General Practice always involves teamwork – Your GP knows a fair bit about a lot, but there are always subject matter experts or specialists. We have Physiotherapy with Rod and Movement Theory, Specialist Urology Services with Dr Nick Brook and the team from EastWest Urology, and Podiatry with Rosie from Foot and Sole Podiatry onsite, but we know so many great practitioners offsite as well. One of these great experts is Danielle Newbery, BOH at Kensington Dental Care, and she has been kind enough to share her expertise with us in this post. Take it away, Danielle!
As a dental practitioner with over 20 years experience, there’s one thing that has always perplexed me about bleeding gums. Why do people think it’s “normal” and ignore it for so long?! If you woke up one morning and your eyes were bleeding, I can guarantee that you’d be in the emergency department or in your GP’s office before 9am. So why do people accept bleeding gums as “normal”?
Is it because the general public isn’t aware of what bleeding gums (gingivitis) can actually mean? Let’s learn together. As soon as one of my patients sits in my dental chair and starts with “I’ve been getting a bit of bleeding when brushing, but that’s all” (or words to that effect), my mind starts ticking. My mental checklist is:
● Is this patient pregnant or breastfeeding?
○ Dental plaque has been shown to significantly increase the risk of preterm labour and low birth weight babies
● Is the patient at risk of diabetes?
○ Gingivitis is an early warning sign of undiagnosed or poorly controlled diabetes
● Is the patient at risk of heart disease or stroke?
○ Patients who have gum disease are 2 to 3 times more likely to have a heart attack or stroke than someone with a healthy mouth
● Is the patient a smoker or taking prescribed/non prescribed substances?
● Could this patient have a vitamin deficiency?
○ Smoking, medication/substance use and vitamin deficiencies are a precursor to a very nasty (and particularly smelly) disease called Acute Necrotising Gingivitis
● Could there be an oral cancer?
○ A bleeding mouth can be a sign of oral cancers, particularly squamous cell carcinomas
What will your dental professional do once you tell them you have bleeding gums?
What will your dental professional do once you tell them you have bleeding gums? Firstly a thorough oral examination must be carried out. Best practice is a full oral cancer examination at every recall, ideally twice a year. They will check your lips, cheeks, gums, tongue, and palate, as well as all of your facial structures for any changes. If they find any unusual lumps, bumps, swelling or lesions you will probably be referred to an Oral Surgeon for assessment. Oral Cancers are not common, but for every hundred suspicious areas we refer, we will see a handful of them return as malignant lesions.
If your gums are bleeding because of a build up of plaque and bacteria, an Oral Health Therapist or Dental Hygienist can see you for a deep clean and oral hygiene instructions. If further or more extensive treatment is needed, you may be referred to a Periodontist who specialises in all things gum related. Pregnant women with heavily bleeding gums will have them thoroughly cleaned and debrided, placed on a 3 month recall and sometimes referred to a Periodontist, depending on the severity. In rare cases a painful growth, called Pregnancy Epulis, may need surgical intervention.
If you see your GP for your bleeding gums, your next stop should be an appropriate dental professional for investigation. Whilst your GP is a fantastic place for your general health, no one knows your mouth like your dental professional. So if you spit out blood after tooth brushing, if your gums are spontaneously bleeding while eating (or just bleeding full stop), please make an appointment with your Dentist, Oral Health Therapist or Dental Hygienist to make sure your bleeding gums are not a warning sign for something sinister.
After all, you wouldn’t ignore bleeding eyeballs, would you?
PartridgeGP works with you to help you make your best health decisions. , and that includes recommending other practitioners to you who care as much as we do. Thanks Danielle! Read more from Danielle right here.
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Better, for you.
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For everyone, we believe that having a usual GP or General Practice is central to each person’s care and recommend that people with any health issues that come to the attention of other health professionals should be advised to attend their usual GP or General Practice rather than a specialised service (ie a place not providing the holistic care a specialist GP would). If they say that they don’t have a usual GP or general practice, they should be helped to find one and to actually attend it. Call PartridgeGP on 82953200 or make an appointment online here.
(Hat tip: Dr Oliver Frank)
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