Chronically Generalized Periodontitis and Gingival Recession

Healthy gums prevent the need for parodontitis treatment

Watch Dental Video about Gingival Recession

Did you know that gums can be transplanted?

If teeth become visually longer and gums are retreating, this is called gingival recession. The causes of gingival recession can be many, and successful treatments and therapies exist. First, it must be clarified whether an inflammation of the gums – a so-called periodontitis – is present. If this is the case, then a periodontal therapy should be initiated.

If it is not a periodontitis, but a recession of the gums unrelated to an inflammation, then the surface of the dental root can be covered again by means of a gum transplant. This is called a root cover. So a recession of the gingiva is not always due to a periodontitis. Sometimes, gums do not recede because of an inflammation, as in a periodontitis, but retreat downwards without any inflammatory stimulus. There are many causes for recessions, e.g. the wrong tooth brushing technique or an incorrect eruption of a tooth.

An incorrect eruption of a tooth means that, in the normal case, if a tooth erupts in the center of the alveolar ridge, there is a sufficiently thick layer of bone and gingiva on the outside of the tooth, allowing for a sufficient blood supply. However, if the tooth erupts too far on the outside (toward the lip or cheek), then the bone in this area is thinner than in normal cases and thus, the blood supply is reduced as well. Now, if a compression of the bone socket occurs as well - for example, due to an improper stressing of the tooth while biting down – then a reduced blood flow results. A reduced blood flow always means a worse supply of nutrients of the respective anatomic region, the bones, and consequently gums recede – a so-called recession. Besides an increased sensitivity (cold/warm reaction), the exposed tooth necks can be affected more easily by the toothbrush or by caries, so a therapy is essential. The therapy is called a root cover and/or includes a correction of the occlusion by means of a retainer.

So are my gums diseased or not?

Healthy gums are light pink, fit tightly to the teeth, and, when observed at close range, show a fine stippling, similar to an orange. Healthy gums do not bleed, even if you eat an apple, brush your teeth, or the dentist works in your mouth. Slightly bleeding gums are always a sign of an inflammation – a so-called gingivitis! Many people stop brushing their teeth for fear of blood – this only makes the gum inflammation worse and lead to increased bleeding! So it is imperative that you continue brushing and you may also use a dental water pick! If you continue to suffer from bleeding gums, you should consult a dentist, because that could be an indication of a periodontitis – more about that in the next reports!

There is a small bump on my gums – is that a fistula, an abscess, or a consequence of gum recession?

All three symptoms could be forms of a chronic gum inflammation! An abscess is an acute incident; they are a frequent occurrence in the summer, when temperatures are very warm. The cause for abscesses is gum diseases, necrotic teeth, and teeth with badly treated root canals.

A gingival fistula is a symptom for a chronic event. In most cases, patients have experienced several abscesses and at one point, the inflammatory processes get organized and a gingival fistula develops. Receding gums are a late symptom and, in most cases, a sign for a periodontitis or an abscess that was left untreated for years or was treated in the wrong way. If you have one of these three symptoms or if they are recurring, you should see a dentist immediately!

A chronic apical periodontitis – what is that?

The causes of a chronically apical periodontitis are either a necrotic tooth whose root was not treated or a tooth with a bad root canal treatment. The dentist can recognize this on an X-ray as a dark spot at the end of the root. Wherever X-rays can penetrate more easily, the resulting X-ray image shows darker spots; wherever they cannot do that, the X-ray image remains light. So why do X-rays penetrate bones more easily in a chronic apical periodontitis? Because the inflammation leads to the loss of bone substance, thus making it easier for the X-rays to go through the tissue.

Click here to see the video: Periodontosis

This post is also available in: German

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