Receding Gums, want dentist's opinion

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#1 Post by **DrunkPanda** » Mon Sep 25, 2006 8:59 am

i made a thread about this a while ago because i was worried that i might have periodontitis. i made an appointment with a periodontist a few months ago but my dentist said it wasn't necessary so i cancelled it. he said that i didn't have periodontitis and my gums were receding because i was brushing incorrectly. but i don't think he even saw the way i brush my teeth. i was wondering, how would he be so sure that i didn't have periodontitis? from what i heard, it can be hard to detect and the only thing my dentist did was take xrays. my gums have receded so much that the root of the tooth is showing in a lot of my teeth and sometimes they feel loose while other times they don't. i don't understand why they feel loose sometimes but not all the time.

if a dentist reads this, do you think i should just trust what my dentist says or should i go see a periodontist anyway? my mom said i should trust the dentist because she says he's really good. he's in his 70s, i don't know if that could be causing him to make mistakes or something.
i don't know if i have periodontal pockets or anything because i'm not sure what they are supposed to look like. i'm 20 and when i was younger, i didn't brush my teeth much and had a few problems with my teeth. my old dentist said i had tartar on some of my teeth when i was like 10 which i guess he tried to scrape off. i think i started brushing regularly starting from when i was 12 (i actually don't remember when i started brushing regularly but it was between late elementary school and middle school), before that i wouldn't brush much.

#2 Post by **Zondrae** » Mon Sep 25, 2006 2:39 pm

I'd be interested in the dentists reply to this post too. I posted a week or so ago about my 6 year old with a similar problem.

I hope it all goes ok for you - I'd probably get a second opinion.

#3 Post by **rsprouse** » Mon Sep 25, 2006 7:51 pm

Periodontitis cannot be diagnosed with a clinical exam alone, you have to have radiographs to diagnose PD. Gingivitis turns into Periodontal disease when you begin to have bone loss, and once you start losing bone there is no easy way to get it back. Bone grafts do work, but they are expensive and you need a healthy environment. Receding gums do not necessarily equate to PD, especially in a young patient like yourself. It is very possible that your gums have receded from mechanical abrasion (brushing too hard). If that is the case then STOP!!! Light pressure is all you need to clean your teeth. It is not the grout in your shower, no scrubbing! If you keep it up and your gums keep migrating south, you can compromise their support structure and may develop other periodontal problems.

The number 1 reason for a lawsuit brought against a general dentist is undiagnosed periodontal disease. If you feel comfortable with your current dentist and trust his/her judgement then go with it. But regardless of if they have 1 year of clinical experience or 50, there is no harm in seeking a second opinion with your body.

Good Luck,
Rory

#4 Post by **jcdamon3** » Mon Sep 25, 2006 8:11 pm

Wouldn't the dentist know if they have gingivitis though? What are the symptoms of gingivitis? Can you have PD without gingivitis? Otherwise wouldn't we all need to be screened for PD if the only way to detect it is with radiographs?

#5 Post by **Clo** » Tue Sep 26, 2006 8:39 am

Having had some issues concerning my gums, I was alerted when I read :

my gums have receded so much that the root of the tooth is showing in a lot
of my teeth and sometimes they feel loose

I would see a perio as soon as possible. It is much easier to prevent major
gum or even bone damage than trying to correct it. Given your age of 20,
this does sound worrying. So, I would certainly try to see a perio. A first
consultation normally costs not much. So, very little to loose, but maybe a lot
to gain.

#6 Post by **DrunkPanda** » Tue Sep 26, 2006 9:42 am

last night i scraped downward some plaque off one of my teeth (it was on the root of my tooth and i missed it with my toothbrush) and caught the gum with my nail, it pulled the that part of my gum about a milimeter off my tooth for a second then went back. it didn't hurt or anything but that has me worried. what does it mean?

#7 Post by **rsprouse** » Tue Sep 26, 2006 4:38 pm

Wouldn't the dentist know if they have gingivitis though?

Yes, and they probably do have it. In fact, (Some ridiculously high number that I cannot remember off the top of my head) 85+% maybe? of people have some form of gingivitis, whether it is localized to a single tooth or generalized through the mouth.

What are the symptoms of gingivitis?

Bleeding on probing, any inflammation in tissue in the oral cavity, any redness, any loss of architecture, lack of stipling, loose tissue, etc

Can you have PD without gingivitis?

