Gum recession is a common dental concern where the tissue surrounding a tooth wears away or pulls back, exposing more of the tooth’s root surface. When this condition affects only a single tooth, it typically indicates a localized issue rather than widespread periodontal disease. This exposure can lead to increased sensitivity, an unappealing “long tooth” appearance, and a higher risk of root decay. Addressing this specific problem requires a professional assessment to identify the precise cause before initiating any treatment to stop the progression and restore the lost tissue.
Primary Causes of Localized Gum Recession
Recession on a single tooth often stems from mechanical or anatomical factors concentrated in that specific area. One of the most frequent causes is aggressive or incorrect brushing technique, where excessive force or the use of a stiff-bristled toothbrush physically wears away the delicate gum tissue around one tooth over time. This trauma is a common culprit when the recession is sharply localized and not associated with generalized gum inflammation.
Another significant factor is the position of the tooth within the dental arch, known as malocclusion. A misaligned, crowded, or jutting tooth experiences greater stress and friction, causing the overlying gum tissue and thin bone plate to recede. Localized trauma, such as a lip or tongue piercing rubbing against the gum line, can also cause chronic irritation that leads to tissue loss on the adjacent tooth.
Localized inflammation can also be a cause, even in the absence of overall gum disease. Poorly fitting dental restorations, like a crown margin or a filling with a sharp edge, can irritate the gum and promote a localized buildup of plaque and tartar. The body’s inflammatory response to this bacterial accumulation can destroy the supporting tissues, causing the gum to pull back around the single irritant.
Non-Surgical Treatment and Early Intervention
Initial treatment for localized recession begins with addressing the underlying cause and preparing the mouth for potential tissue regeneration. If the recession is mild and the root cause is bacterial, a deep cleaning procedure called scaling and root planing is performed. This non-surgical technique involves meticulously removing plaque, calculus, and bacterial toxins from the tooth surface both above and below the gum line.
Root planing involves smoothing the exposed root surface, which removes bacterial toxins and makes it more difficult for new plaque to adhere. This smoothing encourages the gum tissue to reattach more firmly to the clean tooth surface. For cases driven by inflammation, this process can halt the progression of recession and may allow for minimal re-growth of the gum tissue.
The dental professional will also address immediate mechanical irritants, such as polishing a rough filling or removing a sharp edge on a dental restoration. A crucial step is correcting the patient’s home care habits. The dental team must demonstrate proper brushing and flossing techniques to ensure the patient does not accidentally cause further damage to the treated area.
Surgical Procedures to Restore Gum Tissue
When the recession is advanced and has resulted in significant root exposure, surgical intervention becomes necessary. The goal of these procedures, typically performed by a periodontist, is to cover the exposed root surface and strengthen the gum tissue. Gum graft surgery is the traditional and highly predictable approach for restoring the gum line.
The most common method is the Connective Tissue Graft (CTG). This involves creating a small flap on the roof of the mouth, taking connective tissue from underneath the top layer, and stitching the flap back down. The harvested tissue is then placed over the exposed root surface and sutured into place, encouraging new gum tissue growth. CTG provides an excellent, natural-looking result and is considered the gold standard for many recession defects.
Alternative grafting techniques include:
- Free Gingival Graft: A small amount of tissue is taken directly from the palate and placed over the exposed root, often used when a larger band of tough, attached gum tissue is needed.
- Pedicle Graft (Lateral Slide Graft): Utilizes gum tissue adjacent to the recessed tooth; a flap is partially cut and slid laterally to cover the exposed root.
Pinhole Surgical Technique (PST)
A modern, less invasive alternative is the Pinhole Surgical Technique (PST). This scalpel-free and suture-free method involves creating a tiny pinhole above the affected tooth. Specialized instruments gently loosen the existing gum tissue and slide it down to cover the exposed root. Collagen strips are inserted through the pinhole to stabilize the repositioned tissue and promote natural healing.
PST offers a faster recovery time and immediate cosmetic improvement compared to traditional grafts. However, PST is reserved for mild to moderate cases of recession and may not be suitable for patients with very thin gum tissue or severe periodontal disease. The selection of the appropriate surgical technique depends on the extent of the recession, the quality of the patient’s existing gum tissue, and the overall health of the tooth.
Long-Term Prevention Strategies
Preventing the recurrence of localized gum recession relies heavily on consistent changes to daily oral hygiene. Patients must switch to a soft-bristled toothbrush, or an electric brush with a pressure sensor, to eliminate the trauma of aggressive scrubbing. The modified Bass technique, which uses gentle, short, circular strokes angled toward the gum line, is the recommended method for effective cleaning without causing tissue damage.
If the cause was related to excessive force, such as from bruxism (teeth grinding or clenching), wearing a custom-fitted nightguard during sleep is essential to mitigate the pressure placed on the teeth and supporting tissues. Regular dental appointments are necessary to monitor the treated area and ensure the root cause remains controlled. Professional checkups allow the dental team to detect any early signs of inflammation or further tissue loss.