1. Why Your Gums Are Bleeding (And Why It's Not a Hygiene Problem)

🦷 Ready to reset your oral health in 6 minutes? 

Start here: www.mouthymatters.com/start-here

If you've ever been told your gums are bleeding and walked away feeling like you just got a bad grade in brushing, this episode is going to change the way you think about your mouth forever. Bleeding gums are not a hygiene failure. They are a sign of infection, and there is a real difference between those two things. 

What You'll Learn in This Episode:

• Bleeding gums are not caused by poor brushing habits. They are a sign that your immune system has encountered harmful bacteria it could not fight off, and an infection has taken hold inside your gum tissue.
• A traditional dental cleaning is designed for a healthy mouth. If you have an active gum infection, a standard cleaning is not enough to address what is actually living beneath the gumline.
• The bacteria responsible for periodontal disease are highly contagious. They can be passed between family members, partners, and even pets, which is why so many families share the same gum health patterns across generations.
• Over-the-counter mouthwashes marketed as part of a healthy oral care routine can actually disrupt your beneficial bacteria and make the environment in your mouth more hospitable to pathogens.
• A three-tier approach, what happens in the practice, what the patient does at home, and immune system support, is the framework that actually moves the needle on gum infections rather than just managing the symptoms.

Resources Mentioned: 

• Waterpik Aquarius

• Waterpik Pik Pocket tip. 

• IoTech Concentrated rinse (great for Waterpik)

• PerioBrite Cleanse (Amazon or Natures Answer)

• DailyDentalCares.com PROtektin (great for oral health) TOSH for 10% off

• DrJennatural.com I love their eggshell Nanohydroxyapatite Toothpaste and all of their floss (is plastic free!)

• Supermouth.com I love their toothbrushes and products for different stages of life. TOSH for 10% off

Connect With Tosha on IG: @toshardh  

Dental Professionals: tosh.care 

🦷 Ready to reset your oral health in 6 minutes? 

Start here: www.mouthymatters.com/start-here

Disclaimer: This podcast is for educational purposes only.  Information discussed is not intended for diagnosis, curing, or prevention of any disease and is not intended to replace advice given by a licensed healthcare practitioner.  Opinions from guests are their own.  This podcast and its guests may have direct or indirect financial interests associated with products mentioned.

Transcript

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Welcome And Why This Matters

Tosha Kozlowski 0:00

Hello and welcome to the Mouthy Matters Podcast. I'm your host, Tosha Kozlowski. I have been a dental hygienist for 20 years, turn practice coach, where I help dental teams connect the mouth to the body. Today is an exciting episode. We are talking all about bleeding gums. So if your gums are bleeding and you are they've ever bled and you're wondering what in the world is going on, that's what we are diving into. I am here with our co-host, Lisa Charles. She is my bestie and has been with me on this ride for a very long time. So I thought, who better than to ask me all about bleeding gums than Lisa? Lisa, welcome. Hey there.

Lisa Charles 0:36

And just for all of you listening and watching, if you are the patient, I am you. I am not in the dental field, but I feel like I'm an honorary dental professional through Tosha. And just walking alongside her in her path these last 20 years together as friends, and then also getting to witness and help support her starting this incredible business. So today, especially, I'm going to be asking the questions that you would be asking. Um, maybe you're sitting at home or in the car and you're thinking these questions. Hopefully we get some of those answers today. I love it. All right, let's do

Bleeding Gums Are Not Normal

Lisa Charles 1:16

it. Okay, number one is okay, we keep hearing about bleeding gums, and you tell me my gums are bleeding all the time. If it's so common, why is it such a big deal?

Tosha Kozlowski 1:25

Totally. So I have to be honest with everybody. When I was a young early hygienist, I actually believed that everyone's gums bled a little bit because I saw it so much in the dental chair, and it wasn't something that I personally was prepared for. Because in hygiene school, you do clean people's teeth, you do all different kinds of um dental treatments to help people get healthier gums, but you don't actually see a whole lot of patients. I mean, you may have, you know, one patient for your whole day. So then when you get out in clinic, you're seeing roughly eight patients a day. Some practices see even more than that per day. I can't even imagine as a hygienist seeing more than eight patients a day. But it is very common. And what we actually know now is that dental disease in general is, according to the World Health Organization, is the most common disease out there. Dental caries, cavities, are actually even more common. Untreated dental cavities in adult teeth are actually more common even than periodontal disease is what the World World Health Organization has said. Even companies like Listerine have done worldwide studies where they found that 90% of the world's population has some form of chronic gingivitis. What that means is some type of chronic bleeding. And that's Listerine trying to sell more Listerine. But still, I mean, it's really, really common, but it's not normal. And the part that I didn't understand when I graduated was that there was a reason for it that had nothing to do with plaque and calculus on people's teeth, debris on people's teeth. What's actually going on is that we've come in contact with some unhealthy bacteria. Our immune system didn't fight them off, and we got sick. So kind of like Lisa, have you ever had strep throat or had the flu or got a virus?

