Gum recession occurs when the margin of gum tissue wears away or pulls back, exposing the tooth structure, often including the root surface. This frequently leads to increased tooth sensitivity and a higher risk of decay because the exposed root lacks protective enamel. Lost gum tissue does not regenerate naturally, so restoring a healthy gum line requires stopping the progression and utilizing professional procedures to physically restore the lost tissue.
Understanding Gum Recession
Gum recession occurs for several identifiable reasons, often involving a combination of factors that compromise the soft tissue surrounding the teeth. The most frequent cause is periodontal disease, a bacterial infection that inflames the gums and slowly destroys the supporting tissue and bone. As the infection advances, it creates pockets between the teeth and gums, encouraging further bacterial accumulation and tissue destruction.
Trauma from overzealous oral hygiene practices is another major contributor. Aggressive brushing, especially with a hard-bristled toothbrush, physically wears away the delicate gum tissue over time. This mechanical abrasion causes the gums to pull back, exposing the tooth root structure. Incorrect flossing, such as pushing too forcefully, can also cause localized trauma and recession.
Genetic predisposition and anatomical factors also play a significant role in susceptibility to gum recession. Some individuals are born with thin, fragile gum tissue, making them more prone to recession even with proper brushing. Misaligned teeth or a crooked bite can also place uneven forces on the gums and bone, which accelerates tissue loss in certain areas.
At-Home Strategies for Stopping Progression
Managing gum recession requires correcting the habits causing the tissue to pull back. This means shifting to a gentler, more effective daily oral care routine that targets plaque buildup and trauma. Prevention of further loss is achieved by adopting a meticulous, non-abrasive approach to cleaning the teeth and gum line.
The correct brushing technique involves using a soft-bristled toothbrush or an electric brush with a pressure sensor. The brush should be held gently and moved in short, circular or elliptical strokes, avoiding harsh scrubbing motions. Angle the bristles toward the gum line at about 45 degrees to effectively clean the sulcus, the space between the gum and tooth.
Flossing or using interdental cleaners removes plaque and food debris from between the teeth and under the gum line without causing injury. Use controlled movements, guiding the floss gently against the tooth surface and avoiding snapping it forcefully into the gums. This disrupts the bacterial biofilm, the precursor to periodontal disease.
Selecting the right oral care products is also important. Avoid highly abrasive toothpastes, as they contribute to the mechanical wear of gum tissue and exposed root surfaces. For managing inflammation, a dentist may recommend an antimicrobial mouth rinse, such as one containing chlorhexidine, to reduce the bacterial load. Warm saltwater rinses can also soothe irritated or swollen gums.
Professional Interventions for Tissue Restoration
When recession is moderate to severe, or when the goal is to physically cover the exposed root, professional interventions become necessary to restore the gum line. The initial step for recession linked to periodontal disease is often scaling and root planing. This non-surgical deep cleaning removes hardened plaque and tartar (calculus) from both above and below the gum line. The root surfaces are then smoothed to eliminate toxins and allow the gum tissue to reattach to the tooth.
For true tissue restoration, surgical procedures, collectively referred to as gum grafting, are required. These procedures cover exposed root surfaces, strengthen gum tissue, and prevent further bone loss. Grafting involves taking soft tissue from a donor site (often the roof of the mouth) or using a processed donor product, and transplanting it to the recessed area.
Specific grafting techniques are used to cover the exposed root:
- Connective-tissue graft: This is the most common method and uses tissue harvested from beneath a flap of skin on the palate.
- Free gingival graft: This involves taking a small piece of tissue directly from the palate and placing it onto the exposed root.
- Pedicle graft: This involves cutting a flap of gum tissue adjacent to the recessed area and stretching it sideways to cover the exposed root, which is only possible when sufficient tissue is nearby.
- Pinhole Surgical Technique: This modern alternative involves minimally invasive methods where existing gum tissue is gently repositioned over the exposed root through small holes.