Gum Issues: Treatment, Symptoms, and Recovery Insights

Gum issues

Hello Doctor: I have long-term irregular sleeping patterns and experience significant stress.
Recently, I was diagnosed with mild periodontal disease.
After treatment, I have noticed the following: (1) Occasionally, when I skip using dental floss for a few days (about 2-3 days) or go to bed late, I experience bleeding from a few teeth during cleaning.
However, after taking B vitamins, the bleeding stops the next day when I use dental floss again, although it sometimes still occurs.
After using dental floss for a few days, the bleeding usually resolves.
I would like to know if this recurring situation indicates inadequate treatment.
Should I consult a periodontist for further evaluation, or do I need to continue long-term supplementation with B vitamins and vitamin C? (2) There are specific areas where my teeth do not bleed when brushing or using dental floss, but my gums feel uncomfortable and painful during brushing and flossing, although I do not experience any discomfort while eating or drinking.
I feel a slight swelling, as the corresponding teeth on the other side do not have this sensation.
This discomfort has been present both before and after periodontal treatment.
What could this symptom indicate? (3) If periodontal disease is successfully treated and recovery is good, will the receded gums return? (4) Additionally, I have a question regarding the alveolar bone in the back of my lower right jaw, which has been significantly resorbed due to not having my wisdom tooth extracted for a long time.
I am concerned that this may affect the molars in front, so I recently had the wisdom tooth removed and am considering bone grafting.
Can you tell me if collagen and bone powder serve the same purpose? Is it sufficient to choose just one? Thank you for your assistance, and I appreciate your response!

Miss Hsieh, 20~29 year old female. Ask Date: 2017/03/10

Dr. Zeng Guanghui reply Dentistry

(1) Periodontal disease is an inflammatory response caused by bacteria in the oral cavity affecting the gums or periodontal tissues.
The first step is to thoroughly remove dental plaque from the mouth by brushing and flossing regularly.
Maintaining a normal lifestyle, avoiding late nights, and managing stress are also important to prevent exacerbation of the inflammatory response.
Taking B vitamins or vitamin C is only a supportive measure.
If there is persistent bleeding, it is essential to return to the dentist for an examination.
(2) If brushing and flossing cause mild discomfort, it indicates that the gums are still inflamed, which may suggest chronic gingivitis, and a follow-up appointment is necessary.
(3) Mild gum recession has the potential to recover.
(4) Both collagen and bone grafts can aid in bone regeneration, so it is advisable to consult a periodontist for further evaluation.

Reply Date: 2017/03/10

More Info

Understanding gum issues, particularly in the context of periodontal disease, is crucial for maintaining oral health. Periodontal disease, which includes conditions such as gingivitis and periodontitis, can lead to symptoms like gum inflammation, bleeding, and even tooth loss if not properly managed. Here, I will address your concerns and provide insights into treatment, symptoms, and recovery.

1. Recurring Bleeding and Treatment Compliance
It’s common for individuals with periodontal disease to experience intermittent bleeding when they neglect their oral hygiene routine, such as skipping flossing for a few days. The bleeding you observe during dental cleanings can be a sign of inflammation in the gums, which is often exacerbated by plaque buildup. When you resume flossing, the bleeding may subside as the gums begin to heal. However, if the bleeding continues despite regular oral hygiene practices, it may indicate that the underlying periodontal disease has not been fully addressed.

If you find that bleeding persists or worsens, it would be prudent to consult a periodontist for a thorough evaluation. They can assess the health of your gums and determine if additional treatments, such as scaling and root planing or more advanced therapies, are necessary. Additionally, while B vitamins and vitamin C can support overall health, they are not substitutes for proper dental care.

2. Discomfort and Pain in Specific Areas
The discomfort and pain you experience when brushing or flossing certain areas of your gums could be due to localized inflammation or infection. This discomfort may also indicate that there are pockets of bacteria or plaque that need to be addressed. If you notice that one side of your mouth is more sensitive than the other, it may be worth discussing this with your dentist or periodontist. They can perform a detailed examination to identify any underlying issues, such as gum recession or periodontal pockets, that may be contributing to your symptoms.

3. Gum Recession and Recovery
Regarding your question about gum recession, it is important to note that while some degree of gum tissue can regenerate, significant recession may not fully reverse. However, with proper treatment and maintenance, you can prevent further recession and improve the overall health of your gums. Procedures such as gum grafting may be considered if the recession is severe and affecting your dental health.

4. Bone Loss and Grafting Options
After the extraction of your wisdom teeth, it is understandable to be concerned about the surrounding bone structure. Bone loss can occur if teeth are missing for an extended period, and it may affect adjacent teeth. Bone grafting is a common procedure to restore lost bone and provide a stable foundation for future dental implants or to support existing teeth.

Regarding your question about collagen and bone graft materials, both serve different purposes. Bone grafting materials, which can include bone powder or synthetic options, are used to promote bone regeneration. Collagen may be used as a membrane to protect the graft site and promote healing. It is essential to discuss with your oral surgeon or periodontist which option is best suited for your specific situation, as they can provide tailored recommendations based on your oral health needs.

Conclusion
In summary, maintaining a consistent oral hygiene routine is vital for managing gum health, especially after a diagnosis of periodontal disease. If you experience persistent symptoms, do not hesitate to seek further evaluation from a dental professional. They can provide targeted treatments and advice tailored to your condition. Additionally, addressing any concerns about bone loss and potential grafting options with your dentist will help ensure the long-term health of your teeth and gums. Regular check-ups and professional cleanings are essential components of effective periodontal care.

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