Do I need fillings for receding gums?

August 13, 2008 8:02 AM

My wife and I went to the dentist yesterday for an exam. This was our first time at this dentist. He said that both of us had some spots of receding gums, and recommended getting fillings to protect the un-enameled areas of the teeth. I'm not sure that I want a filling for something that seems like brushing habits and taking more vitamin-C can fix.

We've never had a dentist offer fillings of this type before, and it seems perhaps a little extreme since neither of us has any real sensitivity issues (other than when being poked with a metal pick). Since I don't believe either of us had terribly bad gums, just a little recession, shouldn't we just brush softer, change our diet, use fluoride mouthwash, etc.? Is it perhaps that over-proscribing fillings is a profit center?

I'm wondering if this type of filling is generally regarded as necessary and urgent to protect our exposed teeth, or if we should decline the procedure, and try out alternatives to see if we can recover our gums a bit - and if next year its still bad, then perhaps consider the fillings.

Any suggestions or pointers to research would be appreciated.

posted by heh3d to health & fitness (14 comments total)

Watching with interest as I have the same issue and am going to the dentist soon. Forewarned is forearmed. or something like that.

also, Previously
posted by ian1977 at 8:17 AM on August 13, 2008

He recommended fillings? I had receding gums on a couple of teeth that they said was actually likely due to a combination of brushing habits (which I have corrected) and grinding my teeth at night (a habit I hadn't realized I had picked up, but sleeping mates have confirmed). The solution for me was a gum graft, which completely fixed one of the recessions and fixed the other enough that it no longer concerned my dentist.

My company covers all my dental expenses, so I didn't care too much about "profit centers", especially when faced with what unprotected, receding gums can look like after a bit. I get very queasy about these sorts of things and even drugless surgery looked like a better deal.
posted by olinerd at 8:29 AM on August 13, 2008

From what I understand, there's really no "fix" for receding gums, aside from grafts. If you correct the brushing etc, it stops the recession, but they don't come back. I was diagnosed with receding gums and was able to stop the recession by using an electric toothbrush instead of heavy handed regular brushing. Still hurts to drink really cold sodas sometimes though.
posted by electroboy at 8:45 AM on August 13, 2008

I just had this kind of gumline filling done on two teeth at my dentist's recommendation. One is fine, the other is now sensitive to pressure from ordinary chewing, when it never hurt before. Not sure what the problem is or what I'm going to do about it now, but kinda wish I'd left it alone.
posted by Tubes at 8:49 AM on August 13, 2008

My dentist put some other kind of coating on my receding gums. He didn't call it fillings. Dunno what it was called though. It's not permanent though; I'm still having problems. He nags me to floss because it will toughen up my gums. I'm a mouth-breather due to anatomical problems, so that's part of the issue.
posted by desjardins at 8:50 AM on August 13, 2008

I had receding gums (they bothered me a little when drinking cold water), and my dentist mentioned the possibility of gum grafts or fillings, but started with fluoride and teaching me how to brush my teeth (you might think that by one's 30s one will have this kind of thing down pat, but I was doing it all wrong). Anyway, that was a few years ago and my gums have stopped bothering me without any more drastic treatment.

Anecdotal, etc., but there you go. And of course, it might also be that your dentist can see from looking at your particular gums that you need fillings.
posted by hattifattener at 9:13 AM on August 13, 2008

I also just discussed this with my dentist, who told me to (a) brush softer, (b) use OTC flouride mouthwash daily, and (c) schedule an annual flouride treatment before getting more drastic. She did mention the possibility of the fillings down the road if it gets worse, but I'm hoping to prevent that. For what it's worth, she explained to me how they use a measuring tool to calibrate the recession. I don't know what the unit of measure is, but my gums are mostly "2"s with a couple of "3"s. She mentioned that the higher the number, the more serious the recession.

