Muhammed Bahadır Olcay

The honest answer: gum that has receded does not grow back on its own. Once the gum has dropped to that level, no cream, paste or mouthwash will make it climb again; treat products that raise that expectation with caution.

But that does not mean nothing can be done. First we find the cause of the recession; whether hard brushing, gum disease, the position of the tooth or clenching is at work, we deal with it, because as long as the cause remains, everything else stays temporary. And in suitable cases the receded area can be covered surgically with soft tissue grafts; that is squarely within my specialty.

Not every recession is suitable for graft coverage; I can only say after an examination, looking at the type of recession and the state of the tissue. So if you have noticed your gums receding, come early: in the early period it is far easier both to stop the progression and to make use of the surgical options.

The thought that an implant cannot decay and therefore cannot cause trouble is one of the riskiest misunderstandings about implant treatment. The implant itself does not decay, that is true; but the gum and bone that carry it obey the same biological rules as the tissues that carry a natural tooth. When care lapses, the tissues around an implant can become inflamed too, and as that inflammation advances, the bone holding the implant begins to melt away.

What is worse, this picture progresses quietly; because an implant gives no early warning like the ache of decay, the patient usually notices the problem late. That is why I tell my implant patients the same thing as their treatment ends: an implant does not end your duty of care; on the contrary, it obliges you to build the habit of regular cleaning and check-ups. The life of an implant is decided as much by the care shown in the years that follow as by the operating table.

When the loosening in their teeth increased, a patient came to us with the decision already made: all of them would come out and a denture would be made. Both their mother and their father had lost all their teeth at around the same age, they said, and now their turn had come. To them a loose tooth was a lost tooth; there was nothing to talk about, they were only looking for someone to do the procedure.

The examination and the films showed a different picture: yes, there were teeth that truly could not be saved, but a significant share of their teeth could be kept standing with treatment. I explained that loosening is not always the end of the road, and that once the inflammation is brought under control some teeth firm up again. Convincing them was not easy; the picture they had watched in their own family was more real to them than anything I said.

We agreed on a staged plan and completed the periodontal treatment; for the teeth that could not be saved we planned a separate solution, but they came out of that process with their own teeth in their mouth. What stays with me from this case is this: some patients carry tooth loss not as a disease but as a fate. Part of our job, before any treatment, is to open that fate up for discussion.