Gum recession occurs when the gum tissue surrounding the teeth pulls back, exposing more of the tooth structure, including the root. This exposure leads to heightened sensitivity, an increased risk of root decay, and damage to the underlying bone support. Stopping this progression requires identifying and eliminating the underlying cause, followed by methods to stabilize or restore the affected gumline.
Identifying the Root Causes of Recession
Gum recession stems from mechanical trauma and biological infection. The most common non-disease cause is aggressive or improper tooth brushing. Applying excessive force or using a hard-bristled brush physically wears away the delicate gum tissue, often creating V-shaped notches near the gumline.
The primary biological cause is periodontal disease, which starts as gingivitis from bacterial plaque accumulation. If unmanaged, gingivitis progresses to periodontitis, where bacterial toxins destroy the supporting bone and connective fibers. As bone is lost, the gum tissue follows, leading to recession.
Contributing Factors
Teeth grinding and clenching, known as bruxism, place excessive forces on supporting structures, which can trigger recession. Misaligned teeth may have insufficient bone and thin gum tissue covering the root, making them highly susceptible. Tobacco use is also a contributor, as nicotine constricts blood flow to the gum tissue, making it more vulnerable to damage and disease.
Daily Strategies for Prevention and Stabilization
Halting recession requires changing habits that cause mechanical damage or allow bacterial growth. Proper brushing technique is essential, starting with a soft- or ultra-soft bristled toothbrush. The motion should shift away from aggressive horizontal scrubbing toward gentle, short, circular, or vertical sweeping strokes.
The brush should be held at a 45-degree angle where the gum meets the tooth, allowing the bristles to gently clean the area without trauma. Holding a manual toothbrush with the fingertips, rather than a full fist, helps reduce applied pressure. This gentle action, performed twice daily for at least two minutes, removes plaque without wearing down the tissue.
Consistent interdental cleaning, such as flossing or using interdental brushes, removes plaque from between the teeth. This prevents the bacterial buildup that drives periodontitis and subsequent recession. For sensitivity due to exposed roots, desensitizing toothpastes containing ingredients like potassium nitrate or stannous fluoride can help block nerve signals and strengthen the root surface.
Behavior Modification
If bruxism is suspected, a custom-fitted nightguard protects the teeth and gums from clenching and grinding forces. Limiting highly acidic foods and beverages protects tooth structure and prevents gum irritation. Avoiding tobacco use improves blood flow to the gums, enhancing their ability to resist infection and repair damage.
Professional Interventions for Gum Restoration
When recession is caused by disease or significant tissue loss, professional intervention is required to stabilize the condition and restore tissue. The initial non-surgical treatment for recession linked to periodontal disease is Scaling and Root Planing (SRP), often called a deep cleaning. This procedure involves meticulously removing hardened plaque and tartar (calculus) from the tooth surfaces and root areas below the gumline.
After removing bacteria and debris, the root surfaces are smoothed (planing) to eliminate rough spots that harbor plaque. This smoothing allows the gum tissue to reattach and reduces inflammation. This process stops the progression of bone and tissue destruction caused by infection, stabilizing the gumline, though lost gum tissue will not naturally regenerate.
Gum Grafting
To restore the protective tissue barrier and cover exposed roots, a periodontist may recommend gum grafting. The most common technique is the connective tissue graft, where tissue is taken from under a flap on the roof of the mouth and stitched over the exposed root area. Alternatively, a free gingival graft takes tissue directly from the palate, or donor tissue (allografts) can be used to avoid taking tissue from the patient’s palate.
Other options include the Pinhole Surgical Technique, which manipulates existing gum tissue through a small entry point to cover the exposed root surfaces. If misaligned teeth are the mechanical cause, orthodontic treatment may move the teeth into a more favorable position. This correction can allow the gum margin to improve by placing the tooth within the protective confines of the alveolar bone.