Gingival recession is the process where the gum tissue surrounding the teeth retracts or pulls away, exposing the tooth’s root. This is a widespread dental issue that affects many adults, though it can begin in adolescence. As the gum line changes, it leaves parts of the tooth unprotected by enamel vulnerable. This exposure can lead to further oral health complications if not addressed.
Signs and Associated Discomfort
A common indicator of gingival recession is the noticeable elongation of teeth. While the teeth are not growing, the loss of gum tissue creates the illusion of greater length. This root surface exposure often leads to dentin hypersensitivity, causing sharp pain when consuming hot, cold, sweet, or sour foods and drinks. The cementum covering the root is softer than enamel and can be worn away, exposing microscopic tubules within the dentin to external stimuli.
A person might also feel a notch at the gum line where the crown’s enamel meets the exposed root. In some cases, the color difference between the root’s yellowish cementum and the crown’s whiter enamel becomes apparent. The visible changes in a smile’s appearance can also be an aesthetic concern.
Underlying Causes of Receding Gums
Periodontal diseases are a primary cause of gingival recession. Gingivitis, characterized by inflamed gums, can advance into periodontitis. In periodontitis, bacterial infection and inflammation destroy gum tissue and the underlying bone that holds teeth in place. This destruction causes the gums to recede and can lead to tooth loss if the infection is not controlled.
Physical wear on the gums is another factor. Aggressive tooth brushing, either by applying too much force or using a hard-bristled toothbrush, can abrade gum tissue and erode enamel at the gum line. Similarly, the pressure from grinding or clenching teeth (bruxism) exerts excessive force on the teeth and supporting tissues, which can cause the gums to pull away.
Anatomy and genetic predispositions also play a part. Other factors include:
- Thinner or more delicate gum tissue, which increases susceptibility to recession.
- Crowded, rotated, or misaligned teeth that create areas difficult to clean and may place uneven pressure on the gums.
- Prominent frenum attachments (small folds of tissue connecting lips to gums) that can pull on the gingival margin.
- Tobacco use, which aggravates the gum lining and contributes to this condition.
Professional Treatment Options
When gingival recession is caused by periodontal disease, the initial intervention is often non-surgical. A deep cleaning procedure, known as scaling and root planing, is performed to address the infection. It involves removing plaque and tartar from below the gum line (scaling) and smoothing the tooth roots (planing) to help the gums reattach. For recession linked to bruxism, a dentist can create a custom nightguard to protect the teeth and gums from grinding and clenching forces.
For more advanced cases or to cover an exposed root surface, surgical options are considered. The most common surgical treatment is a gum graft, where a surgeon takes a small piece of tissue, often from the roof of the mouth (palate), and attaches it to the receded area. This procedure covers the exposed root and helps thicken the existing gum tissue, making it more resilient against future recession.
Different types of gum grafting procedures exist. A connective-tissue graft involves taking tissue from under a flap created on the palate, which is then stitched over the recession site. A free gingival graft uses a small amount of tissue directly from the palate. Newer, less invasive techniques may be an alternative to traditional grafting, and the choice of procedure depends on the patient’s needs and the extent of the recession.
At-Home Management and Prevention
Preventing or halting gingival recession revolves around proper oral hygiene. Using a soft-bristled toothbrush is important to avoid abrading the gum tissue. Brushing technique is also important; clean the teeth gently without scrubbing the gums harshly. Your dentist can provide guidance on the most effective and safe brushing methods for your situation.
Daily flossing is necessary to remove plaque from areas a toothbrush cannot reach, which prevents the buildup that leads to tartar and gum inflammation. If plaque hardens into tartar, it can only be removed with professional instruments. Regular dental check-ups and cleanings are also important for prevention, allowing for early detection and management.
For those who clench or grind their teeth, using a professionally made nightguard can mitigate damage to the teeth and gums. Addressing lifestyle factors, such as quitting tobacco products, can also significantly reduce the risk of further recession.