Lisa Charles 3:02

No, never. Uh-uh. I'm the, you know, picture of milk. Yes, of course.

Tosha Kozlowski 3:08

So when you have, did you think like, oh gosh, dang, I haven't been showering very well?

Lisa Charles 3:13

I have thought, man, I should have washed my hands after I touched such and such. But no, exactly. Because I touched something, I got into something. Yes, bad bugs.

Tosha Kozlowski 3:23

Bacteria. So our bodies have probably, I mean, depending on the study, our bodies have more bacteria than than they even do cells. So we're full of bacteria, and most of them are really good and really, really protective. But there are some that actually are really, really harmful to us. And sometimes, you know, our lives are super stressful. We don't do as as good of a job brushing and flossing and water picking as we should. And sometimes we're just not getting enough sleep, or maybe we have some other underlying health conditions on our medical history, some autoimmune disease. I mean, there's so many different things that our bodies can have. And so if we come in contact with those bacteria, they actually like to live inside of our gums, not just on top of them, which is why you can do an awesome job at home, but still get sick, just like getting strep throat or the flu. And unfortunately, a traditional cleaning from your hygienist isn't enough to take care of it.

Lisa Charles 4:16

I guess that makes sense that it's deeper than just the surface that I can brush at home. It is.

Tosha Kozlowski 4:23

It is. It is. We need Okay, well, I like to tell people we found something different, so we need to do something different.

Lisa Charles 4:29

That's a great way to put it. It definitely uh it's the definition of insanity, right? You can't keep doing the same thing without expecting

Why You Miss Bleeding At Home

Lisa Charles 4:36

different results. So well, that leads me to my next question, which would be there are so many people who feel like, hey, I'm brushing and flossing at home and I don't see any bleeding, but I come in here and suddenly you're finding all these problems and you're telling me that I have bleeding gums. How can both be true? I love that.

Tosha Kozlowski 4:53

I love that. So, how can both be true? So if I'm brushing my teeth, my goal is cleanliness. And not all toothbrushing techniques are the best. So, you know, my the way that I like to inform patients to to brush their teeth with or without bleeding gums is not just to brush your teeth. Every surface in your mouth can get these bacteria that I was talking about. So brushing your teeth and your gums is super, super critical. I like to also use a tongue scraper. I like a copper tongue scraper because it's naturally antimicrobial. And because of the the very even edge on a copper tongue scraper, you can get these on Amazon, guys, um, is is is not gonna like dig deeper into your tongue or create any like fissures or like accidental cuts or anything like that. So it's good to use some type of a tongue scraper. You know, if you're not a flosser, you don't like flossing, then use a water pick. If you're gonna floss, like I floss when there's food stuck, I water pick every single day, probably twice a day, because I have a lot of recessions. So there's some food traps in there, and it's just easier for me to water pick. So when we go to the dental practice, part of what our job is as a dental hygienist is to assess your gums, not just to clean them, but to assess your gums to see if they're healthy or not. And so part of that assessment is actually using a specific dental instruments to get underneath the little space between the tooth and the gum, and that can get into nooks and crannies that you can't reach at home very well. And the outside of the gum tissue is what's called like keratinized. I like to think of this as like a construction worker's hand sometimes can be a little bit harder on their palms because of all that friction. The outside of our gums is tougher than that little space between the teeth and the gum. Because if you're biting into a potato chip or something like that, you wouldn't want your gums to just like all of a sudden get a laceration. And so that tiny little space between the teeth and the gum are what we're looking at. And those areas are harder to get to at home. So if we slightly go past that when we're doing our assessment, we may find bleeding more than you because your process is to clean. Our process is to assess and actually look, could there be anything causing you harm? I, as you know, love to take it one step further and always take a plaque sample to put it on the microscope to see do you have healthy bacteria living in your mouth or do you have bacteria that should never be found in a healthy mouth? Because if you do, then I know right away, bam, hey, Lisa, you have a problem. And so that assessment piece is just a little bit different. And so it's actually super common to not notice it at home, but we notice it in the office unless it's a pretty severe infection. And so once you start seeing bleeding at home, it's worse than just like your dental hygienist finding it. It means that you probably have an infection that's been hanging around for

Explaining Bleeding Without Blame

Tosha Kozlowski 7:30

a little while. Okay.

