Gum recession

Diabetes Complications and other Conditions Other Conditions
#1

I just went to the dentist. For the past few years I have had very mild gum recession. I always ask about it and they always say it hasn't gotten worse. This time, however, they said there's one area that's gotten a bit worse, but it's still very mild, and my teeth are otherwise completely healthy, no infection or other things happening.

They seem to think it's because I have major problems with teeth grinding and until last year I didn't have a night guard. I have one now but don't always wear it. Today they asked if I grind my teeth during the day when I'm working or concentrating, and I said I sometimes do notice that I'm clenching my jaw. They said I should wear the night guard even during the day if I'm at home doing things where I'm prone to grind my teeth.

I know I definitely grind at night because my night guard has big gouges in the plastic, and it's right on the same side where the gum recession got a bit worse, that's why they think it's connected.

I know diabetes can also cause gum problems so was wondering if anyone else has mild gum problems and anything else that should be done or monitored. I'm in my early 30s so obviously don't want this to get worse! I'm pretty good at brushing and flossing, could be better wearing the night guard, and see my dentist every six months for a cleaning and checkup. Obviously my blood sugars could be better but that is an ongoing goal.

#2

I've had some gum recession for years. Since my diabetes dx, I try to be yet more careful with my dental care. I now floss 2x/day, use listerine, and an electric toothbrush. Recession seems to have stopped in the past year.

#3

I use one of those sonic toothbrushes which they said was fine. I was surprised they said flossing 1x a day was okay! I think I'll do 2x just in case. I don't use any mouthwash but maybe I should ...

#4

Jen,

Increasing the amount of flossing will not help and in fact, may do more harm than good. Gum recession can happen in a number of ways. I had a lot when I was younger, in the front of my mouth, but they were able to rectify it with a simple surgery. (I had my frenulum - the little piece of gum between your gums and lips, both top and bottom - cut.)

If the recessions are further back or around your molars, you may want to look at how your mouth guard fits. As you grind your teeth, you might actually be pushing the gums down. The time frame of when you started wearing a mouth guard and the dentist noticing the recession sounds suspicious...

Good Luck!
Anne

#5

The way the guard is made it doesn't actually touch my gums, it just fits around the tops of my teeth, so it's not possible that it's pushing the gums down. I switched to a new dentist about a year ago - my old dentist casually mentioned a night guard a few years ago, but it was when I switched to this new dentist they said I definitely needed one. So I went for many years without a night guard when I should have been using one.

They did say that flossing/brushing won't help and that they think it's my teeth grinding. Frustrating that I can't make myself stop doing that since I mostly do it in my sleep!

#6

From WebMD: “Like other complications of diabetes, gum disease is linked to diabetic control. People with poor blood sugar control get gum disease more often and more severely, and they lose more teeth than do persons with good control. In fact, people whose diabetes is well controlled have no more periodontal disease than persons without diabetes.”
Link: http://www.webmd.com/diabetes/periodontal-disease

Elevated blood sugars will cause continued gum destruction that flossing and brushing your teeth umpteen times per day is unlikely to stop. Virtually all PWDs know that serum glucose will bond to proteins of cells in the body via glycosylation and that what you measure with a blood glucose meter is the percentage of glycated RBCs in your blood. However, serum glucose is an equal opportunity destroyer; it bonds with proteins of virtually every organ in your body including your gums. As the WebMD extract noted, “people whose diabetes is well controlled have no more periodontal disease than persons without diabetes.” You have to give much higher priority to reining in your high blood glucose numbers or you’re headed for complications a lot worse than receding gums; particularly as you age. (Please don't shoot the messenger).

#7

"... that what you measure with a blood glucose meter is the percentage of glycated RBCs in your blood."

Isn't that A1c, not what you're measuring with a meter?

The thing I can't figure out is that my dentist didn't say I have gum disease. He said my gums weren't inflamed, there was no infection, the roots/bones and whatever else they look at were fine. I think this is why he feels it's related mostly to teeth grinding. There's just a few areas near my molars where my gums are receding - so far very mild, like 1 mm which when I looked it up seems to be borderline if anything. So I'm not at all certain I have "gum disease" or just gum recession, or whether they are one in the same.

And I do agree about control, I have read that before. It's something I am working on and have been trying to work on for 23 years. With my diabetes it's not a simple matter of "priority", though - trust me, I put a very high priority on diabetes. But, for whatever reason, my diabetes is not at all easy to control. (And I'm not saying that as an excuse - I try and fail on a daily basis to "rein in" my blood sugars.)

#8

I actually had (past tense) a lot of dental issues myself but my dentist was familiar with dealing with diabetic patients. He also fitted me with a night guard due to teeth grinding. I worked hard to bring my BG under control and finally achieved an A1c of 4.8 to 5.1 (that's my full range within the last three years). When I cracked a molar (originally undetected) and developed a serious tooth infection, it required extraction since it could not be saved. My dentist is skilled in dental implants but was very hesitant to recommend one to me because he had previously experienced three implant failures; all of the failures were in patients who were diabetic. After a long consultation, we both decided to proceed.

The yardstick to determine if the implant post is "taking" is an examination of the bone structure after 6 to 8 weeks. He was surprised to find bone growth around the post to be solid; better, in his opinion, than most of his patients who were not diabetic. After another month or so to ensure full healing, I now have an implant that is solid as a rock; thanks in large part to having attained near normal BG levels. I suspect that your gum problems may, in part, be due to sustained high blood sugars and there are plenty of research studies that link periodontal disease to diabetes. My post was intended as a warning that your problems could be related since some of your other posts suggest that you are still struggling with high BG levels. My own bout with neuropathy took almost 2 years to fully fade ("heal" may not be fully accurate) and I am thankful that I now have no detectable complications (either via tests or in symptoms). Hoping you can enjoy a similar outcome.

