In today’s world there is plenty of talk on how to fix the recession. I personally am a bit turned off by government bail outs in part because I know that we, the people, are going to end up paying for their mistakes. I do not have all the answers for the ailing economy but there is one kind of “recession” that I do know how to fix, and that is gingival recession or receding gums.
Gums recede for a number of reasons. One is age. Well actually it is not a foregone conclusion that as we age we will become “long in the tooth”, but it does seem to be that way. As it turns out recession affects about 22.5% of the “less than 30 crowd” and up to 75% of the “over 60 crowd” in the USA. The older you get the more likely you are to suffer gingival recession.
In reality age is not the causative agent for recession. It is most often gum disease that causes gums to recede. What happens is gum disease, an infection around the teeth, destroys the bone around the teeth and the overlaying gum tissue goes with it. For this type of “recession” periodontal therapy such as scaling and root planing along with follow up teeth cleanings keep gum disease under control and patients out of trouble.
Another cause of recession is vigorous tooth brushing in a sawing type motion. Now do not misunderstand me, you still need to brush. You just need to pay attention to what the hygienist is telling you when she says brush in circles and use a soft tooth brush. Mechanical tooth brushes often help aggressive brushers. They allow you to just hold the brush against the teeth to spin and vibrate thereby breaking the habit of sawing back and forth.
Some causes of recession we are just born with. For example, if you inherit thin gums they will recede a lot quicker than thick gums. A prominent tooth, one that sticks out because the teeth are crooked, will also suffer more recession than the others. Some people have a hereditary component where the gums recede. I have treated entire families with this type or recession.
Problems caused by gingival recession include sensitive teeth, unfavorable esthetics, cavities in exposed roots, further bone loss and possible tooth loss. It has been shown that when a tooth reaches 4 mm of recession the likelihood that it will get WORSE is 98%.
There are several ways to treat receding gums. First and foremost is take care of your mouth. If you have gum disease, get it taken care of. Get your teeth cleaned and do the maintenance. Getting your teeth cleaned every 3 to 6 months is a good idea. Pay attention to your own brushing and flossing habits. Brush twice a day, for two minutes; go in circles with a soft brush. Floss. If you can make your mouth healthy and control the factors that lead to the recession then a lot of times the damage can be repaired.
Repairing gingival recession is a surgical grafting procedure. There are three ways to do the surgery all differing in where the gum tissue that covers the defect comes from. The first way to repair recession is using adjacent tissue to repair the recession. The limiting factor is how much adjacent tissue is available the graft the site. There is usually only enough tissue to cover one tooth.
The second way is to use tissue taken from the roof of the mouth to repair the recession. This technique allows for a much larger area to be treated because of the abundance of donor tissue. The draw back is two surgical sites: the graft site and the donor site. This essentially doubles the post operative discomfort that the patient experiences.
A third way to fix recession is using AlloDerm grafting material. If using AlloDerm the donor site surgery is avoided, and unlimited donor tissue is available allowing treatment of multiple sites easily. The donor tissue also provides a more natural esthetic appearance. AlloDerm was introduced in 1994 and was initially used in burn reconstruction, head and neck plastic surgery.
The graft site preparation is less invasive now than it used to be. Now we try to cut the tissue as little as possible. With the current technique, the tissue is stretched and stuffed into a pocket where the overlaying tissue protects the graft. The gums are then repositioned and suture in place with special sutures. The surgical technique results in less post operative pain and gum tissues that match the adjacent tissues.
Patients are given strict post operative care instructions when any of the grafting procedures are performed to prevent infection at the graft site. Post operative treatment includes systemic antibiotics and a prescription mouth wash to prevent infection at the graft site. In addition, patients are put on a steroid and instructed to use ice 10 minutes on 10 minutes off for the first 24 hours to prevent swelling. Patients are prescribed non-aspirin pain medication to prevent bleeding at the surgical site. They are instructed to limit physical activity, not chew food on the teeth at the surgical site, not smoke, or dip for 2-3 weeks after the surgery. You really need to “baby” the graft site to minimize the risk of loosing the graft.
Patients are usually seen at 24 hours and then two weeks to check the graft site. Depending on the type of graft done, the stitches maybe removed at 2 weeks or 3 months. The stitches used with AlloDerm grafts stay in for 2-3months. The suture removal appointment takes some time because the stitches tend to hide after being in the mouth for so long.
Receding gums are unsightly and painful. Do your best to prevent and treat gum disease to minimize the recession that you will have in your mouth. Pay attention to how you brush and floss. Make sure to go in circles using a soft brush. Do not be afraid to try an electric or mechanical toothbrush as they often help break the habit of sawing back and forth.
If you are unfortunate and still suffer receding gums see your dentist and ask about grafting procedures to see if you would be a candidate. Remember that there is more than one way to “fix” receding gums and make your smile more natural and appealing.
If you have questions about receding gums or any other oral health problems please feel free to call or come by Hitchcock Dental 8022 Hwy 6 Hitchcock TX 77563. You can also email Dr. Seume at firstname.lastname@example.org