Lisa Charles 7:30

So as a hygienist, because I I know you and I have talked about this in some of your videos. So you know that patient is gonna be like, well, I think it's just because you're rooting around and digging down deeper in there, or I just had some popcorn last night. What do you say? You know, something like that. There's gonna be some excuse or reasoning behind it that doesn't involve an infection or termites in the foundation, like you've talked about. What advice do you give to that hygienist in that moment? How do they communicate that this is not just a one-time thing? This is a bigger issue.

Tosha Kozlowski 8:06

Yeah. I mean, even my husband came home one time, like a year ago, and was like, man, that hygienist was rough in my mouth. He's like, I don't want to go see her again, Top China. And my immediately, what Ma was thinking was, Well, what do you have living in your gums? Because it sounds like you definitely have gingivitis. If you're cleaning hurt, she must have been trying to get some stuff out of there and maybe felt a little insecure about diagnosing you with gingivitis or something like that. And so the more we talked about it, um, and then of course I reached out to the practice and was like, Hey, what happened at Chad's visit? And they're like, He had gingivitis. Of course you know he got amnesia during that part of the conversation because that was what was going on. So essentially, if you're if the practice that somebody is seeing doesn't have a microscope, it can be much more difficult to articulate the changes that we're seeing because it is confusing as a patient to go like, nothing hurt until you started poking me with that notch metal stick. Like, of course it hurts. You're dinging around in there. But what's actually happening typically is that the gums are slightly swollen. And we're talking just, I mean, millimeters, like the tiniest amount that you can't always see visually. But again, our instruments can get into those tiny little nooks and crannies. So when we touch them and they're swollen, it gives the gum tissue a paper cut. So it's like if I'm walking around with a paper cut on my finger, but I don't touch it, it's fine. But if I start like pinching that paper cut, it hurts. So it's just like that. It's like the patient has a whole bunch of paper cuts because the gum tissue underneath where you can't see, it actually is lacerated. It actually does have these tiny little cuts all along the underside of it. And that's how the bacteria can get into the gum, into the bloodstream, but you can't see that. And when we're brushing, we can't get underneath there either. So you're not touching the paper cut, so to speak. And so my suggestion is always just to explain to the to the person, like, hey, I'm seeing redness, inflammation, and even bleeding. This definitely appears to be a sign that you have a gum infection. You came in contact with some unhealthy bacteria and your mouth got sick. And so the traditional cleanings that we do should really be more like a car wash. Like you're just really shining things up, you're doing an assessment to make sure everything looks good. But if somebody has bleeding in their gum tissue, that's never normal. I mean, it's only normal if, okay, so let's say you did eat popcorn last night and you got a whole lot of popcorn kernels stuck up in your teeth, and then you had to floss to get all those little buggers out of there. And sometimes floss does not get kernels out. So I highly suggest get a water pick to blast them out because it's a lot easier. You may cause some abrasion and you may see some bleeding, of course. Now, as a dental hygienist, I will say that irritation and those types of abrasions do not present the same way as a gum infection. Now, to the untrained eye, you may not know the difference. But when we're in there, we can see floss cuts, we can see different types of abrasion, and a gum infection doesn't look the same to us. So maybe an easier way to think about this is for me, if I see anyone that has a crown, a veneer, a bridge, any kind of dental restoration that's not their natural tooth, I can spot it from a million miles away. But I still had patients that came to me and they'd say, Tasha, this one's a veneer right here, so don't polish. And I'm thinking, I know it is. Of course it is. And I also have your dental and I have your x-rays. Like, I know, but they don't know I know. So it's one of those things that when we're trained to see something, we just see it from a mile away. But if somebody's, if that's not their wheelhouse, like they're not gonna notice it, you know. Like, I mean, my daughter will ask me, Mom, she'll say, you know, some of the kids in my class, they'll come to school and they have some food between their teeth. How can they not see that or feel that? And I just think to myself, oh, you poor thing, I've really rubbed off on you. Yeah. So does that answer it? I kind of went on a few different tangents there, Lisa. Maybe I didn't hit the nail on the head.

