How badly should I be freaking out about noticeably receded gums?

[JustSomeYankee]

I noticed my gums were significantly receded around a year ago when I saw exposed tooth below my cap on the molar I had a root canal in 4 years prior. I brought it up to my dentist and she confirmed it, mentioned it increased risk of cavities, but didn't recommend any treatment other than making sure I floss deep.

I've been learning about it on my own since then. Its at its worst on the outside of my molars/premolars and took me a while to figure out the extent of it. I didn't realize I had exposed roots at the time, and it took a dental mirror to realize my top right molars are to the point where you can see the indentation in the *root surface where the individual roots begin to split.

Not 100% sure what caused it either. I got kinda obsessive about oral hygiene after my root canal so I figured it was brushing.
I also may have issues with my bones, and had **jaw surgery that required arch bars to be temporarily sewn into my gums in 2018. I don't recall having ever been warned about receding gums before I asked. If I was told not to brush too hard I most likely would have freaked out and stopped.

I've been worrying about a bunch of nightmare scenarios, what if I get an infected root, what if aging causes them to keep receding so I start to lose teeth in a few decades. Wondering if I need to consider surgery etc. Can you guys possibly tell me anything about just how serious the situation is and what I should consider doing about it?

*I didn't think a picture was feasible, the gums are high enough where the tooth has 2 visible bulges where the roots start and it gets shallow in between them. There is no open space between them yet. I don't want to give the wrong impression.

** I have a rare health condition I don't want to name, due to its rareness making it borderline self-doxxing. I have some minor bone deformities and may have osteopenia/osteoporosis due to the condition or its treatments, but don't know yet.

 

[Gordon]

Sorry, more questions than answers...

How old are you?
Has your dentist done a gingival health index (usually involves a bit of poking round the teeth followed by them shouting some numbers to their nurse).
Do you know the scores from the last one?

I can give you some answers...

The surgery is irrelevant, your health condition is or is not relevant, without knowing what it is (which is fine, I'm not your dentist!). You won't get an infected root.

 

[JustSomeYankee]

35

The hygenists did at my request last year but I don't know the scores. I don't know how often they did before that.

The thing is I don't know myself.

Its really rare and even researchers don't know that much. A lot of my symptoms are similar to thalassemia. I was in a clinical trial for my condition and they said I might have lost like 7% of my bone mass over 18 months, but they weren't sure because they never got a proper baseline before putting me on the medication. Obviously, I discontinued it. I had bone scans done a year later but they couldn't tell me if anything had changed (too much variance between the scanners).

I don't know if this helps at all, but since I can't take a picture. I drew a line on a reference photo I found online. Its my best guess as to the highest level of recession, with the gums being above the line on my upper right molars.

 

[Gordon]

Thanks, sorry for the 3rd degree

In general things like osteoporosis don't affect the bones which hold teeth in, different kind of bone basically. If it's something like thalassemia then it won't be making any difference to your gums either.

A bit of recession around a crown is pretty normal, the margin is always a bit of a plaque trap, no matter how good a crown fits, but once the gum has established itself away from the margins of the crown it usually won't recede any further.
The hygienist should be doing the scores at every visit.

A bit of recession around the necks of the premolars and first molars is not uncommon, it's generally related to a bit of overzealous brushing coupled with bad technique, do you use a manual or an electric brush?
If you use a manual brush, bin it and get an Oral B electric one, cheapest rechargeable one you can find on Amazon etc, there is no real point in buying one of the fancy ones unless you like gadgets If you're already using an electric brush, just carry on as you are, it won't let you use too much force and it automatically brushes the "correct" way.

Next time you visit your dentist get them to explain your periodontal index score and take things from there. There's really no need to panic, things are easily controlled from where you are now and gum disease is a very slow process which takes decades to get to a point where there is a risk of tooth loss.

 

[JustSomeYankee]

First of all, thanks for responding to me.

I have both. I had an oral B for a year, but a few months ago I saw a periodontist on youtube say mechanical toothbrushes were bad for receded gums, and to use a manual thats brushed from the gum inward. Then I read other stuff saying mechanical brushes were good, and I've been kind of going back and forth since that. So you're pro mechanical?

Can I ask how much people normally experience with age? I've worried decent recession now+ natural recession with age = serious problems later on.

Also, should I be doing anything to cover the roots since they apparently don't have enamel on them? I wondered if I should ask about the sealant they give to kids.

 

[Gordon]

I had an oral B for a year, but a few months ago I saw a periodontist on youtube say mechanical toothbrushes were bad for receded gums, and to use a manual thats brushed from the gum inward. Then I read other stuff saying mechanical brushes were good, and I've been kind of going back and forth since that. So you're pro mechanical?

I'd be seriously looking at the "periodontists" qualifications for that statement, pretty much every study I've seen has said that mechanical brushes outperform manual for most patients. I've not heard crap about "brushing the gums off the teeth" spouted since the early 70s
For most people who are not properly trained in using a manual brush and have no interest in learning the "correct" brushing technique, then a mechanical brush will outperform a manual one.

Can I ask how much people normally experience with age? I've worried decent recession now+ natural recession with age = serious problems later on.

It's not that simple, most gum recession is associated with periodontal disease, which is why I was asking about your periodontal indices. There's also some linked with general tooth wear, as the height of the tooth wears down the body compensates by allowing the teeth to erupt slightly further out of the sockets. That's more down to diet and other habits and is hard to generalise.

Also, should I be doing anything to cover the roots since they apparently don't have enamel on them? I wondered if I should ask about the sealant they give to kids.

Not really no, sealant won't work, it relies on having enamel to bond to. I'd probably suggest manually rubbing some fluoride toothpaste into the areas at bedtime and leaving it there for a few weeks, doing it last thing means it can sit undisturbed for a good long time to strengthen the root surface as much as possible.

 

[JustSomeYankee]

First of all, sorry how long it took me to respond. Life's been hectic.

I don't know if I explained the brushing thing as well as I needed to. He said you kind of start at the gum and brush away from it. It was supposed to defend against receding gums specifically. I could post or PM the video if you're interested, but I don't know if you'd want me identifying a person by name like that.

The guy did a lot of reviews of brushes and flossers that seemed genuine, but he also talked a lot about a surgical technique I haven't heard the best about, which made me a little suspicious.

I also wanted to ask if a water pick could possibly make anything worse. I have one I use at least 2x a day and I've had a few times when I've bled afterwards. Its not a common occurrence.

 

[Gordon]

No worries, I'm lucky to be retired, so I've got plenty of time.

You explained it fine, it's exactly the way it was taught back in the 70s, but things have moved on shall we say?

A water pick should make no difference, they don't do much anyway.

 

[JustSomeYankee]

Sorry to be a thread necromancer but I impulse bought some fluoride rinse thinking it would help protect the enamel between my teeth. The only kind they had also had hydrogen peroxide in it. I looked it up and read conflicting stuff. Supposedly its good for gums but I read a comment saying it could be nonspecifically bad for exposed roots.

Can you tell me if its a good idea for me to use it or not?

 

[Gordon]

Like that one, thread necromancer

The peroxide is a very weak oxidising agent. In theory the bugs that cause most gum issues are anaerobes, they prefer a low oxygen environment. The peroxide might possibly help there by increasing available oxygen at the microscopic level. Big "might". As for the roots, then in theory it might damage the dentine slightly.

In the real world it's going to make hee-haw difference as we say in Scotland

(Just paying you back for the thread necromancer line!)

 

[JustSomeYankee]

I'm guessing that means "none of consequence".

 

[Gordon]

I'm guessing that means "none of consequence".