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MMC Does gum disease rule out teeth whitening?

Tribune Media Services

DEAR MAYO CLINIC: Everyone I know is getting their teeth whitened, so I started thinking about it. I'm 60, and a lifelong coffee drinker and former smoker. My teeth are quite stained. When I asked my dentist about it, he said that my gums are too receded for the procedure to be comfortable for me, and also said I should see a specialist about my gums. What causes gum recession, and can it be stopped or reversed? And is there a way for me to whiten my stained teeth?

A: Manufacturers continue to improve the whitening products available over the counter and through the dental office. I suspect that your dentist is concerned about the possibility of some tooth sensitivity or discomfort if the bleach is applied to root surfaces. Many patients can tolerate the bleaching products even if they have exposed roots. If your teeth become sensitive when using bleaching products, they usually will feel better soon after stopping the product.

It was your dentist, not you, who expressed concern about your gums. Because of this, I am curious if you have experienced any symptoms of gum problems, such as swollen, bright red, tender gums; new spaces developing between your teeth; pus between your teeth and gums; or persistent breath order or bad taste in your mouth.

Gums can recede for various reasons, including vigorous or overzealous brushing, especially with a hard-bristle toothbrush. The gum disease periodontitis also is a major cause. Periodontitis is a serious infection that destroys the soft tissue and bone that support your teeth and eventually might cause tooth loss.

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Gum disease occurs when bacteria build up between your teeth and gums, leading to irritation, inflammation and bleeding. In the early stages, gum disease is treated with simple oral hygiene -- daily brushing, flossing and regular professional cleanings.

If not treated early, gum disease can progress to periodontitis, a condition in which pockets of plaque, tartar and bacteria develop between your gums and teeth. At this point, it's difficult -- and eventually impossible -- to adequately clean with a toothbrush or dental floss.

Some treatment options for pockets that are more than 3 millimeters include scaling (removing bacteria and tartar from beneath the gums), root planing (smoothing out the root's surface), antibiotic therapy and surgery. Uncontrolled gum inflammation and infection can lead to bone loss, loosening of teeth and tooth loss.

Paying regular attention to gum health is a key component of good oral hygiene. It's important that you get a periodontal examination to measure pocket depth each time you visit your dentist. Deep pockets -- those that measure more than 3 mm on the probe -- are obviously cause for concern.

-- Dr. Phillip Sheridan, Dental Specialties, Mayo Clinic, Rochester.

To e-mail a question, go to www.mayoclinic.org, or write: Medical Edge from Mayo Clinic, c/o TMS, 2225 Kenmore Ave., Suite 114, Buffalo, N.Y., 14207. For health information, visit www.mayoclinic.com.

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