Lisa Charles 11:48

I think you did. I think you gave language that people can actually use, that the hygienist can use in that chair. But you also hit on something else that you didn't mention in the um the answer of the first question, which I would like to point out because to me it's one of the most important things.

Mouth Body Connection Gets Real

Lisa Charles 12:05

When we're talking about you're talking of weed. Look at me. See, I told you I'm an honorary hygienist or something. You are. No, you totally are. What are you talking about? When you're talking about bleeding gums and why it's a problem, it's the the biggest issue is because our mouth is not in a box. And you talked about how you have these tiny little micro lacerations or cuts underneath the surface of our gums. And if we have these bad bugs in our gums that are like termites in our foundation, they're getting into our bloodstream. And that's when they're found in our brains, that's when they're found floating all through our entire bodies and adding to inflammation and disease in every part of our body. And so I I want to stress that because that's one of the things that you have taught me that has made such an impact in my life. And it's the thing that I share probably first with anybody that asks me about what I'm doing with you or if they're talking about dental hygiene at all. I mean, I I've told baseball moms, you know, on the soccer field, I've told people like just so many people that one bit of information because I feel like we are not taught that. Hygienists aren't necessarily taught that. We've talked about that in another podcast, but certainly patients aren't educated on that. And when we're searching for information to better our health, how much easier can it get than make sure that you are doing what you can at home to have good dental hygiene? Yep.

Tosha Kozlowski 13:50

Yep. And it's it is such an interesting thing too. I mean, they're on clots of people that have had a heart attack, when they've taken out the clot, they find the same bacteria that causes gum infections in the clot when they culture it. And so we know these bacteria don't just stay in our mouths. I like to think of it as like if you've been in contact with these, these creepy crawly bugs, like they just found some awesome real estate in your mouth. They want to stay there. So they're gonna do everything in their power to stay there. And because of that, they're also resistant to just being cleaned away, which is why a traditional cleaning from your dental hygienist or your dentist isn't going to remove them. So if somebody thinks like, well, I have bleeding gums and I just need to go get my teeth cleaned, I'm overdue. Sorry, dude, like it's not gonna work because these bacteria have a superpower where they have this slimy, almost like a slimy layer that again is invisible to us around themselves for protection. So what that means is that if I'm brushing, flossing, using my dental picks as a hygienist, that actually only smears them around. It doesn't get rid of them. And if I have some really high-tech tools, guided biofilm therapy and these ultrasonics and all these other different tools that uh professionals use, yes, you may be able to get them all out of the mouth for a certain period of time, but because they're also inside your gums, they're gonna rebound and they're gonna flush back into your mouth. So five hours later, you have the exact same bug swimming in your mouth, which is why it's super important what we do for the patient in the practice, absolutely for treatment. So it's like if the car wash is for somebody that's really healthy, then the full detail is somebody that has an infection. So really getting in the nooks and crannies, places the the patient can't reach, using antimicrobials, really flushing out and disrupting all those unhealthy bacteria. But then the person that has those bleeding gums needs to use a water flosser at home and then also consider some immune support. So some of that is in the ways of probiotics and prebiotics, eating really healthy food, getting enough sleep at night. Um, there's some different binders that we can use that are some supplements that actually help to rid the body of some of these, um, some of these bad bugs. So there's a lot of different things

