A Progressive Approach
THE STANDARD OF CARE
Receding gums are a concern to
many. Especially to those that are concerned about the appearance of their
smile. Some of the more common concerns are: exposed root surfaces that have a
higher gum line architecture leaving root surfaces uncovered, the presence of
notches or abfraction lesions and grooves on particular root surfaces. Some of
these exposed root surfaces are reported by some to be temperature sensitive,
touch sensitive, and sensitive to certain foods (citrus, sugary sweet foods,
The loss of gum line contour can be a result of: a mechanical trauma, bacterial
factors, local irritating factors and/ or systemic factors.
(should be considered!)
Traumatic occlusion or excessive rubbing of teeth can result in gum
recession. This type of trauma is the most overlooked and unrecognized since it
is the least obvious! It is a major factor that brings instability to the
surrounding gums and supportive bone.
- Occlusal discrepancies
- Presence of occlusal trauma
- Para functional habits of the patient
A simple example is if you could picture digging a hole for a fence post. Place
the post in the hole and fill the hole with surrounding soil, packing the soil
down well and firmly. Begin rocking on the post, back and forth. It will become
obvious that a mechnical torque and strain will eventually loosen the soil base.
So it is with the bony support around our teeth. Any mechnical torque or skids
on any tooth incline that does not harmonize with the balance of the surrounding
dentition will result in a loosening of the bony base and a receeding gum line.
This can occur naturally every time we swallow (2000-3000 times daily) or when
Gum recession is not only due to heavy brushing, although it is often blamed.
If that is the case, why does one or two particular tooth root surfaces often
only exhibit erosion notches (abfractions) and not the adjacent teeth. Does one
only brush one or two teeth in that region only?
REMEMBER: Gums (the pink tissue) only cover and protect the underlying bone. If
the underlying bone has desolved or receeded up, then the covering gums/ tissue
will also go up, since they need support from bone underneath.
The result is the exposed root surface of the tooth. Without bone to support the
gum tissues, the tissues have no foundation to cover the bone.
WHEN BONE GOES
UP, THEN GUMS GO UP.
These factors act as chronic irritants to gums and underlying bone, the
periodontium. Any rough or non-smooth surface contours will attract bacteria
invasion to those sites thus leading to loss of proper tissue attachment,
bleeding/ swollen gums and eventual loss of bone around the tooth.
- Crowded or overlapping teeth
- Missing teeth causing tipping
- Defective restorative margins
- Inadequate contours/ margins
- Open contacts
- Endodontic involvement
- Root fractures
- Unusual root anatomy
If plaque is not removed each day, it accumulates and hardens into calculus. The
gums may become puffy and red. There may be no discomfort at this stage but
there is danger. If not treated, the resulting inflammation could destroy the
periodontal fibers that hold the gums tightly against the tooth.
- Presence of plaque on teeth
- Mouth breathing
- Various types of bacterial pathogens
Treating and preventing gum disease brings great health benefits. By retaining
your natural teeth, you can chew more comfortably and enjoy better digestion.
You will keep your healthy smile, a natural asset to your appearance. Remember
to brush, floss, and eat a balanced diet.
- Metal allergies
- Tobacco use
- Hereditary factors
- Diabetes and other system diseases
- Pregnancy and other hormonal related conditions
- Compromised immune response
A stable even balanced
bite that harmonizes with the chewing/ clenching muscles, can prevent further
strain to the supporting bone and prevent gum recession!