The truth about recession: Dispelling 5 myths about gingival attachment
By Tracy Anderson Butler, RDH, MFT
Myth #1: Once it’s gone ... it’s gone.
The truth is that regeneration of new cementum, periodontal ligament, and aveolar bone is possible. Most of us were taught in hygiene school that, once the bone and gum are gone, they are gone forever. However amelogenin proteins have been used in regenerative periodontics for over 15 years to regrow hard and soft tissue, reversing recession naturally.
Myth #2: Recession is just a gum disease.
The truth is that recession can be a disease of both hard and soft tissues. We have all heard the phrase “bone sets the tone and tissue is the issue.” The reality is that the periodontium should be thought of as a system working together in harmony. The human body naturally strives to maintain a 1-3 mm relationship between the gingival margin and base of attachment.
Patients understand bone is a good thing. Understanding the biology of the periodontium is critical in educating patients on the truth about recession.
Myth #3: Pocket depths of 1s, 2s, and 3s mean good health.
The truth is that pocket depth plus recession equals clinical attachment level (CAL), which is the more accurate method of assessment. While pocket depth measurements are a key part in the comprehensive periodontal evaluation, this is not the true picture when it comes to recession. Determining CAL is simple. Here is an example: 2 mm pocket plus 4 mm recession equals 6 mm CAL.
Myth #4: Just watch it.
The truth isthat early detection is the key to treating any disease, and patients deserve to know their options for reversing recession. Most of us were taught to treat recession by using topical adjuncts such as fluorides, desensitizing pastes and gels. All of these modalities simply monitor and manage symptoms and do not address the true etiology of the disease.
Myth #5: Recession is caused by toothbrush abrasion.
The truth is that recession often may have an etiology related to multifactorial aspects and not just aggressive tooth brushing. This means the role of biofilm, salivary environment, occlusal function, para-functional habits, tooth position, and history of orthodontic treatment can be associated in part or as a whole to the true cause of recession.
It is important to take an interdisciplinary approach between the dental hygienist, general dentist, and periodontist to determine the individual needs of each patient and communicate as a team with the patient to understand the true cause of recession and a plan to reverse it.
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