The Three Tier Treatment Plan

Tosha Kozlowski 15:54

that we can do. So, what I train teams is we want to use a three-tier approach. So it's what are you doing for the patient in the practice? What are they going to do for themselves at home? And what about their immune system? So if I'm talking about somebody that's super healthy and maybe they just kind of took a dental sabbatical, they weren't doing a very good job at home, they may just need a little bit of catch up. But if I have a patient that has type two diabetes and they also have rheumatoid arthritis and they have a history of a heart attack, well, that person is immunocompromised. They have a lot going on in their immune system. So for them, I'm going to be saying, I need you to use your water pit twice a day at home. I need you to brush your teeth for two full minutes twice a day, hopefully with an electric toothbrush, every single surface. Because when we're brushing, it's not just about removing food debris. It's about trying to disrupt and disorganize the invisible bacteria from every surface of that person's mouth. And also don't go to Walgreens, Walmart, Target and go get just some over-the-counter mouthwash. Because a lot of it is actually really disruptive to your good bacteria because we're we're dentistry is looked at as beauty products. So a lot of the products that we're using in our mouth actually does more harm than good. Brands like Supermouth and things like that are actually really great because they work with your beneficial bacteria. So we want to be looking at some of these products that are that are that are better for us. And I'll put some links in the show notes to some products that I personally use on my with my in my family that are really helpful. But I didn't know any of that stuff when I graduated as a hygienist. Like I was like, mouthwash is mouthwash. It's all the same. And now I'm like, it's not? Okay. Right.

Lisa Charles 17:26

Well, and we're being educated by commercials. And commercials, as we all know, are just to sell product. But the other thing is these bacteria that you talk about, you know, they're they're learning as quickly as AI is these days. You know, they are learning to protect themselves and continue to feed just that quickly. It's like in real time, they're figuring out how to survive. And so yeah, you've got to, like you said, disrupt that and maybe feed it something else that that can trick it into thinking that they're doing well and thriving and then kill them off. We've got to get them out. Okay, so let's see. What other questions do we have here? Okay, this

Home Tools That Actually Help

Lisa Charles 18:08

is great. Why do some patients get differing treatment suggestions from different offices in hygienists? I think that's twofold. It can be why do like you can take a husband and wife. The wife can go in and she gets a treatment plan and then she sends her husband in because we know they're sharing the bacteria, and the husband gets a different treatment plan. It can also be that it differs from hygienist to hygienist within the same practice or office to office. So there's a lot to to kind of like distill down there, but I think they all play.

Tosha Kozlowski 18:44

They do. And this is, you know, I I want to say this is uncommon, but it's it's not uncommon because all of us have a different level of education and understanding. And there are so many absolutely fabulous hygienists and dentists out there. I mean, so many. And for the most part, I mean, we're all doing our very best every single day, but I can promise you, Lisa, that the Tasha that you would have had 15 years ago cleaning your teeth versus the Tasha that I am now would be radically different in what I recommend. And and I promise that every every time I would have been doing my very best. So most of it has to do with the level of education and understanding that our providers have had. And so there's there's so many, there's so many facets to dentistry. I mean, we have the airway section and we have the cavities and the minerals, and I mean, there's literally just dozens of different, you know, streams. And so, because we're seeing patients all day long, we don't have an unlimited amount of time to educate ourselves with all the things that are changing in science. And so part of this is the more educated that our patients can be about their own health will help to empower them to ask the right questions. So if you're getting a very different treatment plan from your spouse or from your friend that sees the same practice, I would honestly just have a conversation with Claude AI and say, what questions might I ask my dental professional to better understand what they're telling me? Because this doesn't feel right. I certainly in my early days thought of periodontal disease and bleeding gums and gingivitis kind of as a dirty mouth problem. And so when I was talking to my patients about the treatment, I the vocabulary and the types of things that I said sounded like that. And I'll never forget I had this young man, he was a waiter and you know, in his funds were tight. He was already coming in every three months. I mean, I want to say he was in his late 20s, but he had some, he had a serious gum infection. And he had had a quote unquote deep cleaning before. And so when he saw me, you know, maybe it was the third time that he saw me, and I kept saying that he needed this deep cleaning again, that he, you know, we needed to get in the nooks and crannies and all this kind of thing. And he looked at me and he goes, Tasha, I just think you're trying to sell me something. And I remember I remember I just didn't even know what to say. I was almost panicked and I felt

