George has had gum disease. The main feature is gum recession (arrow (->) in Fig.1,3) between two front teeth (C, L). In other word, there is a big gap between these two teeth (*). In contrast, the neighboring gums are pretty normal in shape and position (arrowhead, >). What is the reason for gum receding?
Let us take a look at X-ray. The bone above (Fig.2) or below (Fig.4) the big gap (*) is shrinking (arrow), whereas the bone level of the neighboring space is quite normal (white line in Fig.2,4). In brief, the bone loss is the basis of gum recession. When our jaw bone is gone, the gums recede. Once bone is gone and the gums recede, they usually do not come back. What we can do is to control gum disease to prevent bone loss and gum recession getting worse.
George has been our patient for about two years. When he first came to our office, his gum condition was very bad. We did deep cleaning initially. Since then he has come back for periodontal maintenance (a special type of cleaning for gum disease patients) every three to four months. In the meantime, he uses dental floss every day. The other best way to clean the big gaps is to use small toothbrush (#5 device in Oral Hygiene Devices Lecture). Due to our mutual effort, George's gum disease is under good control as shown in Fig.1,3.
What will happen if we do not take care of bone loss and gum recession? Our teeth may shift, have mobility and finally need extraction.
Xin Wei, DDS, PhD, MS 1st edition 08/08/2011, last revision 08/08/2011