Gums that bleed when you brush your teeth may be a first sign of gingivitis, or inflammation of the gums. This is one of a number of microbial infections that dentists group together as periodontal disease. Two out of three young adults have some sign of it, possibly without knowing. In recent years dentists have paid more attention to periodontal disease, which may affect not just the gums but the deeper tooth-supporting structure, because in adults over the age of thirty-five this is the major cause of tooth loss. The teeth may be quite healthy, but the disease loosens them. Eventually, with nothing to hold them securely in their place, they fall out. The various form of the disease are nearly all caused by bacteria and our failure to remove them at least once a day from our teeth and gums. Dense microbial deposits called plaque build up along the gum-line. Sometimes this is difficult to detect. The plaque infects the gums, which sell. Deep pockets form between the teeth and gums. These hold more plaque and cause more inflammation. Swollen gums bleed quite easily, even when cleaned with a soft toothbrush. If the initial inflammation is ignored, the infection spreads deeper, and in time the tooth wobbles in its socket. Some quite healthy people are more prone to the disease than others. So are those suffering from diabetes, anaemia and nutritional deficiencies. Periodontal disease may be triggered by puberty, pregnancy, the menopause and the taking of oral contraceptives. Thorough professional cleaning can stabilize the disease, but advanced cases often need surgery. The dentist reshapes the gums so that in daily brushing the patient can reach all areas effectively. But essentially the job of keeping the teeth clean and the gums healthy is a matter of sound dental hygiene at home. This may entail a range of measures, especially thorough brushing, and particularly between the teeth, to remove plaque. Your dentist will advise you about mouthwashes that may help. Also, you can check your efficiency by occasional use of tablets or drops that stain the plaque you haven’t removed. This will show you where your brush isn’t reaching. Dental floss, toothpicks and rubber tips all help to keep a bacteria a day. There are always body wonders.