Why Treatment Plans Can Differ

Tosha Kozlowski 20:55

really guilty and I felt bad. And I didn't think at the time that I was trying to sell him something, but when I reflect back, I was. And what I was trying to sell him is treatment that I knew he needed. And to this day, I know he needed that treatment, but I was clearly not explaining it in a way that he understood. I was, I just didn't have the training at that time. And so now what I understand is that when I'm communicating with patients, I need to communicate in a way that anyone can understand. I mean, even my husband, I mean, he knows all about dentistry because he has to hear me all the time. But he does not know dentistry to the point where I do. I mean, I talk to dental hygienists and I say, does your husband fully understand the gravity of a five millimeter pocket? Like what had to happen in the body for the bone to literally necros and go away? And they're like, no. And I say, so make sure that you assume that your patient doesn't know either because they didn't go to hygiene school to learn it. Of course not. And so now that's so that's how now when I train dental teams, I say, don't talk about this as a dirty mouth problem because it's not. Some people might have hardened debris with their infection, but a lot of people don't. And so the cleaning that we really should be doing is a medicated cleaning. We need to be getting in the nooks and crannies with medicine. We need to disrupt and disorganize the bacteria. Not Lisa, your upper right has some bone loss and some deeper pockets up there. So why don't you come back in and do a localized cleaning? Well, if the bacteria from your upper right can get to your brain, I'm pretty sure they can get to your lower left. So that localized cleaning, that's what we were taught in school. That's what they teach to this day, isn't quite enough. What we want that dental professional to do is at least use an we all have ultrasonics, at least disrupt and disorganize every single spot in the mouth. And then at home, the patient disrupt and disorganize, brushing, brushing full mouth, palate, even your cheeks, friends, getting a tongue scraper, getting a water pick going on every single tooth, outside, inside. You know, even if you have tonsils, please gargle. You know, even gargling with salt water is really good because our tonsils can hold so much bacteria. And then, of course, it's it's the immune support thing. And sometimes that's as simple as get enough sleep at night, friends. I mean, we know that our bodies, that's when they heal. That's when your brain literally detoxifies, is when you're sleeping. If you have sleep apnea, wear your CPAP machine, wear your sleep appliance, don't take, don't take those things lightly. If you have diabetes, think about what you're eating. I mean, yes, you may be on metformin or one of these other medications, but nothing can, nothing can compensate for the way that we treat our bodies. And we really we're we're all so busy now that we can tend towards like the fast, easy things that can be kind of damaging over time. Sometimes it's just that immune support is just taking a little bit better care of yourself. Right.

Lisa Charles 23:34

Well, and I think you also just hit on when you're trying to explain to a patient why they need a service. You and I have talked a lot about this piece that everywhere I go, they're either, you know, they're wanting a tip, it's an upcharge for this, they're trying to upsell me that. You know, it's all everything is an add-on. And so I go in for a cleaning and I've been seeing this dentist for however long. And now suddenly they've learned, you know, that what's going on in my gums isn't just going on in my gums and it's going on in my entire body. And it feels like snake oil. It feels like you're just trying to sell me something, make your practice more money, and I don't have it. I don't have that extra money. But that's when something like the microscope comes into play and it it sells itself because so if I I I've told you this before and and like being at events with you and things like that, I'm like, guys, you don't have to convince your patient. Show them the slide, show them the sheet that you've made that says, you know, look for these individual things. And if you see any of these, they're a problem. But you know, if somebody can see that they have these things in their mouth, then they're gonna say, okay, so how are you gonna fix this? What do I need to do? Rather than you convincing them. And it stops being an upsell and it becomes a valid issue that they can see with their own eyes. Because, like you've said so many times, these things are in the foundation, they're deep down in our gums. I can't see them until it's too, you know, I see the the repercussions and I see the the side effect. Yeah, and you see that yeah, the side effects of those things. Right. But getting a microscope, chair side, is the answer to so much of these questions that hygienists specifically are gonna have.

Tosha Kozlowski 25:26

So if you're a patient, it truly makes our lives so much easier. But not all patients have yeah, not all patients have a microscope. But yeah, I mean call around and find someone that does. Go see them instead. Yeah, it totally makes such a difference for the patient and for the hygienist. I mean, for me personally, I remember having patients that I would do the traditional assessment with my with my notch metal stick, my probe, my periodontal probe, and I didn't see any bleeding, and the patient looked pretty good. And then I would start cleaning and I would see bleeding, and I would be like, oh my gosh, I just told this patient that they looked really good and I was gonna get them shined up and get them out of here. And then I was just flabbergasted because at this point I'm halfway through my appointment and I'm thinking, this patient already does such a good job. Like, why do they have this bleeding? And I was so confused as a young hygienist why that was because I knew that they didn't have a dirty mouth problem, but I didn't know

Microscopes And Saliva Testing

Tosha Kozlowski 26:20

what kind of treatment they needed to stop the bleeding.

Lisa Charles 26:22

And it was all of a sudden petal and be like, oh sorry, just kidding.

