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Receding gum tissue can be an issue especially as we get older. Normal healthy gum tissue will follow snugly against the conforms of our teeth. Gum recession occurs when the gum tissue recedes or pulls away from teeth exposing the root below. This creates an esthetic issue as well as a functional one. The roots of our teeth do not have a protective layer of enamel. This can make your teeth sensitive to hot and cold as well as increase your risk of tooth decay. Once recession occurs, this tissue cannot grow back to its original state. There are treatments to restore lost gum tissue and bring your smile back to its original healthy state.

What Causes Gum Tissue To Recede?

Several factors can cause our gum tissue to recede including:

Periodontal Disease (ranges from ginigivitis to advanced periodontitis) – Periodontal disease (also called gum disease), refers infections of the structures around the teeth, which include the gums, periodontal ligament and alveolar bone. In the earliest stage of periodontal disease — gingivitis — the infection affects the gums. In more severe forms of the disease, all of the tissues are involved. This inflammation occurs due to an accumulation of bacterial deposits called plaque.

Contributing factors of periodontal disease include:

-poor oral hygiene maintenance

-misaligned or crooked teeth

-damaged or faulty fillings

-bridges or partial dentures that no longer fit

-genetics

-hormonal changes due to pregnancy or oral contraceptives

-medications that cause dry mouth (xerostomia)

-certain immune disorders

-stress

-tobacco use

Periodontal Disease Stages

-Gingivitis causes gum redness, swelling, and sometimes bleeding. If left untreated, gingivitis can progress to periodontitis.

Periodontitis is the advanced stage of periodontal disease and can cause the gums to recede. As the gum and connective tissues pull away from the tooth, a pocket forms between the tooth and gum, which begins to accumulate bacteria. Over time, the bacteria cause further damage and inflammation. If the gums recede too much, it may lead to bone loss, which can cause teeth to loosen or fall out over time.

Is Incorrect Brushing The Cause?

Maintaining a regular brushing and flossing regimen is essential for maintaining good oral hygiene. However, using an incorrect brushing technique could actually contribute to receding gums. The part of the gum that comes into contact with the crown of the tooth is called the gingival margin. Brushing incorrectly or too hard can damage the gingival margin, possibly triggering gum inflammation and recession.

Incorrect brushing techniques can include:

-brushing too forcefully

-using a hard or medium bristled toothbrush

-brushing the teeth in a broad, horizontal motion

Teeth grinding and clenching

Some people grind their teeth together while sleeping. This motion of teeth grinding puts intense pressure on the gums, which can cause them to react by receding over time. Teeth grinding can also cause teeth to become loose in their sockets. Grinding creates deep pockets between the tooth and the gum, where bacteria can collect. These bacteria trigger gum inflammation, which can then worsen gum recession.

Injury

Sustaining direct trauma to the gum tissue may cause the gums to recede in that area. These injuries could include:

-during a fall or other accident

-during dental procedures

-while wearing ill fitting partial dentures

-trauma while playing contact sports

Treatments For Receding Gums

Scaling and root planing

Scaling and root planing is one of the first treatments for receding gums that a dentist will recommend. This procedure will remove plaque and tartar from below the gumline, where routine brushing cannot reach. Root planing removes plaque and tartar specifically from the roots of teeth. Following removal of plaque and tartar your dentist or hygienist will use special instruments to smooth the roots, which helps the gums re-attach to the tooth.

Gum Tissue Grafting

Your dentist may recommend gum graft surgery if your gums have severely receded to the point where surgical intervention is needed. During gum grafting, a surgeon will take a small piece of gum tissue from a different area in the mouth and transplant it to cover the exposed tooth roots. This gum tissue grafting helps prevent bone loss and the gums from receding farther. It can also protect the previously exposed tooth roots from decay and tooth sensitivity

Pinhole Surgical Technique

Pinhole surgical technique is a fairly new treatment for mild to moderate receding gums. Pinhole Surgical Technique is a minimally invasive procedure that requires no incisions and no suturing. It is a quick and effective treatment for gum recession that is virtually pain-free and requires only a very short recovery time. Patients can resume normal activities the same day as their procedure.

