Do receded gums rule out orthodontics?

[dentalguy]

When I was a kid my routine of dental hygiene wasn’t great. Often I’d skip cleaning my teeth at night only to ‘make up’ for this by brushing my teeth overly severely the next morning. When I got braces in my teens this behaviour was amplified as I found cleaning more cumbersome; I lazily avoided it only then to take into absolutely scrubbing my teeth to put things right. This was particularly sore on my gums as I was rubbing back and forth on the bottoms of the outside of my teeth below the tracks of my brace. The result was that the hard bristle brushes I used then scoured and bled my gums regularly seemingly causing them to recede over time.

I could really kick myself now when I think what I did to my gums/teeth over the years through a combination of lax hygiene and then ridiculously excessive brushing.

However, although it was too late for the damage already done, since I realised the harm my brushing was doing I have taken things much more gently; thankfully, it seems my gums haven’t moved for the last ten years.

Interestingly, the condition of my gums hasn’t been raised as an issue by any of the dentists, or even oral and maxillo-facial consultants I’ve seen over the years since my braces were removed. Indeed, on my recent visit to the dentist I mentioned my concerns and she said there was nothing to worry about.

So why the topic then? Well, a few years ago I went for an assessment with an orthodontist and having taken x-rays and looked at my mouth he informed me that orthodontic treatment wouldn’t be advisable as I was one of the small number of people whose gums had receded with previous work. On hearing this I was a little taken aback while at the same time too embarrassed to explain what I felt was the real reason behind the recession. Indeed, although he seemed quite young, I was probably somewhat resigned at the time to him being right given his professional expertise as opposed to my… er, casual assumptions.

However, examining my teeth since has really convinced me that severe brushing was the problem as it’s the teeth that were most easy to scrub – around the cuspids (fang teeth) – that have the most gum recession. By comparison there’s little or no recession elsewhere.

My concerns about this returned recently when speaking on the phone to the registrar at a clinic where I may be able to undergo SARPE. One thing he mentioned was that a patient had to have healthy teeth and gums for the procedure. It’s not that I think my teeth and gums are unhealthy, it’s just that my gums may not be up to the mark for the intensive work that might be required.

Even if previous orthodontics didn’t do it, is the presence of a receded gum line going to bring down the boom on any hope of me having orthodontic or othognathic work to correct my bite? Am I a lost cause?

Here’s a link to my picks and story so far: viewtopic.php?t=31490

[wcllana]

I had a similar problem - bad and receided gums which were mostly due to over agressive brushing. My orthodontist had me consult with a periodontist before he would start anything. He said he recommended a perio consult to many of his adult patients. Maybe it was because they shared the same lobby or maybe it was because it was twenty years ago and adult patients weren't as common and perhaps more caution was warrented.

I ended up getting some scaling and grafting of my upper gums which I admit was no fun. The main problem with gum scaling is that it takes a really long time in the chair and my gums had to be packed with some type of rubber or clay compond while they healed. Its the only time other then getting spacers when I was told not to floss. Having the gum work made the actual orthodondic work seem like a picnic in comparison

I had to wait six months to complete the perio work and the gums to completely heal before I could get my upper brackets, in the mean time I got braces started on the lower, so my lower teeth were ready way ahead of time.

Once the uppers went on I saw the periodontist in between my regular dentist's cleanings so I was getting a full cleaning every three months. Even with a mouth full of braces I don't think my mouth could have been any cleaner.

[ITeachMY]

Same here. I had fairly severe periodontal disease. Scaling and regular cleaning has helped prevent the problem from coming back. My lower front gums have a lot of recession, and I mean A LOT! I have had braces on for close to 2 months now and the gums actually have less recession now. The ortho is pushing the teeth down and the gums are moving up. He was worried about losing my lower front tooth and though it was loose for awhile, it is not now.
I too go for perio cleaning every 3 months to keep and eye on the problem but so far so good! My perio and ortho work in the same office which helps as they work closely together.
I would get a second opinion. In many cases, ortho treatment can improve recession.
Best of luck!