“All of my gums look pink and healthy, except for my bottom gums at the front … I think my gums are receding…
“One of my teeth is getting longer than the others. They don’t bleed and are less red sometimes than others, but I want to know if I can stop or cure gum recession and save those 3 teeth.
I want to do what I have to do to save them. Is that possible? The rest of my gums look healthy. Thank you.”
– Question from Jenny of Mango Hill in Brisbane
Dr David Kerr replies:
There are two general causes for gum recession:
- Infection (such as gingivitis) or Periodontal disease: In this case the gums may be a darker red, blue or purple colour, they may intermittently bleed when you brush – this may vary from person to person. But really the only way to really tell is for your dentist to take measurements using a periodontal probe and through dental X-Rays.
- An anatomical reason called fenestrations in the bone: The position of the tooth in the jawbone can mean that there are areas on the roots of some teeth that have no bone covering them at all. It is just the gum sitting against the root of the tooth – it is exposed. This sometimes occurs naturally and sometimes occurs after Orthodontics because teeth get moved through the bone. This is a common area for gums to recede. Usually that will be self-limiting, ie usually the gum will recede until it is back on the bone forming
There is a fair bit of variability from tooth to tooth and person to person which is why it is important to see your dentist to measure your gums and check for any gum recession. We are currently loving our new 3D X-Ray machine as it gives us a much better insight into these problems than other X-Ray machines.
So what is the treatment for receding gums? Can gum recession be stopped?
Treating receding gums we would first look at whether there is gum disease or infection and would deal with that first. Stop the infection and we stop the gum recession. Naturally the earlier this is done the greater our chances are of saving the teeth.
If the gum recession is caused due to anatomical reasons, there are options to regenerate or graft gum tissue. The gum will attach itself to the tooth but with not as secure attachment as the original gum. It will be more fragile and prone to receding again.
There is a lot of work being done at the moment around different ways to treat the root of the tooth so as to attach that gum more firmly but there is still a lot of variability between cases, even with the same dentist doing the treatment. I guess what that boils down to is that for the patient there is no ‘bullet-proof’ way to get that gum back.
Looking after teeth where the gum has receded
Where receded gum has exposed more tooth these areas are much more prone to decay, as much as 8 times more susceptible to cavities. The tooth that is exposed when gum recedes has no enamel on it – the enamel on the tooth is 97% mineral whereas the tooth where exposed is only 40% mineral. This means the exposed tooth is softer, more sensitive and it can wear when you brush a lot easier as well.
In elderly patients, in particular, this one of the primary reasons that they can loose teeth. Often gum recession can combine with medications that reduce their saliva flow (saliva protects our teeth) to mean that the roots of the teeth can decay quite aggressively.
If you have gum recession I would recommend a high fluoride toothpaste and fluoride mouth rinse. You will need to purchase these over the counter at your local chemist or pharmacy.
Not all teeth in your smile are created equal
There is a common misconception that all teeth in any given mouth are at the same risk but this is not the case if you have some teeth with receding gums – these teeth need to be treated with extra care.
I would recommend seeing your dentist or hygienist more regularly to have fluoride applied to those more higher risk teeth and to monitor these higher risk teeth.