What your patients NEED to know about gum recession

December 13, 2018

Information you provide your patients about gum recession could be the frontline in improving their oral health.

Your patients can have a great smile and a healthy-looking mouth - and still have gingival gum recession. Receding gums can become concerning if the roots of the teeth become exposed, leaving them susceptible to decay, infection or loss.

Gum recession is a slow process where the pink tissue surrounding teeth wears away, thus exposing the tooth’s root. Patients don’t always realize it’s happening at first. But if treatment begins early, you can stop or even reverse gum recession in your patients.

Educate patients on why gums recede

The most common reason for gum recession is inflammation around gum tissue. Patients can physically wear away the gums by too vigorously brushing their teeth.

“Whenever they brush too hard, it can actually cause more damage than periodontal disease or cavities,” says Sarah Thiel, RDH, a clinical practitioner and CEO of CE Zoom. “If you’re brushing your gums off, then your bone is actually decreasing too.”

Thiel explains to patients that bone is what holds teeth in. Brushing too hard can cause recession, which means bone is also decreasing. Thiel recommends an electric toothbrush that has a pressure protection sensor to gauge how hard patients brush, which helps those who have recession, or are prone to it, to brush using the right pressure.

Some people are prone to gingival gum recession due to genetic factors such as thick gums, the position of their teeth, or medical conditions like hormonal changes and diabetes. Gum recession can also be caused by oral piercings, misaligned teeth, certain medications and bruxism, or teeth grinding.

People who use tobacco products can also be predisposed to recession. “Tobacco products are known to leave behind a sticky plaque that makes gums more likely to recede,” says Jennifer Silver, DDS, of Macleod Trail Dental in Calgary, Alberta.

What’s more, aging can play a role in recession. Eighty-eight percent of patients 65 or older have gum recession around at least one tooth, according to a study in the Journal of the American Dental Association.

And inflamed gums from poor oral hygiene can cause gingivitis (explained to patients as early gum disease) and periodontitis (explained as late-stage gum disease), which are conditions that lead to recession and bone loss.

Even though tooth brushing habits are the No. 1 reason for most patients’ gum recession, Silver tells her patients not to let the fear of brushing too hard keep them from practicing proper dental hygiene.

“If you don’t brush and floss your teeth on a regular basis, you are at a far greater risk of developing a receding gum line. That’s because when too much plaque builds up on teeth, it weakens enamel along with the teeth and all surrounding tissues - including gums.”

How to address receding gums with your patients

Keeping patients in the know about what gum recession is, its likely causes and why it’s best to not ignore it can be critical to their oral health. Every patient who has some recession, is prone to it, or has conditions that make it more likely should understand what it is and how they can monitor any recession and help prevent it.

Here are a few questions to discuss with patients about gingival gum recession:

Do any of their teeth suddenly look longer?

Are they experiencing any tooth sensitivity?

Do their gums bleed while brushing?

Do they think they have bad breath often?

Does food frequently get stuck in a particular spot?

Are their teeth loose or shifting?

Do they grind their teeth? (Fitting patients for a night dental guard is helpful because teeth grinding weakens teeth and can contribute to receding gums.)

Do they have current or prior tobacco use?

What kind of toothbrush do they use and do they think they might brush too hard?

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Talk to patients about treatment for gum recession

Getting patients started on treatment for gum recession early is important for the success of their oral health. Silver stresses, “Receding gums do not grow back.” But there are several options to treat them. The first is for a dentist to clean out the pocket and remove all bacteria before reaffixing the gum in the proper position.

“Treatment includes having a dentist deep clean the area to remove plaque buildup on the teeth and root surface,” Silver says. The root itself can be smoothed out so that it’s not as easy for bacteria to thrive there.

Antibiotics are sometimes necessary to help remove existing bacterial threats in the mouth.

For patients who have had recession for a while, the jaw bone may already be impacted, in which case a full regeneration may be necessary. This involves the use of graft tissue, membrane, or some type of regenerative material to help redevelop bone and tissue that has been lost. With the regenerative material in place, the gums can be secured back into position to restore the appearance of a healthy smile.

Give patients preventive gum recession pointers

Patients should know that they can help prevent gum recession by not brushing teeth too hard, using a soft bristle brush and brushing gently for at least two minutes twice per day. Thiel says one trick to brushing gently with a manual toothbrush is to hold it with your thumb, index and middle finger, instead of your fist. You won’t be able to press as hard.

“Plus, it makes you focus. People can get in autopilot mode when they brush, but at least if you are just holding the toothbrush with three fingers, you can’t push as hard,” Thiel says.

There’s also a surprising link between heart disease and gum disease. The Harvard Heart Letter reports that people with periodontitis may have two or three times the risk for heart attack and stroke than people without gum problems. Be sure to share that information with your patients.

You should also make sure patients know that a variety of dental issues can occur if receding gums are ignored. For instance, their teeth are more susceptible to decay and cavities because food debris tends to build up in the pockets created by receding gums. Long term, this puts excess pressure on their jaw structure and can lead to tooth loss. No one wants to have cavities filled and teeth extracted if they don’t have to.

Talk to patients about preventing and treating gum recession. Information you provide is the frontline in improving your patients’ oral health.