Glucose and sugar


BRITISH DENTAL JOURNAL VOLUME 211 NO. 10 NOV 26 2011 I have always found it useful to discuss with patients (and referring practitioners) one simple point which appears to have been overlooked in this paper to date: that recession cannot occur when the bone contours are normal. Physiologically, no amount of vigorous tooth brushing will remove the bone through the gingival tissues, yet a lack of bone is essential for recession to occur. Many teeth simply have an altered crestal bony contour associated with either anatomical variations of tooth position, tooth width and alveolar disproportion, which, combined with the thin gingival biotype, will predispose to recession in the presence of the traumatic and inflammatory factors described. Not all teeth erupt into a ‘perfect’ envelope of alveolar bone; indeed orthodontic treatment to bring them into that envelope can also be associated with spontaneous improvement of localised recession. This lack of basic foundation underwrites and determines the extent of all gingival recession and of course influences the stability of attempts to repair this surgically, although these have been strengthened in recent years by the introduction of regenerative techniques. I have always tried to encourage students and colleagues, when considering their periodontal patients and problems, to ‘look at the outside, but think of the inside’. By trying to conceive the underlying bony anatomy, the effects of the secondary factors contributing to recession become easier to understand and for the patient to appreciate. With that in mind, one might ask your readers to consider whether recession is a sign of health or disease? A. Woodman Portsmouth

DOI: 10.1038/sj.bdj.2011.970

Cite this paper

@article{Beeley2011GlucoseAS, title={Glucose and sugar}, author={Josie A. Beeley}, journal={BDJ}, year={2011}, volume={211}, pages={446-447} }