Gum Disease FAQ.

Or: The teeth are fine, but the gums gotta go...

As biomedical advances make inroads in the fight against tooth decay while at the same time prolonging life expectancy, the face of dentistry is changing. No longer is fixing cavities the predominant role of dentistry. The prevention and treatment of gum disease and the promotion of periodontal health has moved to the forefront of modern dental practice and research.

Q: Well for the longest time now my gums have been really really sore. They bleed all the time and I have holes in between my teeth. Is there any one who can let me know what it is and how I can treat it? Someone told me that it was gingivitis or something like that.

A: Periodontal disease runs the gamut from mild gingivitis to severe periodontitis with bone loss. Most people are not equipped to make a precise diagnosis by themselves. Certainly I cannot determine the full nature of what you have from your description. Without a diagnosis, an appropriate treatment cannot be prescribed.

What are you waiting for? Get thee to a dentist!

Q: Is there any way to reverse a receding gum line?

A: There are gum grafting procedures intended for this purpose. They are variable in their success, though. I would suggest a consultation with a periodontist (gum specialist) if you wish to investigate this further...

Q: I am 26 and I am having problems with gum recession. How can I stop it?

A: Gingival (gum) recession is due to a variety of physiologic and pathological factors.

In order to determine an appropriate approach to management and prevention, a proper diagnosis must first be made. If there is periodontal (gum) disease, it must be treated professionally, since this is amenable to self-treatment at only the earliest stages. There are some pre-disposing factors to gingival recession which are not under either a patient's or dentist's control, such as the shape and position of the supporting bone relative to the root of a tooth. There may also be instances of gum recession resulting from poor tooth position, which may be effectively managed with orthodontic tooth movement (braces).

If other causative factors have been eliminated, attention should be turned to oral hygiene technique. If a hard-bristle toothbrush is used, it should be exchanged for a soft nylon bristle variety. If an abrasive toothpaste is used (e.g., smoker's toothpaste), it should be dropped in favor of a milder type, such as any of the ADA-approved dentifrices. Finally, if you hold your toothbrush in a white-knuckled death grip and scrub until you're spitting out gum tissue, you should refine your technique to a light grasp, using a gentle, short-amplitude stroke.

Once recession has occurred, it is prudent to attempt to limit any further progress. There are periodontal procedures intended to re-claim lost root coverage that have varying degrees of success; they are useful if the gum recession has produced a cosmetic deficit. Otherwise, you may need to deal with root surface hypersensitivity; this is usually manageable with one of the "sensitive teeth" toothpastes such as Sensodyne.

Q: Is it possible to restore gums that have receded because of disease?

A: Before an answer can be given, you will have to clarify 3 imprecise terms:

  1. Restore - if you mean restore the gums to their previous health, it is often possible. If you mean to restore the gums to their exact previous position and shape, it is somewhat less likely.
  2. Receded - do you mean just a change in the position of the gums without any inflammatory gum disease (periodontal disease), or is there a more serious underlying gum problem?
  3. Disease - are you referring to a constitutional, systemic disease, or a local periodontal (gum) disease?

If you have periodontal disease, priority should be given to eliminating the inflammation and infection. Subsequently, the issue of re-positioning the gum tissue higher on the roots of the teeth can be addressed. (The elimination of gum recession is not always practical, but has become more effective in recent years.)

If you do not have periodontal disease, it is sometimes possible to surgically re-position the gum tissue for greater root coverage. Again, modern techniques have improved the results of late. This is primarily a cosmetic procedure, but may also mitigate any root sensitivity you experience.

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