My dental hygienist was really hyping me up this last trip to the dentist to check in on progress since my deep cleaning (scaling and root planing). She was super stoked that my gum depth pockets had improved significantly (from 5 and 6s back to majority 2s and 3s). These pockets measure the depth between your gums and teeth, essentially showing how well your gums are attaching to the teeth. Shallow pockets are important because they indicate healthier gums and less risk of issues like gum disease or tooth loss.
I had a deep cleaning three months ago. It was definitely intense, but manageable (though I’d prefer to never have one of these again). And followed it up with a round of antibiotics to continue to fight the bacteria beneath my gums. Here’s what’s changed since my last appointment, what I’m still doing, and how I hope to tackle my teeth grinding.
Gum health potential game changers
I continued to keep up my existing dental habits, but my deep cleaning in addition to a new toothpaste may have helped with added improvement. I’m worried about making adjustments that will make my gum health worse, so I’m hesitant to change or tweak. Below is a full summary of my dental health choices:
Flossing
Obviously! I have been flossing consistently for years, but I was still impacted by periodontal disease. I use string floss. I have heard water picks are good for only certain types of mouths/teeth, but my hygienists said string flossing would likely still be best for me.
An electric toothbrush and switching the toothbrush head on time
Using an electric toothbrush helps to prevent over-brushing (which can lead to gum recession). Because you just guide the toothbrush over teeth vs. manual pressure, it reduces the risk of added recession due to brushing and also still helps to remove plaque. Many electric toothbrushes also have features like pressure sensors to signal when there is too much pressure while brushing. Mr. Nacho and I both invested in a Philips Sonicare DiamondClean electric toothbrush.
Switching the toothbrush head on time (don’t be stingy)
I used to stretch out changing my toothbrush head for way longer than recommended to try and get the most out of the head and save money. BUT now I swap it as soon as I get the notification by my toothbrush that it’s time to change it (every 3 months).
All toothbrush bristles harbor bacteria over time. Moist environments like bathrooms are ideal for bacteria growth, and old bristles can hang onto that bacteria, reintroducing it to your mouth each use. Regularly changing the head helps ensure you’re not undoing all good hygiene efforts with a dirty brush.
Paradontax toothpaste
Paradontax was recommended by my hygienist to start using after my deep cleaning in case there was bleeding from gums. I did not experience any bleeding, but continued to use it. I don’t know if this has been majorly impactful to my gum health improvement, but I don’t want to risk changing what’s working, so I will continue to use this brand. Some people may not like the taste- it is less minty and more medicinal/herby tasting (but I don’t mind!)
Mouthwash every night
After my deep cleaning, my dentist recommended Closys every night as a mouthwash which I followed. It’s much gentler than alcohol-based mouthwashes. It is not minty like traditional mouthwashes, so it also takes some getting used to. I was only able to find this locally at one of the two grocery stores I searched.
After two months or so my hygienist suggested I switch back to regular mouthwash and use Closys only one or two times a week. She mentioned that consistently using this mouthwash every night for a long period of time could result in some sort of undesired effect (I can’t quite remember the specifics here but I do remember her saying only 1-2 times per week).
Grinding, gum recession, and what’s next
While I’ve made great progress with my gums, nighttime teeth grinding is still an ongoing challenge. The wear and tear from years of grinding still continues to leave its mark, as my dentist recently pointed out recession notches (small grooves near the gum line caused specifically by the pressure of grinding). These notches result from enamel erosion, and unfortunately, cannot be reversed.
Even with a custom night guard from my dentist, I’m still dealing with the effects of grinding and clenching at night. For the record, a dentist-issued night guard provides far better protection than the over-the-counter or Amazon options I used for years. If you can afford it, I strongly recommend investing in a night guard directly from your dentist. It is absolutely worth it and I wish I had gotten one earlier than a few years ago.
The mechanics behind teeth grinding
Teeth grinding, or bruxism, contributes to gum recession through a combination of excessive pressure and strain on the surrounding tissues.
Teeth grinding generates an immense amount of force, which is transferred to both the teeth and surrounding gums and bone. Over time, this constant pressure can cause the gum tissue to pull away from the teeth, leading to recession. The gums essentially “retreat” in response to the trauma.
Bruxism can also cause enamel erosion due to the repetitive force exerted, particularly near the gum line. This can create notches or grooves (also called abfractions) where the tooth meets the gum, further weakening the gum’s attachment to the tooth.
These are what the dentist has shared as options to address the issue:
Botox for the masseter muscles
Botox relaxes the jaw muscles that cause clenching and grinding. The interwebs notes that it can be anywhere from 15 to 50 botox units needed per side.
- Pros: Non-invasive, quick results, and reduced jaw tension. Cosmetically, masseter botox could also decrease the size of your jawline due to the relaxing of the muscles
- Cons: Temporary (typically lasts 3-6 months, meaning you need to continue to get this for upkeep) and can be pricey. Another risk is that if you don’t have a very experienced professional inserting botox into your masseters, it could change how your smile looks if injected incorrectly. Every insurance provider is different, but it’s possible masseter botox would not be covered
- Cost: Typically around $400–$700 per treatment ($10-15 per unit)
Given that botox seems to be only a short-term solution, it is unlikely that I’ll pursue this route.
Orthodontics (Invisalign and beyond)
A misaligned jaw can contribute to teeth grinding by causing uneven pressure on the teeth and jaw muscles, making the body attempt to compensate by clenching or grinding the teeth to achieve proper alignment.
Aligners like Invisalign correct bite issues that contribute to grinding.
- Pros: Long-term solution for jaw alignment, reduced teeth grinding due to better teeth alignment, and could reduce notching over time
- Cons: Expensive and a longer process (12-18 months, usually)
- Cost: Invisalign and braces seem to both be within the same range of $2,000–$9,000 with a majority of costs between $5-6K
Some dental plans may cover a portion of adult orthodontics, so it’s worth checking with your provider or plan. For example, the more expensive dental plan offered by my employer covers 50% of adult orthodontics, but it also has a $1,500 annual limit on dental care. This means that any additional dental services I need throughout the year would count toward that $1,500 maximum.
Despite the cost, I am more seriously considering pursuing Invisalign next year. I have heard there are financing options for Invisalign if needed as well.
Wrapping it all up
This latest check-in with my dentist reminded me that small, consistent changes can add up over time. I’m happy about the progress I’ve made with my gums and I hope to tackle my teeth grinding some time next year before it leads to bigger problems.
If you’re in the same boat, my advice is basically: don’t wait. Whether it’s investing in a custom night guard, exploring orthodontics, or tweaking your routine, these steps can save a lot of trouble (and money) down the road.