Tosha Kozlowski 26:27

Yeah, you actually you lose that trust with that patient. Yep. Yep. And there's also salivary diagnostics, which are really great. I there's definitely a lot more, there's a lot more practices throughout the United States that use salivary diagnostics and they don't yet have a microscope. And you can go to oraldna.com and look for a provider that has salivary diagnostics. Um, and there's there's some other tools like that. Now, that doesn't give you like the visual, like seeing the shapes on the microscope slide. I mean, that's another step, but that is one thing that is super helpful that people can do. So if it's like, well, I want to find a practice, sometimes that can be a little bit tricky, but the phase contrast microscope has certainly changed my understanding because also when I was able to see the bacteria that were causing the bleeding, I mean, it brought that mouth-body connection so clearly because now I went, oh my gosh, that's what's swimming in the blood that I'm seeing in this person's mouth. Those critters are swimming in the blood. And that same blood just came out of the patient's capillaries. And the capillaries are fed by the veins and the arteries. And the last time I checked, all of our vasculature is connected. And so it like for me, it it was this whole like aha moment. And for my patients, I noticed the exact same thing. It was like, oh, that's what's going on. So I do wish everyone would get a microscope because it it helps that conversation look real. I do think photography is really helpful too when when practices will show their patients what we're seeing. Because when you're laid back, Lisa, you don't know what I'm doing in your mouth. Like, I mean, you can kind of feel where I'm at, but you're not seeing what I'm seeing or even watching what I'm doing, you know? And so there's this huge separate piece that I think in dentistry, when we can just show you versus tell you, it's easier because showing somebody a problem, they already know what the solution is. It's like, oh so then I mean, even from a motivational standpoint, I've had spirochetes in my mouth before. They're very unhealthy guys. They eat out of both ends, they look like a little snake, they're nasty little critters and they have teeth. So I've had those in my mouth before. And I was like, oh my gosh. But I mean, talk about me being motivated to use my water pick every single night to spend extra time brushing to even get in an extra cycle of that water pick and you know, really take care of myself. Believe me, I was super motivated.

unknown 28:49

Oh, yeah.

Lisa Charles 28:50

Maybe because I was a girlfriend. I had the same kind of issue recently. And I I went in and my Galamanda is digging in there and she's like, girl, what's changed? What's going on? Because I've never seen your mouth like this. And, you know, and I said, I know what it is. I know exactly what it is. You know, my husband had an infection when his root canal failed, and I had not been flossing as diligently and using my water pick as diligently. I got really complacent and lazy for like two months, and it was right before I went in. And she's like, Okay, well then here's what we're gonna do. And and I went back in two weeks later or whatever, and she's like, you're good. But that's because I know what I'm supposed to be doing. I've learned all of this. Um and there's one more question that I was gonna ask, and it almost seems silly to ask this, but I'm gonna go ahead and ask it

Hereditary Or Contagious Bacteria

Lisa Charles 29:42

anyway. Just you know, with all that we've already shared and and discussed, I still think you're gonna end up having some patients throwing this out there is like the Hail Mary. They've always had bleeding, it's normal for them. Their family has talked about the fact that you know, yeah, my gums have, you know, always led to it's probably just a familial thing, right? It's it's hereditary. That's just how our bodies do life. Yeah.

Tosha Kozlowski 30:11

I can't even like ask that question because anyway. From a dental professional standpoint, that might be it's in the top three hardest questions to answer because I I just know, I mean, I I know so many dental professionals, and we all want the best for our patients. And I can say, without I have never met somebody that was just trying to sell people stuff and you know, doctor needs a new boat, you know, and and these comments that sometimes patients would say. And it just kind of takes you back because I mean, we're healthcare providers, we're in the medical profession. This isn't an easy profession. We still love it and we and we totally value our patients and their health. And so those kinds of questions, they're real, they're honest. And truly, if I had, if my whole family had always talked about this, it would be totally normal to me. I'd be like, yeah, we all have had bleeding. Like, this is no showstopper, dude.

Lisa Charles 31:04

You're desensitized to it. It doesn't seem like a big deal.

