Gum recession occurs when the tissue surrounding a tooth wears away or pulls back, exposing the underlying tooth root structure. While this condition can affect the health and appearance of the entire smile, recession limited to a single tooth often indicates a specific, localized issue rather than a widespread disease process. Addressing this localized recession requires both identifying the precise cause to halt its progression and employing targeted restorative methods to repair the lost tissue.
Causes of Localized Recession
A single receding gum line is frequently a sign of an external force or a specific anatomical vulnerability focused on that one area. The most common cause is aggressive or improper toothbrushing, where excessive horizontal scrubbing force or the use of hard-bristled brushes physically abrades the delicate gum tissue over time. This mechanical trauma strips away the gum tissue, often affecting teeth like the canines or pre-molars.
Misaligned teeth also contribute significantly to localized recession. A tooth that is tilted or positioned outside the dental arch has thinner bone and gum tissue supporting it, making the area more susceptible to recession even under normal brushing pressure. Similarly, a traumatic bite, where one tooth receives excessive force during chewing or clenching (bruxism), can stress the surrounding tissues and cause them to pull back.
Other localized factors include poorly fitting dental restorations, such as crowns or fillings with uneven margins, which can irritate the gum line. Physical trauma, an oral piercing that rubs against the gum, or a localized flare-up of periodontal disease can also cause the gum to recede from just one tooth. Identifying this specific irritant is the foundational first step necessary to prevent further tissue loss before restorative treatment begins.
Immediate Changes and Non-Surgical Management
Before or while pursuing professional restoration, certain immediate changes can stabilize the gum line and prevent the recession from worsening. Modifying the way one brushes is primary, which involves switching to a soft-bristled toothbrush or an electric brush with a pressure sensor. The recommended technique is a gentle, circular, or vertical motion, focusing on sweeping away plaque rather than scrubbing the gum line horizontally.
If the exposed root has led to heightened sensitivity, using desensitizing toothpaste can help manage the discomfort. These specialized products contain compounds like strontium chloride or potassium nitrate that physically block or desensitize the tiny channels (dentinal tubules) leading to the tooth’s nerve. Managing nocturnal habits like teeth grinding with a custom-fitted nightguard can also reduce the traumatic forces contributing to tissue wear.
Professional deep cleaning, known as scaling and root planing, may be necessary if localized plaque and tartar buildup are irritating the gum below the visible line. This procedure removes hardened deposits and smooths the root surface, which reduces inflammation and encourages the remaining gum tissue to reattach more firmly. While these non-surgical methods halt the progression, they generally do not regenerate the lost gum tissue itself.
Professional Treatments to Restore Gum Tissue
To physically restore the lost gum tissue, surgical intervention performed by a periodontist is typically required. The most common method is gum grafting, which involves placing new soft tissue over the exposed root surface. The specific grafting technique is chosen based on the amount of lost tissue and the patient’s anatomy.
Connective Tissue and Free Gingival Grafts
The connective tissue graft is the most frequently used method. A flap is created on the roof of the mouth (palate), and a small piece of subepithelial tissue is harvested from the layer beneath the surface. This tissue is then securely placed over the exposed root and sutured into place, providing a durable and aesthetically favorable result.
The free gingival graft is another option, which takes tissue directly from the outer surface of the palate. This technique is often used when a thicker band of gum tissue is needed to fortify the area and prevent future recession.
Pedicle Grafts and Allografts
For localized recession on a single tooth with sufficient gum tissue nearby, a pedicle graft may be performed. This involves partially cutting and rotating the adjacent gum tissue to cover the exposed root. This technique is advantageous because the graft remains attached at one end, preserving its blood supply and often leading to faster healing.
Alternatives to using the patient’s own tissue include allografts, which utilize sterile, processed human donor tissue. Allografts eliminate the need for a second surgical site on the palate.
Minimally Invasive Techniques
A modern, minimally invasive alternative for some cases is the Pinhole Surgical Technique (PST). This technique uses specialized instruments to make a tiny access hole in the gum tissue. Through this pinhole, the existing gum tissue is gently loosened and repositioned to cover the exposed root, held in place by small collagen strips instead of traditional sutures. Furthermore, some surgical procedures may incorporate the topical application of growth factors or proteins to the root surface to encourage the body’s natural regenerative processes.