Prevention Of Gum Tissue Recession

-Practice good oral hygiene

The following oral hygiene tips can help avoid receding gum tissue:

-flossing between the teeth at least once per day preferably after each meal

-fluoride toothpaste

-brushing your teeth 2x/day using a soft bristled toothbrush

-using an antiseptic mouthwash to reduce bacteria and flush out debris

-choosing a size and shape of toothbrush that allows access to all parts of the mouth

-replacing toothbrushes at least every 2–4 months or as recommended by your dentist

-maintaining a regular schedule of dental appointments

-Wear A Mouthguard

Wearing a mouthguard at night can help prevent gum recession due to teeth grinding. Mouthguards create an even pressure across the jaw and act as a physical barrier to separate the top and bottom teeth. Mouthguards can be bought at your local pharmacy. A dentist can also make a customized mouthguard, which will provide a better fit and be much more comfortable and long lasting

-Replace Dentures That Do Not Fit

Partial dentures that once fit well can become incompatible with the mouth over time. This can happen for several reasons, including:

-the bone and gum ridges shrinking over time

-differences or changes in jaw alignment

-overall wear and tear of the partial dentures over time

Ill fitting partial dentures can rub and irritate the gums, causing the gums to recede around healthy teeth. People can prevent this by replacing partial dentures as needed. If you are concerned have your dentist evaluate your partial dentures at your next visit.

-Maintain Regular Dental Visits

Attending regular dental checkups is vital for detecting the early stages of gum recession. Routine examinations also allow your dentist to identify and replace any failing restorations or ill fitting partial dentures, which can contribute to receding gums.

Gum Recession Conclusion

Unfortunately once the gum tissues have receded, they cannot grow back on their own. With Advancements on treatment your dentist can reattach and restore gum tissue around the teeth. Remember to maintain a good oral hygiene program at home and seeing your dentist regularly can help prevent, slow, or stop gum recession. If you notice changes in your smile speak to your dentist to see what options are right for you.


Periodontal Disease is most frequently associated with adults and most people believe that periodontal disease as well as other major dental issues are strictly an adult problem.

Periodontal Disease Marielaina Perrone DDS

Maintain Good Oral Hygiene To Keep Away Periodontal Disease

This is simply not the case. Children and adolescents are also at risk of developing periodontal disease and associated health problems. When children have periodontal disease, signs and symptoms include bleeding gums, especially when brushing, swelling of gums, red and tender gums, receding gums, bone loss, and persistent bad breath.

Factors That Put Children at Risk for Developing Periodontal Disease

According to the American Academy of Periodontology, periodontal disease rarely occurs in young kids and is uncommon in teenagers. Hygiene, genetics, hormones, medications, and disease put you at greater risk for developing periodontal disease. The most frequent type of periodontal disease seen in children is gingivitis, which is the earliest stage (and only stage that is reversible) of periodontitis. Without dental treatment, gingivitis can and will progress to periodontal disease. While uncommon, there are certain factors that increase the risk of children developing  juvenile periodontal disease. Juvenile periodontits affects the first permanent molars and incisors.

Genetic Factors

Genetic factors help determine whether children are at risk for developing periodontal disease. Research studies have shown that genetic factors increase the risk of developing periodontal health problems in children. Children of parents with periodontal disease have an increased risk of having the periodontal disease bacteria that can lead to increased gum infections. If one or both parents or a member of the family has or has had some form of periodontal disease, it is strongly recommended that these parents ensure their kids practice proper dental hygiene daily and visit the dentist regularly.

Teenagers – Effect Of Hormonal Changes

The risk of developing periodontal disease increases as children approach puberty. Teenagers experience increases in hormonal levels, which can promote hormonal periodontal disease. Hormones such as progesterone increase blood circulation to the gums making the tissue even more sensitive and easily irritated by plaque and bacteria that cause periodontal disease. Most teenagers also lack the motivation to practice proper dental care due to the pressure of growing up and the effect of these hormones. This increases the risk of periodontal disease such as ANUG (acute necrotizing ulcerative gingivitis) even more. Flaming red tissue, bleeding ulcerated tissue, pain, and gum recession are characteristic of ANUG. It is essential for adolescents to take good care of their teeth and visit the dentist regularly for periodontal evaluations.

Periodontal Disease Marielaina Perrone DDSPoor Dental Hygiene Maintenance

Poor dental hygiene maintenance puts children at increased risk of developing periodontal disease. When children do not take good care of their teeth and gums, plaque builds up and bacteria breaks it down causing periodontal health problems. Teeth clenching and grinding increases the risk of periodontal disease in children. The best way to prevent periodontal disease in children and reduce the risk is to teach good dental care habits early in their lives. Since children copy their parents’ habits, so parents should also take proper care of their teeth.