Gingivitis progresses into PD once you have attachment loss.

Otherwise wouldn't we all need to be screened for PD if the only way to detect it is with radiographs?

You diagnose PD with both a clinical and radiographical exam. But you cannot diagnose it with only a clinical exam

last night i scraped downward some plaque off one of my teeth (it was on the root of my tooth and i missed it with my toothbrush) and caught the gum with my nail, it pulled the that part of my gum about a milimeter off my tooth for a second then went back. it didn't hurt or anything but that has me worried. what does it mean?

It means that you have bacteria in your mouth and are showing signs of gingivitis. In an ideal healthy oral cavity, the tissue will be tight and taught around the neck of the tooth. If the tissue is retractible then you likely have plaque below the gumline (and have had it for some time). You may have some pocketing which is preventing you from cleaning properly, but if you have as much recession as you mention then I doubt you have any noticable pocketing. I would recommend that you google "Modified Bass Tooth brushing" or similar and read up on how to properly brush and make sure you have a soft bristle tooth brush. And most importantly, go easy on your gums, light pressure is all you need to clean properly.

Good Luck,
Rory

#8 Post by **DrunkPanda** » Tue Sep 26, 2006 7:52 pm

so do you think that the fact that i lifted my gum off my tooth like that is not necessarily a big problem? because that really had me freaked out, i thought it might be a sure sign that i had periodontitis because i had never heard of that happening before. my dentist had recommended i use a crest spinbrush toothbrush because he said it could not hurt my gums. but after about a month of it, i think my gums did get worse so i stopped using it. now, i have an extra soft toothbrush and i put it against my gums and brush in a circular motion, is that alright? one thing i noticed is that the last two days, i've noticed like a line of slimy white stuff along a part of my gums. i'm pretty sure that it is skin that comes off my cheek (which happens sometimes) but just to make sure, that's not my gums coming off, right? and like i said earlier, a few of my teeth seem a little loose sometimes. is this a sure sign of bone loss or periodontitis? or could it just be from my receding gums? a few months ago, i started using mouthwash and i told my dentist that it was causing some of my teeth to feel loose and he didn't seem concerned (and my teeth did stop feeling loose after i stopped using mouthwash up until now). he just said i didn't need to use mouthwash. he also said that if my gum recession got much worse, he would need to put fillings in my teeth, does that make sense?
i've been seeing my current dentist for about 8 years and before now, i've never really had serious problems with my teeth. i've had about 5 cavities but i think two of them were baby teeth. when i brought up the question of whether i might have periodontitis, he just shook his head and said i didn't have gum disease. i have another dentist appointment in a couple of week so i'm going to ask him again and i think i will make an appointment with a periodontist.
i really appreciate your help and advice

#9 Post by **stRaighteR** » Tue Sep 26, 2006 10:52 pm

u need to go and see a periodontist...

and the reason the spinbrush was probably hurting ur gums was b/c u were applying too much pressure...i did that with my oral b initially, but then remembered that they said "just let the brush do the work"...

i also get that white film at my gum line soon after i brush...i have no clue what that is...i've realised the more obsessed i have become with my dental hygiene, the more problems i swear that i am having...

u may be allergic to the mouth wash...i was using crest pro health and my gums looked like a complete disaster...i stopped using it and my gums slowly got better...so make sure u're not allergic to some of the products u are using, and make sure u are not scrubbing too hard with ur toothbrush...sometimes people believe they are not scrubbing all the enamel off their teeth, when in fact they are....

#10 Post by **rsprouse** » Wed Sep 27, 2006 5:36 am

so do you think that the fact that i lifted my gum off my tooth like that is not necessarily a big problem? because that really had me freaked out, i thought it might be a sure sign that i had periodontitis because i had never heard of that happening before.

It does not happen in ideal oral health. It indicates that there is a disease process going on in that area so you should have it treated. But it does not mean that you necessarily have a serious or non-treatable problem.

my dentist had recommended i use a crest spinbrush toothbrush because he said it could not hurt my gums. but after about a month of it, i think my gums did get worse so i stopped using it. now, i have an extra soft toothbrush and i put it against my gums and brush in a circular motion, is that alright?

