Rx For Readers: Gum conundrum

Receding gums: Causes and treatment.

By JUDY SIEGEL-ITZKOVICH
Teeth care (illustrative) (photo credit: INGIMAGE)
Teeth care (illustrative)
(photo credit: INGIMAGE)
I am a 30-year-old woman, married and with two small children. In recent years, I have developed receding gums, and my teeth are sensitive as a result. I go to a dental hygienist every six months and try to take care of my teeth. My dentist told me the only thing I can do is use a soft manual – not electric – toothbrush regularly. He said I could also use Sensodyne toothpaste, but he didn’t say if one can use it on a regular basis. What is causing the receding gums, and is there anything more I can do?
-S.S., Jerusalem
Prof. Lior Shapira, chairman of the periodontology department at the Hebrew University-Hadassah School of Dental Medicine, answers:
The main cause of gum recession is aggressive toothbrushing for many years, particularly if the individual has thin gums. It is prevalent also after undergoing orthodontic treatment to straighten your teeth.
To prevent the progression of gum recession, we advise patients to use a soft toothbrush.
An electric toothbrush with the ability to control pressure and with a soft head can also be used. In many cases, it is possible to restore the gums, and this can be done without gum grafting.
One of the side effects of receding gums is root hypersensitivity. It can be treated by using toothpaste with specific materials that aim to prevent the sensitivity. There are several brands of such toothpaste from various manufacturers on the market. If one brand does not help the problem, you can try another one with different active ingredients.
The effect of the toothpaste is evident after only a few weeks.
If this does not help, you should see a dentist or a specialist periodontist, who can diagnose your specific problem, help you to prevent further recession and treat it.
Retired longtime Jerusalem dentist Dr. Steve Sattler adds: Receding gums (also known as gingival recession) is a branch of periodontal disease.
The gums are the weakest link in the whole complex of how our teeth function as “eating machinery” and for talking, smiling and breathing. About 50% of adults develop some form of gingival recession after about 20 years. The recession may be only partial, involving just one or a few teeth, or complete, involving the whole mouth.
The gums are a 1- to 4-mm. soft overcoat for our tooth roots and the bone holding the teeth in place. They seal the circumference of the tooth (where the root meets the crown of the tooth) against germs, food particles and any foreign invader that shouldn’t be anywhere near the root. They function just as skin covers our body.
The causes of gingival recession are one of or a combination of the following: bad brushing habits, buildup of dental stone, chronic layers of plaque, smoking, chronic alcohol consumption, genetic background, breathing through the mouth, taking some medications or having low-quality fillings, crowns or bridges.
The treatment is a combination of five alternatives:
1. Always use a high-quality soft toothbrush twice a day to brush the gums downward in the upper jaw and upwards in the lower jaw. Many people are used to horizontal strokes; never brush that way. Always use a vertical stroke to go with the gums.
2. See a dental hygienist at least twice a year (or more frequently if the situation is problematic), to clean away the stone buildup and control the plaque.
3. Avoid smoking, alcohol and any habits that unnecessarily involve the gums such as holding a pen, a pipe or even a medicinal tablet against the teeth/gums.
4. Electric toothbrushes are less effective in dealing with gingival recession.
5. Find a satisfactory anti-sensitivity toothpaste (or oral rinse).
Sensitivity to cold or hot drinks, sweets or some foods is the most obvious personal problem.
The hygienist will recommend either one or a combination of special anti-sensitivity toothpastes. Choose one, and use it for about three months, twice a day, every day. Then you can either stop because the problem has gone away or change to a different anti-sensitivity toothpaste and give it a try. These special toothpastes (and some oral rinses) are at best about 70% effective. By changing from one brand to another, by a process of trial and error, eventually a satisfactory kind is found that works reasonably.
Many adults are forced to use these special toothpastes – or a combination of toothpaste and an oral rinse – for years.
If after some months, the sensitivity is still a problem, consult with a periodontist about other alternatives that may involve lightcured sealants, surgery or prosthetic treatments.
Rx for Readers welcomes queries from readers about medical problems. Experts will answer those we find most interesting. Write Rx for Readers, The Jerusalem Post, POB 81, Jerusalem 9100002, fax your question to Judy Siegel-Itzkovich at (02) 538-9527, or email it to jsiegel@jpost.com, giving your initials, age and place of residence.