Gingivitis
Plaque contains bacteria which irritate and damage the tooth’s surrounding gums. The early stage of gum disease is known as gingivitis which is reversible, presenting as bad breath, swollen, red or bleeding gums. Bleeding may occur spontaneously or when brushing. In your case, bleeding may occur more often and more regularly if you have gingivitis.
Gum bleeding will occur as a consequence of gum disease. This bleeding tendency may be made worse by the presence of your bleeding disorder. A lack of brushing causes food and plaque to build up around your gums. The more plaque and food that is brushed off, on a daily basis, the healthier your gums will become and the less they will bleed in the long term.
Periodontitis Gingivitis can progress to a condition called periodontitis which is irreversible. At this stage, bone and other surrounding tooth tissues are destroyed, resulting in teeth becoming loose and eventually lost.
Intermittent tooth cleaning by a dental professional may help but will not cure gum disease. Daily care carried out at home is the most important measure to prevent or overcome the problem
Xerostomia
Xerostomia (dry mouth) can be a side effect of medicines you are taking, certain diseases and infections, and certain medical treatments. It’s also common in older people, particularly in women who have poor general health. Having a dry mouth means you are at more risk of dental decay, periodontal disease (gum disease), oral infections (particularly thrush) and intolerance of dentures. Xerostomia may cause you to have bad breath, especially during the night.
Receding gums
Receding gums can be prevented: the best way to avoid, prevent, and delay significant tissue loss is to know the cause. It can be caused by using a toothbrush with stiff bristles, which can also wear down the enamel on your teeth causing sensitivity.
Gum disease (periodontal disease) means your gums become infected and come away from the surface of the tooth, causing deep gum pockets around your tooth and gum recession.
Smoking can cause severe gum recession and your gum tissue to lose vital blood supplies, allowing for infections and tissue loss. Giving up smoking will mean your gum tissue will have better circulation and less irritation, which will help keep your gums tighter around the roots.
Tongue and lip piercings can cause gum tissue to shift out of place, exposing the tooth because of repetitive rubbing against soft tissues and gradual damage to the tissue.
But the biggest cause of receding gums is lack of dental care, delayed cleaning, untreated cavities and persistent gum problems.
Pregnancy
You can experience more bleeding from gums during pregnancy regardless of whether you have a bleeding disorder. Gingivitis pregnancy can cause swollen, red, tender gums that bleed when you brush or floss.
HIV
If you have HIV you are more likely to have sores and infections in your mouth or on your tongue. If you have a low CD4 count, you may also be at higher risk of dry mouth, gum disease, mouth ulcers, thrush, abnormal cell growth, and fungal and viral infections. Speak to your dentist if your sores haven’t healed within 7-10 days or you have an unusual change in your mouth.
You must tell your dentist your HIV status so that they can check for HIV-related gum problems and ensure that any medicines they use don’t interact with your HIV medicines. Also tell your HIV specialist if your HIV treatment is causing you to have a dry mouth. Get your teeth professionally cleaned by a hygienist more often than twice a year if you are prone to plaque build-up.
Hepatitis C
If you have hepatitis C you may have lower levels of platelets or clotting factors other than factor VIII or IX due to liver damage, which can lead to easier bleeding. Treatment for hepatitis C can lower your immunity to infection and so can cause mouth sores. Your dentist can advise you on your diet, vitamin supplements (e.g. vitamin B12) and mouthwashes that may help.
If you have HIV and/or hepatitis C you should:
- Tell your dentist and dental hygienist that you have HIV or hepatitis to ensure you receive appropriate dental care. Your confidentially will be respected.
- Rinse your mouth twice daily with an antiseptic mouthwash.
- See your dentist regularly as they will have a good understanding of living with these viruses and can reassure you about any concerns you may have.
- Contact your haemophilia centre for haemophilia treatment recommendations and platelet levels (if indicated) before invasive procedures.