Gum recession occurs when the gum tissue pulls back from the tooth surface, exposing the underlying tooth root. This gradual process makes teeth appear longer and creates small pockets between the gums and teeth where bacteria accumulate. The exposed root surface is vulnerable to decay and can lead to significant discomfort. Addressing this condition quickly is important for protecting the structural integrity of your teeth and managing potential long-term sensitivity.
Recognizing the Signs and Underlying Causes
The initial signs of gum recession are often subtle, but they become more noticeable as the condition advances. The most apparent indication is the visible lengthening of the tooth, which occurs as the gum line moves down, revealing the lighter-colored root. This root exposure causes increased tooth sensitivity, particularly to hot, cold, or sweet stimuli, because the protective enamel layer does not cover the root surface. Patients may also notice the exposed root area is often yellower or darker than the crown of the tooth.
Recession occurs due to a combination of mechanical and biological factors that degrade the gum tissue. One primary mechanical cause is overly aggressive brushing, especially using a hard-bristled toothbrush or applying excessive force in a horizontal, scrubbing motion. This physical trauma can wear away the delicate gum tissue over time.
The most widespread biological cause is periodontal disease, an infection that damages the gum tissue and the underlying bone supporting the teeth. Gingivitis, the initial stage of gum disease, progresses to periodontitis if left untreated, causing the gums to detach from the tooth and recede. Other contributing factors include a genetic predisposition to thin gum tissue, making some people more susceptible to recession even with good oral hygiene. Habits like tobacco use and chronic teeth grinding (bruxism) also place stress on the gums and accelerate tissue loss.
Immediate Adjustments and At-Home Care
If you notice signs of recession, immediately adjust your daily oral hygiene routine to prevent further damage. Switch from a hard or medium-bristled brush to a soft-bristled toothbrush, or consider an electric brush with a pressure sensor. The proper technique involves gentle, circular motions directed toward the gum line instead of forceful horizontal scrubbing.
The exposed tooth roots are more porous than the enamel, which heightens sensitivity and vulnerability to decay. Using a desensitizing toothpaste, which contains compounds like potassium nitrate or strontium chloride, can help block the small tubules in the dentin to reduce discomfort. Rinsing with a warm saltwater solution can also soothe irritated gums and temporarily reduce inflammation.
Temporary dietary changes can also offer immediate relief from sensitivity. Highly acidic foods and drinks, such as citrus fruits, soda, and vinegar-based dressings, can exacerbate discomfort when they contact the exposed root surfaces. While these measures help manage symptoms and prevent worsening, they cannot restore lost gum tissue, and professional treatment is required to repair existing recession.
Professional Treatment Options to Restore Gum Tissue
Professional intervention begins with a thorough deep cleaning known as scaling and root planing, often the first line of treatment if recession is caused by periodontal disease. This non-surgical process involves scraping away built-up plaque and hardened tartar from above and below the gum line. Root planing then smooths the tooth root surface, making it more difficult for bacteria to adhere and helping the gum tissue reattach.
For minor exposed roots causing sensitivity, a dentist may apply dental bonding, covering the area with a tooth-colored composite resin. This procedure offers a quick, non-surgical way to insulate the exposed dentin and improve appearance. However, for more substantial recession, surgical options are necessary to restore the lost tissue.
The most predictable method for covering exposed roots is gum graft surgery, typically performed by a periodontist. The type of graft chosen depends on the severity and specific anatomy of the recession.
Types of Gum Grafts
- The connective tissue graft is the most common technique, where tissue is taken from beneath a small flap on the roof of the mouth and stitched over the exposed root.
- The free gingival graft uses a small piece of tissue taken directly from the palate, often recommended for patients with naturally thin gums who need to increase tissue thickness and strength.
- The pedicle graft involves partially cutting a flap of healthy gum tissue adjacent to the recessed tooth, pulling it laterally or vertically to cover the exposed root, and then suturing it into place. This method allows for quicker healing since the tissue maintains its blood supply.
- Alternative techniques, such as the Pinhole Surgical Technique, use specialized instruments to reposition existing gum tissue through tiny holes without the need for large incisions or sutures.
Long-Term Strategies for Halting Progression
Long-term success in managing gum recession depends on sustained commitment to preventative habits and professional monitoring. Regular dental checkups and professional cleanings are necessary, as they allow the dental team to remove tartar buildup and monitor the gum line for renewed recession.
Addressing underlying parafunctional habits, such as bruxism, is also important for preventing recurrence. If you clench or grind your teeth, a custom-fitted night guard can be fabricated to absorb the pressure that stresses the gums and supporting bone. Quitting all forms of tobacco use is another factor, as tobacco greatly impedes the gums’ ability to heal and fight infection. Maintaining good systemic health, particularly managing conditions like diabetes, is important because they can compromise the body’s immune response and negatively impact gum tissue health.