Aggressive brushing can physically push gum tissue away from teeth, a condition known as gum recession. This occurs when the margin of the gum tissue wears away or pulls back, exposing more of the tooth or the tooth’s root. Mechanical trauma from a toothbrush is a significant contributor to this common dental problem. The physical wearing away of delicate gum tissue is a gradual process, often going unnoticed until the recession is moderate or severe.
Understanding Brushing-Induced Gum Recession
The term for physical damage caused by excessive brushing force or improper technique is “abrasion.” This mechanical wear and tear occurs when the bristles of the toothbrush are applied too vigorously, particularly with a horizontal, back-and-forth scrubbing motion. Over time, this repeated trauma physically erodes the surface of the gum tissue, causing it to retract from the crown of the tooth.
This type of recession is distinct from the recession caused by periodontal disease, which is an inflammatory response to bacterial infection and plaque buildup. In brushing-induced abrasion, the gum tissue and the underlying bone structure are physically worn away by the external force. The use of hard-bristled toothbrushes or highly abrasive toothpastes significantly accelerates this erosion. Damage is concentrated at the junction between the tooth and the gum, where the pressure is most directly applied.
Recognizing the Physical Signs of Damage
Gum recession often manifests with both visible changes and increased tooth sensitivity. The most noticeable sign is when teeth begin to appear longer than before, exposing more of the tooth’s root surface. Since the tooth root lacks the protective enamel layer found on the crown, its exposure leads to chronic tooth sensitivity.
This sensitivity is typically felt as a sharp discomfort when consuming hot, cold, or sweet foods and drinks. Another common physical indicator is the presence of a notch, groove, or wear mark near the gum line. This indentation, often called an abrasion lesion, is where the toothbrush has physically worn away the softer root surface and the gum tissue over time.
Modifying Brushing Technique for Prevention
Preventing further gum recession involves adopting gentler, more effective oral hygiene habits. Switching to a soft or extra-soft bristled toothbrush is essential, as harder bristles increase the risk of abrasion and trauma to the gums. Many electric toothbrushes now include built-in pressure sensors that alert the user when they are applying too much force, which can be an excellent tool for maintaining gentle pressure.
The proper technique involves angling the brush at a 45-degree angle to the gums, a method often referred to as the Modified Bass technique. Instead of aggressive horizontal scrubbing, the brush should be moved in small, gentle circular or vibrating motions. This action effectively cleans the area where the tooth meets the gum line without causing physical trauma to the delicate tissue.
Using a non-abrasive toothpaste is important, as the combination of harsh scrubbing and abrasive particles can compound the damage to both the gums and the tooth structure. The goal of brushing is to gently disrupt plaque and debris, not to aggressively scrub the surface. The force applied should be light enough that the toothbrush bristles do not splay out over time, which is a simple visual cue that you are brushing too hard.
Professional Treatments for Receded Gums
Once gum tissue has receded significantly, it cannot regenerate on its own, necessitating professional intervention to cover exposed roots and prevent further damage. For milder cases, a dentist may apply desensitizing agents or dental bonding, which uses a tooth-colored composite resin to cover the exposed root surface. This helps to reduce sensitivity and improve the appearance of the tooth.
Surgical Grafting
For more substantial tissue loss, surgical procedures are often required to restore the gum line. The most common solution is gum grafting, where a periodontist takes a thin piece of tissue from another area of the mouth, usually the palate, and attaches it to the recessed area. This procedure can involve several types of grafts, including connective tissue, free gingival, or pedicle grafts, depending on the specific needs.
Pinhole Surgical Technique
Less invasive techniques are also available, such as the Pinhole Surgical Technique. This involves making a tiny hole in the gum tissue and using specialized instruments to gently loosen and reposition the existing gum tissue over the exposed root. Regardless of the technique, the primary purpose of these treatments is to halt the progression of recession, protect the vulnerable tooth root, and restore a healthy gum contour.