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Question of the Week

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Jane Varner, M.D.Jane Varner, M.D.Family MedicinePalo Alto Medical Foundation
Jane Varner, M.D.Family MedicinePalo Alto Medical Foundation

Dr. Varner's professional interests include: fitness and nutrition, menopause, diabetes and high cholesterol management, depression and anxiety, and adolescent medicine.

Question of the Week

I am experiencing bleeding when I floss or brush my teeth. I recently switched to an electric toothbrush. What can I do to prevent the bleeding?

Jane Varner, M.D. answered: I’m glad that you asked — gum bleeding after brushing or flossing is a common concern. Gingivitis, or inflammation of the gums, is the most common cause of bleeding gums. Other symptoms of gingivitis may include swollen or receding gums, tender gums, and even bad breath. The root cause of gingivitis is the buildup of plaque around the gum line—the area where the gum meets the tooth. Plaque contains a significant amount of bacteria and is also known as “bacterial biofilm.” Plaque buildup can best be prevented by gentle brushing and flossing every day, and dental cleanings every six months. Some studies have shown that electric toothbrushes may be slightly more effective at removing plaque.

There are some additional health conditions that can increase a person’s risk for gingivitis. These include pregnancy, HIV infection, smoking, diabetes, poor-fitting dental appliances, and advanced age. Certain medications, such as NSAID’s (Ibuprofen, Naproxen), aspirin, Dilantin, calcium channel blockers (Nifedipine, Diltiazem, Verapamil, and Amlodipine), and Cyclosporine can also increase risk.

If it seems that your gum bleeding is excessive, or worsening, be sure to see your doctor for a medical evaluation. Evaluation may include a history and physical exam, a careful review of your medications, and lab work to assess your platelet count and/or coagulation factors.

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