Maintaining adequate oral health is quite challenging, particularly in old age. Aging and other health conditions can make people more vulnerable to dental problems. A lifetime of chewing, grinding, gnashing, inadequate dental nutrition, poor dental care or eating habits, and a general wear and tear combined with medications and other medical conditions can cause oral health problems in older adults. These issues may result in significant tooth pain, tooth decay, gum infection, inflammation and bleeding in gums. Gum recession is a common geriatric dental problem that occurs when the gums recede or wear away, exposing the pink tissue that covers the root of the teeth. When gums recede, gaps can form between the gum and tooth, allowing disease-causing bacteria to build up. Also, called receding gums, the condition occurs due to poor oral health, which may in turn lead to tooth loss. Treatment modalities for the condition depend on the severity of tissue loss. If left untreated, the surrounding tissue and bone structures of the teeth can be damaged, sometimes resulting in tooth loss. Billing and coding different oral, dental conditions can be quite challenging. Dental billing service providers who are knowledgeable in the dental codes and related guidelines can easily manage the coding and claim submission processes for dentists.
As per reports from the World Health Organization (WHO), between 15 and 20 percent of adults have severe gum disease. Early identification of symptoms and other associated risk factors that lead to gum problems can help prevent these conditions in the long run.
Causes of Receding Gums
There are many factors that can cause the gums to recede and these include – periodontal or gum disease (infection and inflammation of the gums and other structures in the mouth), poor oral hygiene, aggressive brushing over the long term, hardened plaque buildup (tartar), smoking or the use of any tobacco product, family history of gum disease, diabetes, hormonal changes in women, crooked teeth, bridges or partial dentures (that no longer fit), use of medications (that cause dry mouth) and certain immune disorders. However, age is one of the primary risk factors that lead to gum recession. Reports from MedicalNewsToday suggest that about 88 percent of people older than 65 years have a receding gum in at least one tooth. In addition, when compared to men, more women tend to develop receding gums.
Symptoms of Receding Gums
In most cases, the condition does not display any specific symptoms at an early stage. As the condition progresses, patients may experience certain symptoms like –
- Bleeding after brushing or flossing
- Bad breath
- Exposed tooth roots
- Loose teeth
- Pain at the gum line
- Red, swollen gums
- Visibly shrinking gums
- Changing appearance of tooth (as the tooth appears longer and the space between teeth increases)
- Sensitivity to cold and heat due to exposed tooth roots
In most cases, receding gums can be an early symptom of an underlying dental problem like gum disease and therefore can increase the risk of tooth decay and tooth loss.
Diagnosing and Treating Gum Recession
Diagnosis of this condition begins with a detailed physical examination to identify the key issues affecting the gums. A dentist may use a probe – a process that uses a small, painless ruler – to measure gum pockets. According to the National Institute of Dental and Craniofacial Research, normal pocket sizes range between 1 to 3 millimeters and anything larger is a sign of gum disease.
Generally, most cases of mild gum recession do not require any specific treatment. Dentists or periodontists may provide suggestions for gentle brushing and to monitor the gums. Treatment for receding gums depends on the underlying causes and can help reattach or restore gum tissue around the teeth. Common treatment modalities include – scaling and root planing (to remove plaque and tartar from below the gumline), composite restoration (uses tooth-colored composite resins to cover the surface of the root) and using desensitizing agents, varnishes, and dentin bonding agents. If an infection is found in the gums, antibiotics may be prescribed by dentists. Medications like – topical antibiotic gel, enzyme suppressants, antiseptic chips and antimicrobial mouthwash may also be used to treat the underlying problem that is causing gum recession. If the initial treatment modalities do not yield in the desired results, a dental surgeon may suggest surgery for severe cases of receding gums. Common surgical options include – flap surgery and grafting. Regarded as a deep tissue cleaning, flap surgery help reduce bacteria and tartar buildup within the gums. As part of surgery, the periodontist lifts up the gums and then puts them back in place when the procedure is over. Gum graft surgery (GGS) is recommended for persons whose gums have severely receded. The procedure also helps prevent bone loss and the gums from receding further, and protects the previously exposed tooth roots from decay. Also, Pinhole surgical technique (PST) is a relatively new and minimally-invasive treatment for mild to moderate receding gums. PST involves making a tiny hole in the gum tissue above the exposed tooth root. The dentist will insert a special tool into the hole to separate the gum from the tooth and stretch and reposition the gum back over the exposed tooth root.
Dental medical billing and coding involves using the specific ICD-10 codes to report various dental conditions such as gum recession on the medical claims providers submit to health insurers. In addition to billing and coding, dental insurance verification and pre-authorization services are crucial to verify the patient’s coverage. ICD-10 diagnosis codes for gum recession include –
- K06.0 Gingival recession
- K06.01 Gingival recession, localized
- K06.010 Localized gingival recession, unspecified
- K06.011 Localized gingival recession, minimal
- K06.012 Localized gingival recession, moderate
- K06.013 Localized gingival recession, severe
- K06.02 Gingival recession, generalized
- K06.020 Generalized gingival recession, unspecified
- K06.021 Generalized gingival recession, minimal
- K06.022 Generalized gingival recession, moderate
- K06.023 Generalized gingival recession, severe
It is estimated that periodontal diseases such as receding gums are responsible for about 70 percent of adult tooth loss. If treated at an early stage, the outlook for early stages for gum disease can be good. Once the gums have receded, they cannot grow back. However, some treatments can reattach and restore gum tissue around the teeth. Maintaining good oral hygiene and attending regular dental checkups can help prevent, slow, or stop gum recession.
Billing and coding for dental disorders can be a challenging process. For accurate and timely medical billing and claims submission, healthcare practices can outsource their billing and coding tasks to a reliable physician billing company.
Amber Darst is our Solutions Manager in the Healthcare Division, Practice and RCM. With a rich background in dental services, her expertise ranges from insurance coordination to office management.