I personally recommend a Sonicare to patients that are interested in a power tooth brush. But I also understand it is a large financial investment, albeit a good one, into your oral health. Whatever works for you is what you need. I am not a big fan of the spin brushes, but they do work for some people. They are very technique sensitive. You can cause abrasion of teeth and wear away your gums even with the softest toothbrush. It is all in the technique. Hold the brush head at a 45 degree angle to your gum line and brush in GENTLE small circles down towards the gum. This gets the bristles down into the sulcus which is the hardest area to clean. If you are applying pressure (any pressure) to the brush you are pushing too hard. Pay your dentist a visit and ask for a demo on how to properly brush. That is part of their job and they will be happy to explain.

one thing i noticed is that the last two days, i've noticed like a line of slimy white stuff along a part of my gums. i'm pretty sure that it is skin that comes off my cheek (which happens sometimes) but just to make sure, that's not my gums coming off, right?

Sounds like plaque. Some people generate plaque at higher rates than others. It is common to accumulate at the gum line which is why it is so important to clean well. The white stuff on your cheeks is something else. Have you ever been treated for a fungal infection in your oral cavity? If the white stuff on your cheeks wipes away then you really should seek treatment from a dentist. White stuff that wipes away from cheeks is not "normal" and can be treated with medication.

and like i said earlier, a few of my teeth seem a little loose sometimes. is this a sure sign of bone loss or periodontitis? or could it just be from my receding gums?

That is impossible to say from across the internet, I assume you are braced?

a few months ago, i started using mouthwash and i told my dentist that it was causing some of my teeth to feel loose and he didn't seem concerned (and my teeth did stop feeling loose after i stopped using mouthwash up until now). he just said i didn't need to use mouthwash.

Correlation does not mean causation. I doubt the mouthwash was the cause of the loose feeling of your teeth. If you are using an alcohol based mouthwash it will dry your mouth and the white "stuff" wiping off your cheeks could actually be chemical burns (I have seen this, kinda crazy!) I personally like Crest Pro Health rinse which is alcohol free and uses a different chemical to attack plaque (CPC). Mouth rinse is a nice addition to a cleaning regime but doesn't replace anything. Again, I am not a big fan of alcohol based rinses in most cases.

he also said that if my gum recession got much worse, he would need to put fillings in my teeth, does that make sense?

Possibly. He is probably talking about glass ionomer material to prevent root caries. Your root surface is not covered by enamel and is much more prone to decay, especially if exposed to the oral cavity.

i've been seeing my current dentist for about 8 years and before now, i've never really had serious problems with my teeth. i've had about 5 cavities but i think two of them were baby teeth. when i brought up the question of whether i might have periodontitis, he just shook his head and said i didn't have gum disease. i have another dentist appointment in a couple of week so i'm going to ask him again and i think i will make an appointment with a periodontist.

Gingivitis is technically considered gum disease. Like I said previously most people in the world have some form of it, albeit it may be very minor and localized. If you are seeing drastic changes in the condition of your teeth or gums then something is going on. The oral cavity in ideal health remains quite stable and boring. There is no harm seeking another opinion from a specialist or another GP if you are uncomfortable with a diagnosis.

i really appreciate your help and advice

My Pleasure, good luck!

Regards,
Rory

#11 Post by **DrunkPanda** » Wed Sep 27, 2006 11:35 am

i'm not braced. and that white stuff i talked about, it's kinda long slimy and stringy. does that sound like plaque? on my cheek, i thought it was a little part of my skin coming off the cheek. it doesn't happen very often

#12 Post by **rsprouse** » Thu Sep 28, 2006 5:27 am

i'm not braced. and that white stuff i talked about, it's kinda long slimy and stringy. does that sound like plaque? on my cheek, i thought it was a little part of my skin coming off the cheek. it doesn't happen very often

Yes it does sound like plaque. Re: the cheek, the next time it shows up make an appointment with your Dentist. It is likely not a big deal, but you should take care of it to prevent any further complications down the road.

Regards,
Rory

#13 Post by **DrunkPanda** » Thu Sep 28, 2006 8:44 pm

oh good, i thought it was some skin cuz of its texture. and on my cheek, it looks exactly the same as the stuff on my gums and it doesn't stay around long enough for me to go see a dentist about it. anyway does the fact that i'm not braced, change your opinion about my loose teeth? i used to have braces and i know they are supposed to make your teeth loose to correct them. the thing is, after i started using mouth wash, then is when my teeth felt loose (i think). i stopped using the mouth wash, and then my teeth felt fine again. now they feel loose again (i can wiggle them a little) but i didn't do anything. this is my last question because i don't want to bug you too much but thanks