 Diseases and medications that Can  Effect Periodontal Disease

-Diabetes, poor healing

-Asthma ( inhalers can cause oral tissue damage)

-Cancer and cancer therapies(radiation and chemotherapy can cause severe damage to oral tissues)

-autoimmune disease , poor healing

-some medications can cause tissue overgrowth, such as the anti-seizure medication, dilantin.

Forms Of Pediatric Gum Disease

Gingivitis is the and mildest stage of periodontal disease. It is the most common form of gum disease in children and adolescents. Chronic gingivitis may affect children and teens causing gums to swell, redden and bleed easily.  Professional treatment and proper dental care is the way to treat and prevent this gum condition. If left untreated, gingivitis will progress and cause further damage  to oral tissues.

Aggressive (Juvenile) periodontal disease is not common in children and adolescents, sometimes it can develop even in healthy children. It mostly affects the visible molarsPeriodontal Disease Marielaina Perrone DDS and incisors, and causes loss of the bone supporting the teeth without plaque or calculus formation.

Generalized aggressive periodontal disease is rare in children but less so in teens. This form of periodontal disease has serious symptoms including gum inflammation, calculus, plaque and loose teeth.

Advanced gum disease that contributes to systematic health conditions may also occur in children and teenagers. This type of periodontal disease is especially common in children with Down syndrome, Type 1 diabetes, Kinder Syndrome, and Papillon-Lefevre syndrome.

Since kids are at risk of developing periodontal health problems just like adults, it is important for parents to take good care of their children’s teeth and gums and instill in them a lifetime habit of proper dental care including brushing and flossing.

Understanding The Risks Can Help You To Help Your Child Fight Periodontal Disease

When kids start early, they will continue practicing proper oral care, hopefully carrying that habit into adulthood.  It is essential for parents to ensure their children have regular dental checkups, periodontal health evaluations and professional cleaning. If a parent or member of the family has gum disease, it is especially important that other family members undergo a professional gum evaluation and take serious care and consideration of their teeth and gums.

Periodontal disease, comes in two forms gingivitis (reversible) and periodontitis (treatable but non reversible), is an infection of the gums caused by bacteria found in

Periodontal Disease Treatment Marielaina Perrone DDS

Good Oral Health Leads To Good Overall Health!

plaque. Recent studies have shown between 50-75% of people have some form of periodontal disease. More statistics show that approximately 30% of Americans are at an increased risk of developing periodontal disease due to genetic factors. These statistics show how much a health concern periodontal disease can be especially when you add in even more research showing periodontal disease links with systemic diseases.

Factors in Development of Periodontal Disease

-Poor Oral Hygiene.

Tobacco Use.

Medications.

-Teeth Grinding or Bruxism.

-Genetics.

-Poor Immune System

-Systemic disease.

The earliest and mildest stage of gum disease is gingivitis, where the gums redden and bleed easily. If not treated, inflammation of the tissue occurs, resulting in progression of  the disease to periodontitis. Gingivitis is characterized by receding gums, loose teeth, sores, sensitive gums, swollen gums, red or discolored gums, chronic bad breath, change in teeth alignment and teeth movement. The ultimate consequence of advanced periodontal disease is loss of teeth, which occurs when the tissue and bone supporting the tooth breaks down.

Periodontal disease was previously thought to affect only the teeth and gums, but researchers have discovered that periodontal disease influences the overall health and well-being of an individual. Research has shown that gum disease is a risk factor for many health conditions throughout the body. The gum disease causing bacteria that normally resides around the teeth can enter the blood stream and reach other organs and tissues in the body. Once there, the bacteria  release disease-causing agents that can lead to chronic inflammatory conditions that can include:

Diabetes Mellitus (or simply Diabetes)

Periodontal disease impairs the body’s ability to maintain blood sugar levels making you more prone to diabetes or making diabetic symptoms worse. On the other hand, diabetic patients are more likely to suffer from periodontal disease due to a weakened immune system, making it easier for them to catch infections, viruses, and exhibit delayed wound healing.

Stroke

According to scientific studies, gum disease increases the risk of stroke and coronary artery disease. A chronic infection of the gums can be directly related to an increased risk of reduced blood flow to the brain. Stroke and gum disease have similar risk factors and severe inflammation from periodontal disease increases the risks of having a stroke.

Las Vegas Cosmetic Dentist Marielaina Perrone DDSHeart Disease

Having periodontal disease puts you at higher risks of heart disease. Just like periodontal disease, heart disease is a chronic inflammatory disease which can be greatly impacted by periodontal disease. The more severe the periodontal infection, the higher the risk of developing heart conditions such as high blood pressure, high cholesterol and acute coronary syndrome.

