Gingival recession is a common dental finding where the gum tissue surrounding a tooth pulls back, or recedes, from its normal position. This process gradually exposes the root surface of the tooth, which is normally covered and protected by the gums. This condition affects a majority of the adult population. While it often progresses slowly and painlessly, the resulting exposure of the root surface can lead to several oral health concerns.
Understanding Gingival Recession
The most noticeable sign of recession is the appearance of teeth that look “longer” than before, due to the visible exposure of the root surface below the crown. This exposure typically manifests as a noticeable notch or groove forming at the gumline. The cementum covering the tooth root is not as durable as enamel, making the exposed area highly susceptible to abrasion and decay.
The primary consequence of this root exposure is dentin hypersensitivity, characterized by a sharp, sudden pain in response to thermal, chemical, or tactile stimuli. The exposed root contains thousands of tiny channels, called dentinal tubules, which lead directly to the tooth’s nerve center. When these tubules lose their protective covering, they allow stimuli like cold air or sweet foods to reach the nerve, causing discomfort. Recession also increases vulnerability to root surface decay, as the softer cementum is more easily breached by bacteria.
Primary Causes of Gum Line Changes
Gingival recession usually results from a combination of factors contributing to its development. One of the most frequent mechanical causes is trauma from aggressive or incorrect oral hygiene habits. Brushing with excessive force, or using a hard-bristled toothbrush, can physically wear away the delicate gum tissue over time.
Underlying anatomical factors also contribute significantly to susceptibility. Individuals with naturally thin gum tissue or a thin underlying bone structure are more prone to tissue loss. Similarly, teeth that are malpositioned or tipped outwards may have a thinner layer of bone and gum tissue covering their roots, making them vulnerable to recession.
A major biological factor is periodontal disease, an inflammatory condition caused by bacterial plaque accumulation at the gumline. The body’s inflammatory response to the bacteria destroys the supporting tissues around the tooth, including the gum and bone. This process leads to the downward migration of the gum margin.
Treatment and Management Strategies
Addressing recession begins with a professional assessment to measure the extent of tissue loss. Management strategies are tailored based on the severity and the underlying cause. Non-surgical treatment is prioritized to stabilize the condition and alleviate symptoms.
This non-surgical approach focuses on modifying hygiene habits to eliminate the source of trauma, including instruction on using a soft-bristled toothbrush and a gentle brushing technique. To manage pain, desensitizing agents like fluoride varnishes can be applied professionally to seal the exposed dentinal tubules. Specialized toothpastes containing potassium nitrate can also be used at home to reduce sensitivity.
When recession is severe or the exposed root is highly susceptible to decay, surgical intervention is considered. Gum grafting procedures, such as a connective tissue graft, are commonly performed to cover the exposed root surface. This procedure involves taking tissue from the roof of the mouth or using a donor source and attaching it to the area of recession to rebuild the lost gum line.
Long-term prevention is integrated into the management plan, including addressing issues like teeth grinding, known as bruxism. A protective night guard is often used to reduce force on the teeth and gums.