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Not just teeth

The challenge of a healthy mouth is more than preventing cavities

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As many may know, there is more to oral health than having teeth without cavities. Although discussing tooth decay and preventing cavities is important, other issues that can arise in the mouth are equally essential. An important topic discussed in this article is the gingival tissue, also known as your "gums".

Throughout my years in dentistry, many parents have asked me questions such as, "Why are my child's gums bleeding" or "Whenever I floss my child's teeth, the gums start to bleed."

Various conditions of the gum tissue can result from improper brushing or lack of flossing. One of the most common conditions I see in young children and teens is gingivitis. Gingivitis is a mild form of gum disease, which causes swelling, irritation, redness, and often bleeding of the tissue. Usually, this is located where the teeth and the gums meet or the gum tissue right between the teeth. As mentioned, gingivitis is most often a result of poor oral hygiene. Many times during our exams and cleanings in the office, as soon as we start brushing patients' teeth and removing plaque around the gum line, they start bleeding immediately. It is often during these moments that I allow the patient to see in the mirror where they need to improve their brushing and flossing technique to help their gingivitis subside. I have even seen gingivitis in young babies due to parents' struggle to brush efficiently along the gumline.

There are various states of gingivitis. It can be mild, moderate, or severe, and it can be localized (located in one specific region in the mouth) or generalized (located throughout the mouth in multiple areas). Pictured in photo A is how localized gingivitis may present. In this photo, the gum tissue around the upper teeth in the front is red and inflamed, but the other areas in the mouth appear normal.

Detecting gingivitis is extremely important because, left untreated or unaddressed, may cause the disease to progress into a more severe condition called periodontitis. Periodontitis is a gum infection that can cause enough damage to destroy the bone structure around the teeth, which can cause the teeth to become loose or even fall out. It's a condition that is mainly seen in adults. In fact, according to the American Dental Association, about 42% of all adults with teeth 30 years of age or older have periodontitis.

In photo B, the stages of gum health can be seen, ranging from healthy teeth and gums to gingivitis to periodontitis. Although I do not see many patients with periodontitis, I stress the importance of forming healthy habits as a child, so they continue into adulthood. When brushing their teeth, many children focus mainly on the parts of the teeth they can see and miss the areas right along the gums.

Photo C depicts the proper technique for brushing teeth. One of the main points is the ensure that when brushing teeth, the brush is placed at a 45-degree angle, allowing the bristles to touch both the tooth and gums.

Photo D pictures the proper technique for flossing. When flossing, it is crucial that when bringing the floss in between the teeth, it curves around each tooth (making a "C" shape with the floss) before bringing it back out.

Dr. Alma Correia, Baptiste Dentistry for Kids, Flossing, Gum Health, Gingivitis, Periodontis

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