Gum recession occurs when the gum tissue pulls away from the tooth surface, exposing the root underneath. Patients often notice this loss because the affected tooth appears longer or feels sensitive. Understanding the difference between expected, gradual changes and actively harmful processes is important for maintaining long-term dental health and determining appropriate monitoring and intervention.
Defining Gum Recession and Measurement
Clinically, gum recession is defined as the displacement of the gingival margin below the cementoenamel junction (CEJ), the boundary where the enamel of the crown meets the cementum of the root. This apical displacement exposes the softer root surface, which is not covered by protective enamel. Dental professionals use a specialized instrument called a periodontal probe to precisely measure the vertical distance from the CEJ to the present gum margin in millimeters.
This measurement is tracked over time to monitor progression. The extent of recession is also categorized using classification systems, such as the widely recognized Miller classification or the more modern Cairo classification. These classifications consider factors like the amount of tissue loss between the teeth and the level of the mucogingival junction, which helps the dentist predict the potential for treatment success and determine the severity.
Factors Influencing Baseline Gum Levels
A small, slow loss of gum tissue over time is often attributed to non-disease factors and is considered a baseline change. This physiological recession is frequently seen with natural aging; approximately 88% of people over the age of 65 have recession on at least one tooth.
An individual’s gum structure, known as their gingival biotype, is a significant anatomical factor influencing recession susceptibility. People with a thin biotype, meaning naturally thin gum tissue, are genetically predisposed to recession. This thin tissue has less resilience and less blood supply, making it more prone to pulling back when faced with any trauma or inflammation.
Mechanical trauma is another common, non-disease driver of localized recession. This often happens from overly aggressive horizontal brushing, especially with a medium or hard-bristled toothbrush. The repetitive, excessive force can physically wear away the gum tissue, leading to V- or U-shaped defects. When recession occurs slowly over decades due to these benign factors, and without active inflammation or deep periodontal pockets, it is generally considered stable.
Pathological Recession and Warning Signs
Pathological recession, in contrast to gradual baseline changes, is driven by active disease or severe structural issues and can progress rapidly. The most significant cause is periodontitis, which is an advanced stage of gum disease. Periodontitis involves chronic inflammation and the destruction of the supporting bone and soft tissues around the teeth.
Recession caused by periodontitis is typically generalized, affecting multiple teeth, and is often accompanied by the loss of the gum tissue between the teeth. A dentist will measure periodontal pockets deeper than three millimeters, which indicates that the gum has detached from the tooth surface due to bacterial infection. The presence of bleeding gums, tenderness, persistent bad breath, or a bad taste, along with the receding gums, are clear warning signs of active disease.
Other pathological drivers include severe malocclusion, or a misaligned bite, which places excessive force on certain teeth, contributing to tissue loss. Teeth grinding, known as bruxism, can also apply destructive forces leading to recession. Signs that recession requires immediate attention include rapid, noticeable changes, increased tooth mobility, or the appearance of a visible notch where the root is exposed.
Next Steps for Monitoring and Care
Anyone noticing signs of gum recession should seek a professional evaluation to determine the underlying cause and classify the severity. A diagnosis is necessary to distinguish between stable recession due to mechanical factors and active tissue loss from periodontitis. The primary goal of care is to halt the progression and prevent further damage to the exposed root surface.
Prevention often begins with modifying oral hygiene habits. Switching to a soft-bristled toothbrush and using gentle, circular motions instead of aggressive back-and-forth scrubbing can prevent mechanical wear. Addressing risk factors such as tobacco use and managing teeth grinding, possibly with a custom night guard, are also important preventive measures.
If the recession is pathological or causing significant sensitivity, treatment options are available. While lost gum tissue cannot grow back naturally, procedures like gum grafting can be performed to cover the exposed root surface. The success of the procedure depends heavily on the initial classification, emphasizing the need for expert consultation.