Receding gums occur when the gum tissue surrounding the teeth pulls away, exposing more of the tooth surface or its root. When gums recede, small gaps or “pockets” can form between the teeth and the gum line, creating areas where disease-causing bacteria can accumulate. Addressing receding gums is important for maintaining oral health and preventing complications.
Understanding Receding Gums
Several factors can contribute to gum recession. A primary cause is periodontal disease, which involves bacterial infections that destroy gum tissue and the underlying bone supporting the teeth. Untreated, this inflammation progresses, detaching gums from teeth and forming deeper pockets where bacteria thrive.
Aggressive tooth brushing, using a stiff-bristled toothbrush, can physically wear away gum tissue and tooth enamel. Poor oral hygiene, with inadequate brushing and flossing, allows plaque to build up and harden into tartar, a calcified deposit that irritates gums. Genetics also play a role, with some individuals having a predisposition to thinner gum tissue or a higher susceptibility to gum disease.
Other contributing factors include teeth grinding or clenching (bruxism), which places excessive force on the teeth and gums. Tobacco use, whether smoking or chewing, can reduce blood flow to the gums and promote plaque buildup, increasing the risk of recession. Hormonal changes, such as those during pregnancy or menopause, can also make gums more sensitive and vulnerable. Symptoms include increased tooth sensitivity, teeth appearing longer than usual, visible tooth roots, pain or discomfort near the gum line, sensitivity to hot or cold temperatures, and bleeding gums.
Non-Surgical Management
Initial management of receding gums often involves non-surgical approaches. One common procedure is scaling and root planing, a deep cleaning technique performed under local anesthesia. This process removes accumulated plaque and tartar from root surfaces and below the gum line. Smoothing the exposed root surfaces helps prevent bacteria from reattaching and encourages the gums to reattach to the teeth.
Antibiotic treatments are used to control bacterial infections associated with gum disease. Topical antibiotics, such as gels or chips containing doxycycline, minocycline, or chlorhexidine, can be placed directly into the gum pockets to release medication over time. Oral antibiotics, including doxycycline, amoxicillin, or metronidazole, may be prescribed for more widespread or severe infections to reduce bacterial loads and inflammation. These medications are often used with deep cleaning to enhance effectiveness.
Improving daily oral hygiene practices is a foundational non-surgical step, including proper brushing, flossing, and using antimicrobial mouthwashes. Dental bonding, using tooth-colored composite resin, can sometimes camouflage exposed roots and reduce sensitivity in minor recession cases.
Surgical Treatment Options
For advanced gum recession where non-surgical methods are insufficient, various surgical procedures are available to restore lost gum tissue. Gum graft surgery is a common solution, aiming to cover exposed tooth roots and add thickness to the gum line. These procedures involve transplanting tissue from one area of the mouth to the receded site.
Types of Gum Grafts
Connective tissue graft: Tissue from under a flap on the mouth’s roof (palate) is removed and stitched to the gum around the exposed root.
Free gingival graft: A small piece of tissue is taken directly from the surface of the palate and attached to the recession site.
Pedicle graft: Tissue from the gum adjacent to the receded tooth is moved over to cover the exposed root, maintaining its blood supply.
Regenerative procedures are used when bone supporting the teeth has also been lost due to recession. These involve folding back gum tissue, cleaning the area, and then applying regenerative materials. Materials like membranes or tissue-stimulating proteins encourage natural regeneration of lost bone and gum tissue. Newer, minimally invasive techniques, such as the Pinhole Surgical Technique, involve creating small pinholes in the gum line and gently repositioning existing gum tissue over exposed roots without traditional grafts or sutures.
Preventing Future Recession
Preventing gum recession involves consistent, proactive oral care and lifestyle adjustments. Maintaining meticulous oral hygiene is fundamental, including brushing teeth twice daily with a soft-bristled toothbrush. Gentle, circular brushing motions are recommended to clean effectively without causing trauma to the gum tissue. Daily flossing is equally important for removing plaque and food debris from interdental spaces and along the gum line.
Regular dental check-ups and professional cleanings are crucial for early detection and intervention. Dentists can identify subtle signs of gum issues and remove hardened plaque (tartar). Addressing teeth grinding or clenching (bruxism) is another preventive measure; dentists may recommend a custom-fitted nightguard.
Avoiding aggressive brushing habits is paramount, as excessive force can directly contribute to gum tissue wear. Quitting tobacco use, including smoking and chewing tobacco, significantly reduces the risk of gum disease and subsequent recession, as tobacco products impair gum health and healing. A balanced diet also supports overall oral health, and staying hydrated helps maintain saliva production, which naturally cleans the mouth.