That being said, it's true that dentists seem to make wildly different recommendations based on their experience and preferences. A second opinion never hurts. It's important to find a dentist you basically trust. I like ones that can tell you the research and educate you a bit - it helps convince me there is a basis for their recommendations. Maybe you could ask for a more detailed explanation, other options, prognosis if you don't do it, etc.
posted by Miko at 9:41 AM on August 13, 2008

I have receeding gums due to overzealous/incorrect brushing. My dentist told me to get an electric toothbrush (best $100 I ever spent--Rotadent--lifetime warranty) and potentially to get a gum graft.
I would get a second opinion--many health plans will pay for this. Even if not, it's worth the exam fee if you are considering any type of expensive procedure.
posted by FergieBelle at 10:02 AM on August 13, 2008

I think this is fashionable these days. My dentist wanted to do gum grafts on BOTH me and my husband because of receding gums. He explained it as, you have no problems now, but you MIGHT. Uhhh, yeah. I don't sign up for procedures that cut healthy tissue for something that MIGHT be a problem in the future.
posted by agregoli at 10:19 AM on August 13, 2008

gums don't grow back. you can stop the recession, but you can't make them grow back.

frankly, it depends on your sensitivity level. my teeth are EXTREMELY sensitive due to gum loss, and i would love to get fillings on some of them, but i can't afford it.

instead, every 6 months i get a "desensitizer medicine" painted on my teeth. it helps a little for a few months but it wears off. that costs $50. blah.

at any rate, if you're not having any pain and your teeth/gums don't have that nasty receding look, i don't think it's totally necessary. but, maybe your dentist can tell you'll have problems down the road and is looking to save you some pain and money.
posted by misanthropicsarah at 11:06 AM on August 13, 2008

My gum problems showed up a decade ago when I was in college and stressed out and brushing too hard. They used to hurt all the time. I'd quit sugary or cold drinks because of sensitivity.

It took about three years before my dentist would do side fillings for me - she insisted that I do more fluoride and learn to floss every day and use a more gentle toothbrush first. None of those things helped. My gums did not grow back and at this point, given it's been a decade, they probably won't. On the other hand, they aren't getting worse anymore.

The side fillings do fall out once in a while (because of the funny angles, sometimes it's hard for them to push the putty into place with enough force), but my teeth don't hurt all the time anymore. I love them, and don't even mind paying to redo it. It's not too terribly painful or time consuming to put them in - it's not anywhere near as bad as getting a cavity filled. It's a fairly minor procedure - last time I needed one replaced, they just did it as part of my cleaning visit. They didn't know before I came in that it would need done, either.

Have you asked your dentist if you can try the other things for six months or a year?
posted by arabelladragon at 11:06 AM on August 13, 2008

what about flossing?
posted by muscat at 11:19 AM on August 13, 2008

I went to the dentist last week and had the same thing done; mine were mostly twos and threes, with a few fours that prompted my hygienist to tell me to start flossing every day. According to her, I was still at a point where I could improve things through flossing and not grinding my teeth. They didn't even bring up the idea of fillings to protect my gums, only that if I didn't shape up I might need a gum graft. I would think getting a second opinion might be a good idea, and re-evaluating how satisfied you are with your current dentist.
posted by MadamM at 11:30 AM on August 13, 2008

If it isn't all that cost prohibitive, you may wish to consider at least one of you going to another dentist for a second checkup/opinion. Not all dentists are equal when it comes to what's best for you vs. what's best for their Porsche fund.

Case in point, about 6 years ago we took my daughter for a checkup to her regular pediatric dentist even though it was a fair distance away (we'd moved since she started going there and the ex and I had split up). Lo and behold, the daughter has 6 cavities, and they're quite serious. This isn't something they'd handle through a regular office visit since the daughter doesn't like needles and the whole dental visit's freaking her out, they're thinking we should go for full sedation, book a time, there's the anesthesiologist to factor in, etc. etc. etc. Estimate of over $2500. So, that was a bit of a shock.

Just for a whim, we took her to a new dentist about 5 blocks from where the ex moved to. An hour and a half later, she's done. New dentist tells us, yes there were 6 cavities, but 5 of them were on her baby teeth which should be dropping out any time now, in fact one tooth with 2 cavities on it seems to be a tiny bit loose already, and the 6th he was able to drill and fill without even needing freezing since it was so innocuous. $300 was the bill. And her teeth have been great since.

So I was more than a little pissed off that the other "kids" dentist wanted to subject my daughter to general anesthetic to help pad his bill. You may want to see if a similar thing is occurring here.
posted by barc0001 at 11:36 AM on August 13, 2008