Am I Brushing Too Hard?

recessionQ. My dentists over the years have told me that my gums are receding and that my teeth have notched near my gums because I am brushing too hard.  I don’t think that I brush too hard.  How do I know if this is the reason for my worsening condition?

A.  While heavy handed brushing can cause this, it is only one of many scenarios that can produce these symptoms:

  • Tooth decay – The gumline is one of the most common places for plaque and debris to accumulate.  If the teeth are not kept clean, this area can decay.  When decay is near the gumline, the gums will become inflamed and can cause the gums to recede over time.
  • Tooth wear – Heavy-handed brushing (toothbrush abrasion) is blamed for much of the loss of tooth structure near the gumline. While this can cause tooth wear over time, this has historically been linked to stiff bristle toothbrushes.  Virtually all toothbrushes today are made with soft bristles that prevent toothbrush abrasion under otherwise healthy conditions.
  • Unbalanced bite – Teeth work best when they share the force of the bite evenly.  If the bite is not balanced, teeth can begin to show signs of this increased pressure.  This can include cracking, severe wear, and notching near the gumline known as abfraction. An unbalanced bite can also caused increased gum recession.
  • Acidic oral environment – Acid reflux, bulimia, acidic beverages, medications, and recreational drugs can all create an acidic environment in your mouth.  This effectively softens the enamel of your teeth and can allow normal brushing to wear the tooth more quickly.
  • Periodontal Disease – Gum disease causes bone loss and gum recession over time.  This exposes the root surfaces of the teeth which are much softer than enamel and, therefore, more prone to wear.

Each of these scenarios has clinical signs that your dentist should be able to recognize.  It is also rather common for more than one of these factors to be present at the same time and contribute to the loss of tooth structure. Regular dental visits will help catch and rectify these scenarios before they get out of hand.

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