Respiratory Infections

When the bacteria in the plaque that causes gum disease goes to the lungs, it can cause respiratory diseases such as pneumonia. This explains the increased cases of pneumonia and other respiratory conditions in people with periodontal disease. This also is in conjunction with patients with lowered immune systems which makes it easier for them to be susceptible to these bacterial attacks.

Cancer

After considering risk factors for cancer including age, diabetes, smoking, BMI and more, experts found periodontal disease as a risk factor for lung, kidney, pancreatic, head, neck and hematologic cancers. Inflammation caused by periodontal disease is a major contributing factor to these cancers.

Bad Breath (Halitosis)

Periodontal disease can result in chronic bad breath which is more of a social issue than a medical one. Bacteria deposits on the tongue can also cause bad breath. This is one of the few conditions caused by periodontal disease that can be treated at home by practicing proper dental care to control halitosis (brushing, flossing, mouthrinses, tongue scraping).

Complications with Birth and Pregnancy

Periodontal disease in pregnant mothers has been shown to increase the risk of premature delivery and low birth weight. The  periodontal bacteria involved cause inflammation of the uterus and cervix. Periodontal disease also increases the risk of developing preeclampsia, a condition characterized by high blood pressure and excess protein.

Las Vegas Cosmetic Dentist Marielaina Perrone DDS

Rheumatoid Arthritis

Rheumatoid arthritis is a painful chronic inflammatory disease that affects the joints. The relationship between rheumatoid arthritis and periodontal disease goes both ways as each increases inflammation in the other. Patients with rheumatoid arthritis are faced with increased risks and severity of periodontal disease and treating periodontal disease can relieve some of the symptoms of rheumatoid arthritis.

Conclusion

The best and easiest way to prevent and control periodontal disease is by maintaining a good oral hygiene program which includes regular dental visits as well as diligent at home care. This includes brushing, flossing, use of mouth rinse, and tongue scraping. Your health is important, taking care of your dental health is a great way to start taking care of your overall health.



Periodontal disease (or commonly called gum disease) is a very serious and chronic dental infection of the periodontal tissues that can result in the breakdown of the tissue as well as the loss of bone that surrounds and supports your teeth. This dental infection disease begins when bacteria and plaque form a sticky bio film on your teeth and causes inflammation of the periodontal tissue.  Periodontal disease will continue a downward progression if this is not resolved by maintaining proper dental care and hygiene. Periodontal disease is the leading cause of tooth loss in adults. Scientific studies show that somewhere between 75% and 95% of all adults are suffering from some stage of periodontal disease.

Periodontal disease and tooth decay (cavities) are caused by different types of bacteria, and are considered to be two separate and distinct conditions, however, you can suffer from both issues. Poor oral hygiene promotes the risk of both cavities and periodontal disease. Swollen and receding gums open up the more vulnerable areas of the tooth…The root areas, which, are not protected by enamel and can break down quickly to form root decay.  On the flip side, in patients with significant tooth decay, the broken down teeth allow for food trap areas which keep periodontal tissue chronically inflamed.

Gingivitis

Periodontitis

Stages of Periodontal Disease

The earliest stage of periodontal disease is gingivitis (or simply inflammation of the gum tissues). This is the most mild form of periodontal disease. Symptoms include red, swollen (or puffy) and inflamed gums due to plaque-bacteria build-up. The gums may also bleed easily during brushing or eating of hard foods. During the earliest of stages the periodontal disease process it can be reversed thru proper brushing, flossing and professional dental care to remove the excess bacterial plaque. If the required oral hygiene does not occur, the periodontal disease then progresses  to the next stage. The majority of people with this early form of periodontal disease, do not even know a dental problem exists. This is a crucial period for the patient, as the condition can be reversed (since the bone and connective tissue that hold the teeth in place have not yet been adversely affected) at this point if it is recognized, diagnosed, and properly treated by a dental professional. Gingivitis is commonly seen during puberty, pregnancy, times of high stress, and menopause, as raging hormones can make you more prone to inflammation. As for the rest of the population, poor dental hygiene is generally the most common cause, followed by medication and certain medical conditions.

Periodontitis

As the periodontal disease progresses it is now becoming harder to treat and control. The difference between gingivitis and periodontitis is that gingivitis only infects the gum tissue that surrounds the teeth while the periodontal disease process also invades the bone that provides support and stability for the teeth. The bacteria eventually invades past the initial the gum line area and destruction begins to the point that gums may begin to separate or pull away from the teeth (taking away support and connective fibers with it). What results are called periodontal pockets. These pockets allow for bacteria to invade below the gum line.  They eventually become loaded with toxic plaque and bacteria that moves and works its way deeper. It begins to erode the bone below the gum line. A patient’s bite will be affected (as the teeth shift or loosen) by the lost support which then affects chewing and other daily functions.

