Q.
Dear Dr I am 34 years old and, from 2006 onwards, have been experiencing gum recession on the gums of the upper and lower jaw, from the incisors back. There is some root exposure on two teeth on the lower jaw. I have always looked after my teeth and my current dentist describes me as one of his best patients. He attributes the recession to overbrushing. Until recently I suffered from anxiety disorder and I suspect this may also have contributed, as I often clenched my teeth in my sleep (and sometimes still do). Following a phase of underbrushing due to my worry about the recession, I had a tutorial with my dental hygienist to ‘relearn’ my brushing technique and, since November, I have also been flossing, more or less on a daily basis. I am doing my best to ensure that I brush and floss as thoroughly but also as carefully as possible. However, the recession does not yet appear to have stabilised and I am very concerned about the long-term health of my gums and teeth, as well as about the aesthetic aspect. Is it likely that, despite my efforts to brush and floss carefully and thoroughly, an inadquate technique is still causing recession, especially where the flossing is concerned (on a few occasions the tape slipped and caused bleeding)? Or is it more likely to be the ongoing product of past overbrushing in my teens and twenties? Also, would you recommend that I obtain a second opinion, either from another dentist or from a peridontal specialist? I am very worried that I am may not be getting appropriate advice or treatment and am anxious to prevent the problem getting worse. I have begun to consider cosmetic treatment but I understand, of course, that treatment and prevention of underlying causes are of primary importance. I am a junior academic on a modest salary and therefore somewhat restrained in terms of funds. Nevertheless, I am willing to make a significant investment (timewise and financially) to deal with my problem. If you are able to recommend a respected dentist I would be immensely grateful (I live in Aberystwyth, west Wales, and I currently visit a private practice in Newtown). I would also be prepared to visit your own practice. Any advice or recommendations you are able to give me would be greatly appreciated.