Dental Procedure For Dental Recession
Dental recession is a displacement of the gum around the teeth that results in greater tooth exposure and a longer looking tooth. As the gum that protects the root surface of the tooth is lost, not only does it create an esthetic deformity, it makes the tooth more sensitive to changes in temperature (hot and cold), touch, and to proper oral hygiene techniques. The exposed root surfaces also are more susceptible to cavities. Causes of dental recession include:
- Periodontal disease: The bacteria that cause gingivitis can release toxins that injure the gum tissues and create gum recession. Once the gum is affected by gingivitis (see article "Gingivitis"), it is even more susceptible to further dental recession and bone loss. So if the gum is red, swollen, or bleeds when probed, it is more likely to continue receding. Eventually, there may not be enough healthy gum and bone left to protect the tooth and the tooth may need to be removed. If there is less than 2 mm of healthy gum in an area of recession, a dentist may recommend a gum graft to help prevent further receding gums and help protect the tooth.
- Trauma: Medium or hard bristle toothbrushes, brushing too hard, or brushing inappropriately can damage the teeth and the gums. It is very important to use a soft bristle toothbrush when cleaning the teeth, and to follow proper technique. Mechanical trauma to the gums also can be caused by improperly fitting dental restorations or dentures. Fillings that are rough or dentures that are loose or poorly designed can injure the gums and cause them to recede.
Gums also may recede as a result of orthodontic treatment or from manipulation during restorative procedures. To prevent this from occurring, a dentist may recommend gum grafting before orthodontics or restorative treatment.
Gum grafts are indicated if an individual has root sensitivity to touch or temperature changes, if new restorative work will be done in the area of the dental recession, if the roots are susceptible to cavities, or if an individual is having problems following proper plaque control procedures. In addition, gum grafts are cosmetic periodontal procedures that can be performed to enhance smiles if recession has created esthetic problems such as long teeth or exposed roots.
By Laura Minsk, DMD
Gingivitis - Everything You Need To Know
Gingivitis is the most common periodontal disease, affecting 90% of the population. It is an infection of the gums caused by bacteria that form plaque.
In small amounts (when it is newly formed), plaque is invisible and relatively harmless. But when left to accumulate, it increases in volume and the proportion of harmful bacteria grows. These gingivitis bacteria release toxins that result in inflammation of the gum tissue and bad breath.
Eventually, the plaque hardens and forms hard deposits called calculus or tartar. If not properly treated, gingivitis may progress to periodontitis, a periodontal disease in which there is loss of the bone that supports the teeth.
Signs of Gingivitis
Gingivitis can be identified by red or swollen gums. In some circumstances, the gingivitis can cause bleeding gums when brushing or eating, and there may be bad breath. To diagnose gingivitis, a dentist may probe gently under the gums. In healthy gums, there should not be any bleeding with this gentle probing. A bleeding gum indicates that there is gum inflammation or gingivitis.
Who's At Risk for Gingivitis?
Certain people are more susceptible to gingivitis. Stress, smoking and poor nutrition can contribute to the development of gingivitis. Certain medications such as steroids, heart medications, cancer therapy drugs, anti-epilepsy drugs, and anti-depressants also increase the risk for gingivitis.
In the presence of plaque, these medications can lead to gum overgrowth. The enlarged gums can further interfere with oral hygiene, precipitating a vicious cycle of further gum enlargement.
Changes in female hormones can also increase the vulnerability to gingivitis. Adolescent women, pregnant women and women who take hormone replacement or birth control pills also have a greater risk of developing gingivitis.
There are several systemic illnesses that are associated with gingivitis. These include
- acute leukemia
- Addison's disease
- diabetes
- hemophilia
- immunodeficiency diseases (including HIV)
The swelling and redness of the gums may be disproportional to the amount of plaque present. To prevent further complications, meticulous plaque control is critical for people with these illnesses.
Gingivitis Treatment
For gingivitis treatment, the bacterial plaque and tartar have to be removed from the surfaces of the teeth by a dentist or hygienist. Then, the factors that contribute to plaque retention have to be altered in order to facilitate oral hygiene procedures.
This can involve re-shaping existing restorations or even moving teeth with braces so that they are not crowded. Essential to the success of the gingivitis treatment is the person's ability to control plaque build-up after initial treatment. Daily brushing and flossing are key to gingivitis prevention and helps prevent bad breath.
If there is a lot of gum inflammation, if the gums are very sensitive, or if there is a lot of tartar buildup, it may be necessary to numb the gums in order to remove the buildup of bacteria underneath the gum margins. If the gum is very inflamed and swollen, it may be necessary to remove some of the excess gum tissue surgically.
Gingivitis is reversible, and with proper gingivitis treatment and maintenance, it can be controlled. However, untreated gingivitis can result in gum defects, bone loss around the teeth, and eventual tooth loss and systemic complications. The best way to prevent gingivitis is by brushing and flossing daily, and by visiting the dentist for a routine cleaning and an examination at least every six months.
By Laura Minsk, DMD