Dear It's your teeth or your gums...,

Dental disease is the most common chronic disease in the United States — nearly 95 percent of residents have tooth decay and/or gum disease. The major culprit in these preventable diseases is dental plaque, a sticky substance composed of millions of bacteria that accumulate around and between teeth. If not removed by effective daily brushing and flossing, plaque can cause tooth decay, gum infection, and tooth loss.

You can check your plaque at home in an easy, inexpensive way. Disclosing tablets, available at pharmacies, contain a harmless red vegetable dye that stains food debris and dental plaque. As the tablets melt in your mouth, hold your saliva and do not swallow. When you spit and then look in the mirror, as you smile, you can spot areas with plaque. Then you can brush your teeth until the stain disappears; in the process, you will be teaching yourself how to brush more effectively. Don't be discouraged if your first few plaque tests are blotchy and red — this will allow you to improve your teeth cleaning until you substantially reduce plaque.

Plaque build-up and, therefore, receding gums can be due to many factors, most of which are interrelated:

• food packed between your teeth and/or under your gums
• inadequate brushing and/or flossing
• stress (a major culprit)
• lowered immune resistance due to lack of sleep
• poor diet
• ill health
• lowered immune system

Options for managing your symptoms and preventing long-term disease are to:

• Rinse your mouth vigorously with hot salt water (one teaspoon of salt to one cup of water) for two minutes, three-times-a-day.
• Use dental floss twice a day — perhaps the best technique for preventing receding gums. Try various types of floss (plain or flavored, waxed or unwaxed, thinner or thicker, etc.) until you find your fave. Floss in front of a mirror so that you can see, to get the floss down the sides of each tooth. Glide the floss along the front, back, and sides of every tooth until it squeaks, even if there's not a tooth next to it, and even if the gums are tender and bleed. Within a few days of flossing daily, you will notice that your gums no longer bleed.
• Brush with soft bristle toothbrushes — hard bristles can encourage receding gums. When you brush, brush your gums as well as your teeth.
• Take an over-the-counter pain killer, as necessary, for minor discomfort of your gums.
• See your dentist every 6 to 12 months for check-ups. If you are at Columbia, visit the Health Services at Columbia website for dental care options for students and their spouses, partners, and children.

Once receded, gums don't grow back on their own. Following the above suggestions, you can maintain your oral health and prevent further gum recession. If your gums have receded to a point where they cause serious pain or other problems, your dentist can help you decide whether or not a surgical gum replacement procedure makes sense. Some herbal and homeopathic treatments may be helpful, but do some research first. Since herbs and homeopathic remedies aren't regulated by the U.S. Food and Drug Administration (FDA), it's important to know the ingredients and side effects of anything you use. Some people give these a try before considering surgery, however speak with your dental care provider before trying any new treatments.

Best of luck getting your oral hygiene regimen going!

Alice

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