Gum recession, medically known as gingival recession, is a common condition where the margin of the gum tissue moves away from the tooth crown, exposing the root surface beneath. This gradual process often goes unnoticed until the exposed area becomes sensitive or the teeth appear noticeably longer. Understanding the causes and consequences of gum recession is important for protecting long-term oral health.
What Causes Gum Recession
Gum recession is often the result of a combination of mechanical trauma and biological disease processes. Aggressive or improper brushing technique represents a significant form of mechanical trauma, where excessive force or the use of a hard-bristled toothbrush physically wears away the delicate gum tissue over time. This kind of abrasion can cause the gum line to recede.
The primary biological driver of recession is periodontal disease, a bacterial infection that causes inflammation and the destruction of the supporting tissues around the teeth. Plaque and tartar accumulation below the gum line harbor bacteria that release toxins, triggering an immune response. This response breaks down the connective fibers and the underlying alveolar bone. The loss of bone support often results in the apical migration of the gum tissue, leading to recession.
Genetic predisposition plays a role, as some people naturally have thinner or more fragile gum tissue, making them more susceptible to recession. Misaligned teeth, or malocclusion, can cause uneven biting forces that stress the gum and bone, contributing to tissue breakdown. Furthermore, habits like teeth grinding (bruxism) and friction from lip or tongue piercings can also physically injure the gum margin.
How Recession Leads to Tooth Instability and Loss
The gum tissue and the underlying alveolar bone work together as the primary support system, anchoring the tooth within the jaw. When the gum recedes, it exposes the root surface, which is covered by a soft material called cementum instead of the protective, hard enamel that covers the crown.
Exposed cementum is softer and more porous than enamel, making the root highly susceptible to decay (root caries) and erosion. This creates a pathway for bacteria to penetrate the tooth’s interior, leading to potential infection and eventual structural failure. The recession often correlates with the degradation of the alveolar bone, which is the actual foundation holding the tooth. The loss of this bone structure reduces the surface area that supports the tooth, leading to increased tooth mobility. As the bone deterioration progresses, the tooth loses its secure anchor, eventually becoming so loose that it may require extraction or fall out naturally.
Identifying and Measuring Gum Recession
Gum recession is often a subtle process, with the first sign noticed by the patient being increased tooth sensitivity or the appearance of teeth that look “longer” than before. A visible notch or indentation near the gum line is another common sign that the soft tissue has pulled back from the tooth surface. The exposed root surface can also appear yellower than the white enamel crown because cementum has a different coloration.
A dental professional quantifies recession using a specialized instrument called a periodontal probe. The probe measures the distance, in millimeters, from the cementoenamel junction (CEJ) to the gingival margin (the edge of the gum tissue). The CEJ is the boundary where the enamel of the crown meets the cementum of the root. A positive measurement indicates true recession, showing the exact distance the root has become exposed. Regular measurement of this distance allows the dental team to track the progression of the condition and determine the urgency of intervention.
Corrective Treatments for Receding Gums
Management of gum recession is to address the underlying cause, which often involves modifying damaging habits like aggressive brushing or treating periodontal disease. For cases involving active disease, a non-surgical deep cleaning procedure called scaling and root planing is performed to remove plaque and tartar from below the gum line. This removes the bacterial source of the inflammation and allows the gum tissue to become healthier, which can stop the recession from worsening.
For more advanced recession where the root is significantly exposed, surgical procedures are often necessary to restore tissue coverage. These procedures, collectively known as gum grafting, aim to cover the exposed root surface and increase the thickness of the gum tissue.
- The connective-tissue graft is the most common, involving harvesting tissue from beneath a flap on the roof of the mouth and stitching it over the exposed area.
- A free gingival graft involves taking a small amount of tissue directly from the palate’s surface and is often used when a thicker band of gum tissue is needed to reinforce the gum line.
- For patients with sufficient neighboring tissue, a pedicle graft involves partially cutting a flap of gum from an adjacent area and stretching it over the recession site while keeping one edge attached for blood supply.
- Alternatively, donor tissue can be used in an allograft procedure, avoiding the need to harvest tissue from the patient’s palate.