentist to refer you to a periodontist.

Patients with advanced gum disease will be observed to have excessive plaque (and bad odor) and loose teeth. Even without a cavity patients can lose teeth because of advanced gum disease.

Patients with advanced gum disease usually have it on all sides of the mouth, not just one area as you've indicated.

The general rule is that everyone has some level of gingivitis. Gingivitis is caused by bacteria. We all have bacteria in our mouth and can never get rid of them. The objective is to keep the bacteria levels as low as possible to keep the gingivitis at the lowest level possible. Bacteria form plaque and it's the plaque that leads to bleeding. Everybody has some level of plaque formation, which is why even in the healthiest of mouths there can be gum bleeding.

So assuming you're diligent with cleaning your teeth, attending your check-ups, and haven't been advised to have an advanced cleaning (referred to as scaling & root planing or even a surgical-like cleaning procedure) compared to a basic cleaning, it's not likely you have a more serious problem. It could be the affected area is such that more plaque is able to form and cause more persistent bleeding. Our jaws can change subtley over time. Even if this never happened before, subtle changes in the shape of your gums can lead to more bleeding in the area you're referring to.

As for using a water-pik it won't get rid of all the bleeding. If anything it will put your gums at a higher risk of receding. Water-piks are nice, they can have some advantages. I only recommend them if patient's are compromised doing good, old fashioned brushing, flossing, & rinsing. I really don't like them.

Same with electric tooth brushes. The tendency is for patients to hold their brushes with a lot of pressure. That can inadvertently cause the enamel to wear down. Once your enamel's gone, it's gone. If you're dilligent with keeping your teeth clean, water-piks, electric tooth brushes, and other "gimicky" gizmos really aren't critical or necessary to invest in.

Oh, an open contact on an existing restoration could be the culprit too. Have the contact between the teeth in this area checked as well.