Gum recession & bone loss

Just the other day I had a friend share with me that she noticed when looking in the mirror that her gums are receding and her roots are getting exposed and notched. She asked me – what causes this?

I thought it was a good question and that I would share the answer with all of you. If you had asked me the same question 20 years ago in dental school the answer would have come quickly – you are brushing too hard and/or incorrectly. I would have answered it almost as a reflex even though this never really made sense to me for several reasons. First of all, if you were brushing your gum tissues away then wouldn’t you expect bleeding and raw gum tissue? After all, this argument states that you are abrading your tissues. Secondly, when you look in the mouth you often see many different levels of gum loss on teeth that are right next to each other. Your toothbrush head is larger than one tooth, so how could you possibly attack one tooth more than its neighbour? That just doesn’t make sense. And finally, even on teeth that have lost a lot of gum tissue, you never see the bone exposed. That means the bone is also being lost, and there is no way you are brushing your bone away.

So what’s the cause then? It could be gum and bone disease (gingivitis and periodontitis); however, we most often see this occurring in locations of healthy gum tissues. So let’s eliminate that explanation. What about pressure? Let’s imagine your mouth to be two horseshoe shaped fences (upper jaw and lower jaw) where each tooth is like a fence post. If you were to “wiggle” the fence posts (teeth in our case) you would damage the supporting dirt (bone and gum tissue in our case). Not only that, you could damage the fence posts as well. So one would expect to see wear on the teeth, shortening and fracturing of teeth and possibly notches in the teeth near the gum line where the teeth are held in the bone.

This pressure is why we are concerned about clenching and grinding. Not only can it harm the teeth, bones and gum tissue, it can also harm jaw joints and supporting functional muscles used to chew, talk and smile. A misaligned bite can definitely give rise to this problem. This is a serious condition to have looked after because if you lose enough bone and gum tissue – you will lose teeth. And, if you irritate the muscles and joints enough you will likely develop pain.

Look in the mirror and do a self assessment. Feel free to contact us with any questions or concerns you have on this matter, or on any other topic we have touched on.

This article is written by or on behalf of an outsourced columnist and does not necessarily reflect the views of Castanet.