Tosha Kozlowski 31:07

You're totally desensitized to it. So what we actually know now is that it's something like 10% dental issues are hereditary. But what the difference is with the periodontal disease bacteria, they are ultra contagious. So earlier I mentioned spirochetes, those little snakes that eat out of both ends with teeth. So those types of bacteria can literally live in more than one host at a time. So, for example, let's say I board my dog and they drink out of a communal dog bowl. So he comes back with really stinky breath. So let's say he's opportunistic and he wants to always try to lick my face and lick my mouth. Let's say he has a spirochete and it gets up in my mouth. Nasty, even thinking about it. But let's say my instinct doesn't fight it off. So those spirochet go, ooh, sweet, new host, love it, new new house. I'm gonna just build my family here. So this infection just starts brewing in my mouth, and then I kiss my husband, and those same spirochetes can then transfer to his mouth. And then maybe my daughter comes in and she's really thirsty and she sees that I have a big old glass of water and she takes a swig of it. Well, now we have one big family of bacteria, and now we all have the same infection, and maybe it's just like this slow simmer of an infection, meaning nobody has this raging infection that you're brushing and you're spitting out blood in the sink. It's just this slow simmer that you can't hardly see. So that's what's happening in most of these families is that mom has bacteria in her mouth, maybe even while she's pregnant. Maybe the OBGYN says, well, it's pregnancy gingivitis, so don't worry about it. After you have the baby, it'll go away. We used to think that. We now know that even these bacteria, if you have them in your mouth, it can actually make it harder for you to get pregnant. And the same is true for the man. It can decrease the swimmers, it can decrease their ability to impregnate the egg. The whole fertility piece is huge with gum infections. What happens within families is that we're passing these bacteria because we're living in a house together. There's no way that you're not sharing bacteria. So if you've been having this all your life, and then, you know, your kid has braces and everyone has gum inflammation when they have braces, and then it's just like you just keep passing it around, passing it around. And maybe sometimes it kind of gets held at bay, and then other times it flares up and it goes back and forth like this, but you never actually get rid of it. So when you've always had bleeding, chances are there's more going on. My colleague years ago had this little boy, I'll never forget, he was eight years old, mixed dentitian, had baby teeth and permanent teeth. His gums were so red and inflamed and bloody. I mean, it was so hard for her to get him healthy. So talk to mom and dad. He went through gingivitis therapy. I mean, talked to his pediatrician. I mean, they even threw an antibiotic at it because his gums were just so blood, bloody, bleedy, bleedy. And we kept talking to the parents about we really think that there's some type of contagious thing going on here. We really want the parents to come in. And so, as finally, after two years, I bet, the parents finally said, okay, we'll come, we'll come see you. But they always brought their son in every three months, you know, this this little boy. And then turns out they had advanced gum disease. I mean, very I mean, extreme bone loss, both mom and dad. Wow. And so now looking at this child, it's like, oh, no wonder. Well, then we did saliva testing on them. And what do you think their saliva test came back with? The exact same pathogens, exactly the same. And this is seen all the time. So it's one of those things that because we have treated periodontal disease very mechanically for a long time, we've we were always taught that once somebody, like I, this is what I was taught, once somebody has periodontal disease, they will always have periodontal disease. But what that doesn't mean is that once you have an infection, you will always have an active infection. We now know that you can halt this infection. Now, if you've lost bone, you have recession and things like that, you can't always get that back without some gum grafting and some, you know, larger intervention, but you can stop that infection. And it's the infection that's causing the problems to the systemic health, to the mouth, that mouth-body connection that we've been talking about. So that's really what we're striving for is if your gums are not bleeding, they're not inflamed, and everything looks great on your microscope slide or your lab test, like you're good. You've arrested that infection. You may not be out of the woods forever. Yeah. I've had I've been sick more than once in my life. So get back. But you now can kind of know what to do to keep yourself healthy.

Lisa Charles 35:17

Yeah. Well,

Wrap Up And Free Download

Lisa Charles 35:18

I think that's all of my burning questions for today. But I know we've got a laundry list of them, so we'll have to do another podcast to uh discuss more. And maybe people will write in and give you some questions that we can ask on another.

Tosha Kozlowski 35:31

I would love to answer people's questions. Awesome. Well, thank you everyone for listening to our bleeding gums conversations. I hope you got some great tools, tips, and tricks. And I before I forget, I also have a six minute daily guide to a healthier mouth that you can download. That'll also be in the show notes. These are the things that I do myself at home. And what I've also shared with my good pal Lisa here. So we'll see you guys next time.