Q. How to control gingival recession caused due to esophageal hernia and acid reflux?

Answered by
Dr. Tooba Qazi
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Mar 14, 2020

Hello doctor,

I am a 49-year-old female. I weigh about 62 kg and my height is 168 cm. I have a long time problem with receding gums on all my teeth. The teeth are quite tight also. I have also had esophagus hernia for many years and the stomach does not close properly and this makes it so that I feel the effect of my stomach acid like heartburn. It is very unfortunate for the teeth because it also changes pH in my mouth and makes it acidic. This happens especially when I sleep at night since I feel some dull pain in my teeth at night or when I wake up in the morning.

I am trying to do something so I take the medicine that hinders acid production before I go to bed (Prazol) and I also rinse my mouth with water whenever I wake up even at night. Still, I think this acidity weakens my gums and teeth. The tooth that is in the picture has been fixed a few times with neck filling but now I feel there is some inflammation there that causes pain and the gum is very sensitive. I can hardly brush this tooth. I have an ointment that I started to use yesterday, it is called Carident and is made of Framycetini sulfas, Papainum and Natrii benzos.

Do you have any recommendations on what I should do? I could go to a dentist to try to put a new neck filling but I am afraid that the gum has gone so low already that there is not enough of it left to put another filling. I am not even sure what will happen when I have this tooth extracted if it will be possible to make up for the hole in the gum. I am quite worried about it.

Dr. Tooba Qazi

Dentistry
#

Hi,

Welcome to icliniq.com.

I checked your query and attached files. (attachment removed to protect patient identity).

I can totally understand the situation you are going through. The best part is you know the root cause is stomach issue, you are doing best and accurate already to keep the pH maintained. I would like to add some points.

1. Do saline water mouth rinses instead of normal water rinses. Take a pinch of salt in a half cup of lukewarm water and do its rinse before sleeping and after breakfast. Do it for one week. This is the best remedy by book and by practice so far for strengthening the gums, as healthy gums will grow they will attach to tooth more firmly.

2. Change your brushing habit. Do brush with very light hand pressure. This canine tooth root exposure as is evident in the picture clearly indicates that while brushing unconsciously more pressure or harsh brushing is done at this corner of the mouth, so if this is the case try breaking down your habit. This will prevent gum from going down further.

3. At this stage, extraction is not recommended. Take Brufen 400 mg twice a day for three days. This will cover the inflammatory condition at the gum line of this sensitive tooth. Now get slight scaling done of this area and get neck filling done again. This will save the tooth. Do not brush this area as it is very sensitive.

4. Oral gel: Revomet Plus (Metronidazole and Chlorhexidine gel) can help with swollen gums. Put at the affected part thrice a day for five days. Do all these recommended things and please give me followup after five days.

I hope this helps.


The Probable causes:

Acidic pH of mouth due to stomach problem and hard brushing habit.

Investigations to be done:

It would be very helpful if a PA x-ray is done of lower right canine.

Differential diagnosis:

1.Filling.
2. RCT (root canal treatment).

Probable diagnosis:

Filling and scaling.

Treatment plan:

Medications plus scaling followed by filling.

Regarding follow up:

I need follow up right after five days.


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