Receding gums occur when the margin of the gum tissue pulls back, exposing the root surface of the tooth. This gradual process often leads to increased tooth sensitivity and makes the root more vulnerable to decay, as it lacks the protective enamel layer found on the crown. While the mouth has a remarkable capacity to heal from minor injuries, the biological answer for gum recession is complex and generally requires professional intervention to restore the gum line.
Understanding How Gum Tissue Works
The gingival tissue, commonly known as the gums, is composed of specialized soft tissue that fits snugly around the tooth, forming a protective seal. Unlike some other tissues in the body, the connective tissue that makes up the bulk of the gum does not have the biological capacity to naturally regenerate once it is lost. This distinction is why receded gum tissue does not grow back to its original position on its own.
The gum tissue is designed to be a fixed boundary. Once this boundary migrates apically, or away from the tooth crown, it remains in that new position. Loss of this tissue boundary exposes the cementum, which covers the tooth root, making it susceptible to wear and decay. Therefore, the only way to cover the exposed root surface is through medical procedures that physically replace or reposition the missing tissue.
Primary Causes of Gum Recession
Gum recession is typically the result of long-term factors that either physically damage the tissue or cause underlying structural loss. A common mechanical cause is overly aggressive brushing, particularly using horizontal scrubbing motions with a medium or hard-bristled toothbrush. This chronic trauma gradually wears away the delicate tissue over time, often combined with wear on the tooth surface itself.
The most significant biological factor is periodontal disease, a bacterial infection that causes inflammation and destruction of the supporting tissues and bone around the teeth. As the underlying bone structure is lost due to this infection, the gum tissue follows, pulling back and creating pockets where more bacteria can accumulate. Other contributing factors include genetic predisposition, where some individuals are born with naturally thinner gum tissue, making them more susceptible to recession despite good hygiene. Misaligned teeth or a crooked bite can place uneven forces on certain teeth, contributing to tissue and bone loss around those roots. Habits like habitual teeth grinding or clenching (bruxism) and the use of tobacco products can accelerate tissue damage and recession.
Professional Options for Gum Restoration
Since the gum tissue cannot spontaneously repair itself, periodontists use surgical techniques to restore the lost coverage and protect the exposed roots. The goal of these procedures is to graft new tissue onto the affected area, effectively covering the tooth root and stopping sensitivity. The most common approach involves various types of gum grafting surgery, often using tissue taken from the patient’s own mouth or a donor source.
- Connective Tissue Graft: This is the most frequently performed procedure, particularly for moderate to severe recession. It involves creating a flap on the roof of the mouth and harvesting the subepithelial connective tissue underneath, which is then placed over the exposed tooth root and stitched into place. This method offers reliable and long-lasting results that blend well with existing tissue.
- Free Gingival Graft: This involves harvesting a small piece of tissue directly from the surface of the palate, rather than underneath a flap. This technique is typically used when the goal is to increase the thickness and strength of naturally thin gum tissue.
- Pedicle Graft: This localized approach uses tissue adjacent to the recessed tooth. The tissue is partially cut and stretched laterally or vertically to cover the root while remaining attached at one end to maintain its blood supply. This technique requires sufficient healthy gum tissue nearby and generally results in quicker healing.
- Alternative Grafting Materials: For patients who prefer to avoid a second surgical site on the palate, processed donor human tissue (allograft) can be used.
Beyond traditional grafting, some specialists may use regenerative procedures that involve applying membranes or tissue-stimulating proteins. These procedures encourage the body to naturally restore some of the damaged bone and tissue supporting the gum.
Strategies to Halt Further Recession
The first step in preventing existing recession from worsening is controlling the underlying cause, often beginning with non-surgical treatments. For recession caused by periodontal disease, a deep cleaning procedure known as scaling and root planing is performed to remove hardened plaque and bacteria from beneath the gum line. This procedure smooths the root surfaces, allowing the gums to reattach more firmly and creating a healthier foundation.
Correcting the oral hygiene technique is paramount to stopping mechanical trauma. This involves switching to a soft-bristled toothbrush or an electric brush with a pressure sensor. Brushing should be done with gentle, circular motions, avoiding the harsh back-and-forth scrubbing that wears down tissue and enamel. Daily flossing is necessary to remove plaque and debris from between teeth and along the gumline, preventing the buildup that leads to disease.
Quitting all forms of tobacco use is advisable, as tobacco irritates tissues and increases the risk of plaque buildup and gum disease. If teeth grinding or clenching (bruxism) is a factor, a custom-fitted night guard can be used to alleviate the excessive pressure placed on the gums and supporting bone. Consistent dental checkups and professional cleanings every six months allow a dentist to monitor gum health and address any changes early on.