Dear Dr.: 
My gums are bleeding a lot when I brush my teeth and I’ve heard people talking quite a bit about gum disease. How do I know if I have it, and if I do what can be done about it? James in Tecumseh

Dear James,
If your gums are bleeding when you brush, there is a good chance that you are at some stage of gum (periodontal) disease. It does affect approximately nine out of ten adults at some point in their lives and it may not even hurt or you may not even be aware that you have it until a more advanced stage. If you notice any of the following warning signs, see your dentist ASAP:

– Bleeding gums
– Red or swollen gums
– Gums that look like they have pulled away from the teeth
– Pus between the gums and teeth
– Loose teeth or ones that have changed position (can make your bite feel different)
– Constant bad breath

In terms of treatment, it depends on the severity of the problem. The first step after a comprehensive exam is usually to remove plaque and tartar (calculus) deposits from above and below the gum line (scaling). The root surfaces may also be smoothed (planing) to decrease the chance of future plaque attachment and also to facilitate healing and reattachment of gum tissue to the teeth. In more advanced stages of the disease deep pockets can form between your teeth and gums that may even make it difficult for your dentist to do a thorough job. In this case, and possibly before, you may be referred to a Periodontist (gum specialist) for evaluation. If you have had any of the warning signs, don’t let it go any further. Allow your dentist to treat it, educate you about it and how to control it, and put you on a proper maintenance schedule. The longer you wait, the worse it will get!

Any questions for Dr. Mady can be e-mailed to drmady@drmady.com and also visit his blog at www.dentalden.com (dental education network)

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This column is reprinted with the permission of the author and The Windsor Star. “Ask the Dentist” is written by Windsor dentist (and ECDS member), Dr. David Mady Jr.. The column appears the first Thursday of each month in the Windsor Star. Readers with questions can write to “Ask The Dentist”, c/o The Windsor Star, 167 Ferry St., Windsor Ontario, N9A 4M5