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Periodontics/determining cause of gum recession


I'm a male 43, never smoked, in good general health and not taking any medications. Can a dental hygienist or dentist know just from looking in a patient's mouth and seeing gum recession that this recession is caused by periodontal disease and not brushing too hard with toothbrush or by clenching.
Is there a difference in appearance of recession caused by periodontal disease than that caused by overly brushing gums? What test does a hygienist or dentist perform to conclusively say that gum recession is caused by periodontal disease?
If one has periodontal disease what non-surgical methods do you consider to be best? How do you feel about laser surgery?
By the way, is gum recession a normal aspect of aging?

Yes, an experienced periodontist can know the cause of gum recession just by looking in a patient's mouth. Looking in the mouth includes some probing of the gums and periodontal pockets as well as a variety of other measures needed for the evaluation of periodontal health. The periodontist also looks at x-rays and compares their details to what is present in the mouth.

A very experienced hygienist might also be able to tell the reasons of gum recession by similar means.

Periodontal disease never causes only gum recession. There are always other signs of the disease that the periodontist is able to identify.

Asking how the periodontist makes the diagnosis of periodontal disease is like asking a violinist to tell how Chopin is played. Even if the details of the procedure would be listed, the completion of the act is going to remain incomprehensible to the layman. Periodontal expertise takes a lot of learning and experience. If diagnosing a disease could be explained just by listing the "tests" and techniques, then we would have a machine doing this.

The shape and height of the gum line depends on the thickness of the gum itself and the underlying bone as well as on the shape and position of the teeth. Gum recession might result just because the gum is thin and because bone is absent to begin with underneath it. The slightest amount of biting overload or too hard brushing might cause gum recession in such a situation. On the other hand, with advancing age most people get some gum recession and it is usually not possible to itemize the reasons for that.

Periodontal disease is treated non-surgically by cleaning and polishing the teeth and by motivating and teaching the patient to clean the teeth properly at home. There are innumerable other details involved in such a treatment but this is the core. The bad bacteria must be eliminated so as to give the oral environment a chance to heal and develop a bacterial balance that supports health.

Laser-surgery is one of the techniques that the periodontist might use. It is not better or worse than other techniques. The goal is to eliminate the bad bacteria.


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Marketta Hormia, DDS, PhD


I am a periodontist living and working in Helsinki, the capital of Finland, where I have my private dental practice. I am an international member of the American Academy of Periodontology. I have a Ph.D degree and a long background in research and teaching at the University of Helsinki and at the University of Turku, Finland. I function as an adjunct Professor at these Universities. I have also worked as a visiting scientist at the Scripps Clinic and research Foundation, la Jolla, CA. I can answer any question in the fields of dentistry and periodontics.


Private practitioner in Helsinki, Finland over 20 years. Former researcher and teacher at two Finnish Universities.

The Finnish Society of Dentists, Division of Periodontology, American academy of Periodontology

Over 30 scientific research articles published in peer-reviewed international scientific journals (can be found on PubMed)

D.D.S., Ph.D, Specialist in Periodontology. Adjunct Professor.

Awards and Honors
Visiting Scientist at the Scripps Research Foundation, San Diego, California, 1992-1994. NIH grant

Past/Present Clients
Dental patients, national and international. All kinds of dental, oral and temporomandibular joint problems

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