Advanced Periodontitis

As the periodontal disease process advances further, the fibers and bone that provide support for the teeth are broken down and  destroyed. At least half (50%) of the bone support (if not more) will have broken down at this late stage of periodontal disease. It does not grow back naturally. Teeth may begin to loosen. Deep root cleanings and surgical intervention are typical at this stage. This may include cleaning with a periodontal microscope, (Perioscope), grafting of tissue, bone, placement of growth factors, (Emdogain), periodontal antibiotic regimen (Periostat), placement of antibiotics directly into pockets, (Arestin), open periodontal flap surgery, and, possibly even tooth removal.

How Do I Know If I Have Periodontal Disease?

Periodontal disease can happen to a person of any age. It is most common among adults. Remember, if periodontal disease is detected in its earliest stages it can be reversed so it is important to see your dentist right away if you notice any of the following symptoms:

-Gums that are red, puffy or inflamed, or tender.

Periodontitis

X-Ray showing Periodontal Disease Progression

-Gums that bleed easily during routine brushing or flossing.

-Teeth that appear longer due to recession of gum tissue.

-Changes in the way your teeth fit together when you bite or chew.

-Pus coming from between your teeth and gums

-Bad breath odor or bad taste in your mouth.

Treatment of Periodontal Disease

Periodontal Disease

Arestin use in Periodontal Disease

The earliest stages of periodontal disease are reversible. This is accomplished thru proper brushing, flossing, and maintaining a regular schedule with your dentist. A professional cleaning by your dentist or hygienist is the only way to remove plaque and tartar especially below the gum line. The hygienist will clean (also called scaling) your teeth to remove the tartar and plaque buildup from above and below the gum line. If the periodontal disease condition worsens, then a root planing procedure may be necessary. Root planing helps smooth irregularities on the roots to make it more difficult for plaque to deposit and stick there. Also makes it easier for you to keep your teeth clean at home. Treatment may also include use of antibiotics.

If you have advanced periodontitis, your gum tissue may not respond to nonsurgical treatments and good oral hygiene. In that case, your periodontitis treatment may require dental surgery. This surgical intervention may include:

-Pocket Reduction Surgery (also called Flap surgery). In this procedure, your periodontist makes tiny incisions in your gum so that a section of gum tissue can be lifted back, exposing the roots for more effective scaling and planing. Because periodontitis often causes bone loss, the underlying bone may be recontoured before the gum tissue is sutured back in place. The procedure generally takes from one to three hours and is performed under local anesthesia.

Soft tissue grafts. Gum tissue is often lost as part of the periodontal disease process making your teeth appear longer than normal. You may need to have damaged tissue replaced to return your cosmetic appearance back to normal. This procedure can help reduce further gum recession, cover exposed roots and give your teeth a more cosmetically pleasing appearance.

Bone graft. This procedure is needed when periodontitis has destroyed the bone surrounding your tooth. The bone graft helps prevent tooth loss by holding your tooth in place. It also serves as a platform for the regrowth of natural bone.

-Antibiotics and medicaments – A wide array of antibacterial rinses(Peridex), antibiotics taken in pill form, (Periostat) or localized placement directly into the affected pockets(Arestin), can aide in and promote healing of the affected gum tissue.

-Guided tissue regeneration. This allows the regrowth of bone that was destroyed by bacteria. In one approach, your dentist places a special piece of biocompatible fabric between existing bone and your tooth. The material prevents unwanted tissue from entering the healing area, allowing bone to grow back instead.

-Enamel matrix derivative application. Another technique involves the application of a specialized gel to a diseased tooth root. This gel contains the same proteins found in developing tooth enamel and stimulates the growth of healthy bone and tissue. An example of this is the use of emdogain.

To ensure a successful result following periodontal therapy, patient cooperation in maintaining excellent oral hygiene is essential. More frequent professional cleanings can help reduce the likelihood of the periodontal disease ever returning.

By scheduling regular checkups, early stage periodontal disease can be treated before it leads to a much more serious condition. If your periodontal disease is more advanced, treatment in the dental office will be required. Periodontal disease can be managed and controlled for most patients. Following a regular routine of brushing, flossing, and seeing your dentist should be enough for most to keep periodontal disease at bay.