#9

Thanks for the warning. I am VERY aware that after 23 years of diabetes and having a 7% A1c essentially that entire time, I am at risk of complications. I am very aware that by the time I retire at 65 I'll have had diabetes for well over 50 years - and I want to be able to enjoy my retirement, not spend it dealing with a bunch of complications. I think about it almost daily. But the diabetes control piece is something I work at every day as much as I can.

I am indeed still struggling with high blood sugars, but it's something I've always struggled with. Despite always being a conscientious diabetic (even as a teenager and young adult I never really went through a rebellion) and being on a pump and keeping records and preparing ALL my own food and exercising daily, I have never been able to sustain an A1c below 7%. I've achieved that a handful of times, but always due to too many lows. I'm now dealing with major allergy issues that complicate things even more and am trying to find a balance between multiple food allergies and diabetes. So it's something I am definitely working at daily - it's just far, far from easy or a simple matter of prioritizing.

I'm fortunate that despite having diabetes since childhood I haven't had any dental issues until now. I've had two cavities in my entire life, and when I had my wisdom teeth removed they healed very fast, and this is partly why this new development is a bit worrying. I'll definitely redouble my efforts at control in light of this, but I'll also be honest and say I don't think I will ever reach an A1c of 4.9 or 5.1 - at least not in any foreseeable future. If I can meet and sustain an A1c of 6.5 for the rest of my life I'd be thrilled! Now that I'm done school in a week or so my major next goal is to get my health under better control, and that includes diabetes as well as allergies and other things.

#10

Gum recession can be caused by brushing the wrong way, which is what happened to me,(side to side or up down- a circular motion is best I was told, or by brushing too hard and you shouldn't brush for more than 2 minutes. I had some recession at the top of my teeth near the root which was quite painful to point that the dentist who treated it said he couldn't believe I was living with it.

Anyway, he put some enamel near the root and it helped the pain a great deal- I use pro-namel sensitive toothpaste once a day now and I changed my brushing patterns. I also recommend Dr. Katz's thera breath toothpaste and rinses: specifically the periodontal rinse if you have this problem etc. His products don't have the harsh soaps/detergents that normal toothpastes have which dry your mouth out and which can cause decay. Of course bg control is really important too.

I recently started using a water floss device now which works really well.

I had a tmj/jaw injury and I wore so many devices, none of which helped me. I eventually threw them all away.

#11

I have one of those water flosser devices that I bought because I also have TMJ problems - a disc on one side is out of place so my jaw cracks and gets sore. My jaw also dislocates on that side if I open my mouth too wide. It's happened six times in the past 15 years, and I always end up having to go to the hospital where they end up having to knock me out to put my jaw back. So I hate opening my mouth and holding it open to floss (or even at the dentist gets sore). I haven't used the water flosser that much because I find it really messy, sprays water everywhere, but maybe I'm just not using it right.

The night guard I have actually seems to help somewhat with the TMJ, probably because I'm not putting so much pressure on the joint. The doctor I saw for the TMJ issues didn't recommend a night guard at the time because he said it would have to be several centimetres thick to relieve all the pressure on the joint, but even he said he saw evidence of me grinding my teeth (and that was something like four years ago).

Thanks for the product recommendation. I find regular toothpastes and mouthwashes make my mouth burn - not sure what it is, some chemical in them maybe, but it's the reason I don't use mouthwash. I'll check out that brand of toothpaste if I can find it.

#12

I think I remember you mentioning that about your jaw, sounds awful, have you tried exercises? That is good the guard helps you!

Here are some links... the flosser I use is called the "air flosser" but it uses water, it's not messy at all once you get the hang of it. It works well for me and it's easier than regular flossing. I also use stimudents.

http://www.usa.philips.com/e/ohc/consumer/cons-range-interdental.html?origin=|mckv|tqhq36oj&pcrid=5516757407|plid|{placement}

http://www.therabreathcanada.com/

You can also make your own toothpastes and rinses which probably be less irritating too- I haven't tried it yet myself, there are tons of recipes online:

http://wellnessmama.com/1772/natural-toothpaste/

http://www.mnn.com/lifestyle/natural-beauty-fashion/stories/3-simple-homemade-toothpaste-recipes

http://blog.organicnaturalbeautydirectory.com/10-easy-diy-mouthwash-recipes/

#13

I haven't tried exercises, mostly just lack of time to look into them. Someone suggested a chiropractor once. The doctor said part of my problem is that because it's happened so many times now the ligaments of that joint are all stretched out and don't provide any protection against it moving out too far.

Thanks for all the links! I would love to make my own toothpaste. Someone said the irritation might be a reaction to an ingredient that's in almost all toothpastes (can't remember the name of it), so making my own would probably help.

#14

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The gum market is in trouble at the moment, but economic growth is poised to return and put the recession behind us. The long downturn in the gum industry is predicted to end soon, with a robust pickup in hiring as school starts and kids start the fall chewing and sticking wads under desks -- a long American and Canadian tradition.

--- huh? What's that?

Oh.

#15

lol...

#16

yw..:-) I think I'm going to try making my own too.