How to Reduce Damage to your Gums Caused by Tooth Brushing

The gums in some patients shrink back quite dramatically over the years – sometimes over a few months -and yet in others, they go for decades without any apparent wear and tear on the gums. Why the difference? What are some people doing that others don’t?  I have asked patients what sort of tooth brushing technique they used and reached some conclusions which I will share below. it should be said  though that Shrinkage of the gums is not necessarily all about tooth brushing technique.  Some people are born unlucky with very thin fragile types of gum and they are probably going to get some shrinkage or wear back no matter what they do – which gives rise to the saying “ long in the tooth “…..but if you want to reduce it consider these tips:

The Length of the Brush Stroke

The length of the stroke is in my opinion the key determinant of how much the gum will wear back. The people that I’ve seen the most dramatic or rapid wear of the gums appear to have a stroke that is approximately 2 to 4 cm. This translates into a fair amount of dragging and scratching of the bristle tips on the gum. I recommend a 1 cm length of stroke which produces a shorter and arguably less abrasive 2 to 3 mm of bristle tip movement on the gum – just enough to remove the plaque and no more.

Using a Ridiculously Hard Brush

The other factor that affects gum wear is using a ridiculously hard brush. Most dentists recommend a soft brush for this reason.  A hard brush is like a bed of nails as far as the gum is concerned.  And when you use it with a long stroke and plenty of pressure you can kiss goodbye to several millimetres of gum.  There is not a lot of science to prove that a medium bristle with a short-stroke causes any problem but most dentists err on the safe side and recommend soft only. Some people feel that that does not clean their teeth properly so if you insist on using a medium make sure you use a short vibrating type of stroke … Look in the mirror and confirm it is not much more than 1 cm …rather than a long steam train style four centimetre. How hard you should push on the brush will be the subject of another hint, but as a teaser, I will mention a brief anecdote. When I commenced practice I saw a dental history form from the American Dental Association. It had some good questions – two of them were:

1. Do you brush your teeth vigorously or lightly?
2. Do your gums lead when you brush? 

I made up my own patient record card with these questions and I was shocked at the answers and the conclusions that I reached were the exact opposite to what I expected from my undergraduate training. I expected the correct answer was likely and that would mean your gums didn’t bleed because you were being nice and gentle. How wrong I was! There was an overwhelming preponderance of peoples gums not leading when they brushed vigorously. Bingo! From then on I figured vigorous brushing is a good thing as long as the length of the stroke is short and the bristle is not too hard. But how to tell what is vigorous and how hard to push – that will be in another hint.