What Is Gum Recession

Overview

Gum recession, also known as gingival recession, is a dental condition in which the gum tissue that surrounds and protects the teeth begins to wear away or pull back, exposing more of the tooth and its root. This can lead to several dental issues, including tooth sensitivity, an increased risk of dental decay, and in severe cases, tooth loss. Gum recession is a common dental problem, and it can occur gradually over time, often without immediate noticeable symptoms^.1

Causes of gum recession

Periodontal Disease: One of the primary causes of gum recession is periodontal disease, specifically a more advanced form known as periodontitis. This bacterial infection of the gums and supporting structures of the teeth can lead to inflammation and destruction of the gum tissue, causing it to recede.²

Poor Oral Hygiene: Inadequate or improper dental care practices, such as irregular brushing and flossing, can lead to the accumulation of dental plaque and tartar. This buildup can irritate the gums, leading to gum recession over time.¹

Aggressive Tooth Brushing: Brushing your teeth too vigorously or using a toothbrush with hard bristles can erode the gum tissue and enamel, potentially causing gum recession. It's important to use a soft-bristle toothbrush and a gentle brushing technique.

Genetics: Some people may be genetically predisposed to have thinner or more delicate gum tissue, making them more susceptible to gum recession even with good oral hygiene practices.

Tobacco Use: Smoking or using smokeless tobacco products can contribute to gum recession. These substances can hinder blood flow to the gums, reducing their ability to heal and resist infection.

Teeth Grinding and Clenching (Bruxism): Frequent grinding or clenching of teeth, especially during sleep, can exert excessive force on the teeth and gums, leading to gum recession.

Malocclusion: Bite alignment issues or misaligned teeth can create abnormal forces on the gums, which may contribute to gum recession over time.

Orthodontic Treatment: Braces or other orthodontic treatments can sometimes cause minor gum recession as teeth are repositioned. However, this is usually temporary and can be managed by an orthodontist.⁵

Hormonal Changes: Hormonal fluctuations in women, such as those associated with pregnancy, menopause, or birth control pills, can increase the risk of gum recession due to changes in gum tissue sensitivity and inflammation.

Medical Conditions: Certain medical conditions like diabetes and autoimmune diseases can affect the health of the gums and increase the risk of gum recession.

Medications: Some medications, particularly those that cause dry mouth (xerostomia), can contribute to gum recession by reducing saliva flow, which helps protect the gums.

Signs and symptoms of gum recession

• Tooth Sensitivity: Increased sensitivity to hot or cold.
• Longer Teeth: Noticeable lengthening of teeth.
• Notching or Grooves: Small indentations near the gumline (abfractions).
• Gum Tissue Changes: Irregular or swollen gum line.
• Bleeding Gums: Especially during brushing or flossing.
• Bad Breath (Halitosis): Due to bacterial buildup.
• Visible Tooth Roots: Exposed roots may appear different in colour.
• Loose Teeth: Teeth may become unstable.
• Pain or Discomfort: Especially as roots become exposed.
• Increased Risk of Cavities: Particularly near the gumline.
• Difficulty Chewing: Impaired tooth function.

Management and treatment for gum recession

The management and treatment of gum recession depend on the severity of the condition. In mild cases, improving oral hygiene practices may be sufficient, while more advanced cases may require dental procedures to address the issue. Here are various management and treatment options for gum recession:

Improved Oral Hygiene: Proper oral hygiene is essential for managing and preventing further gum recession. Brush your teeth gently with a soft-bristle toothbrush at least twice a day using fluoride toothpaste.

Floss daily to remove plaque and food particles from between your teeth and along the gumline.

Consider using an antimicrobial or fluoride mouthwash to help maintain gum health.

Use a toothbrush with a small head to reach difficult-to-access areas in your mouth.³

Scaling and Root Planing (Deep Cleaning): This is a non-surgical procedure performed by a dentist or dental hygienist. It involves removing plaque and tartar buildup from the tooth surfaces and below the gumline.

Scaling and root planing can help improve gum health and reduce inflammation, potentially slowing down or stopping further recession.

Gum Grafting: In cases of moderate to severe gum recession, a surgical procedure called gum grafting may be necessary. During this procedure, a piece of tissue, typically taken from another part of the mouth or a tissue bank, is placed over the exposed tooth roots to cover and protect them. Gum grafting can help restore lost gum tissue and improve the appearance of the gumline.⁴

Orthodontic Treatment: If misaligned teeth or a malocclusion contribute to gum recession, orthodontic treatment to correct the bite may be recommended. This can help redistribute forces on the gums and improve gum health.⁵

Bite Adjustment: In cases where an improper bite is a contributing factor, a dentist may recommend bite adjustment to ensure that teeth come together correctly, reducing pressure on the gums.

Lifestyle Changes: Quit smoking or using tobacco products if applicable, as these can exacerbate gum recession.

Manage teeth grinding (bruxism) by using a mouthguard at night if necessary.

Regular Dental Check-ups: Attend regular dental check-ups and cleanings to monitor the progress of gum recession and receive professional guidance on oral care.

Diagnosis

History: Your medical and dental history is reviewed, including symptoms, oral hygiene, medications, and medical conditions.

Clinical Exam: This includes visual inspection of your gums, periodontal probing to measure pocket depth, checking for tooth mobility, and using X-rays to assess bone levels.

Contributing Factors: Factors like bite alignment and habits like smoking or teeth grinding are considered.

Treatment Plan: Based on the assessment, a personalized treatment plan is created, which may include hygiene improvements, scaling and root planing, surgery, or orthodontics.

Monitoring: Follow-up appointments are scheduled to track treatment progress and make necessary adjustments.

FAQs

How can I prevent gum recession

You can help prevent gum recession by maintaining good oral hygiene practices, which include brushing your teeth gently with a soft-bristled toothbrush, flossing daily, using fluoride toothpaste, and attending regular dental check-ups and cleanings. Avoid tobacco use, address teeth grinding (bruxism), and manage any underlying medical conditions that may contribute to gum problems.

How common is gum recession

Gum recession is relatively common, and its prevalence can vary among different age groups and populations. It often occurs gradually over time due to factors like ageing, poor oral hygiene, or gum disease. It's estimated that a significant portion of the population experiences some degree of gum recession during their lifetime.

Who is at risk of gum recession

Several factors can increase the risk of gum recession, including

• Poor oral hygiene habits.
• Gum disease (periodontal disease).
• Tobacco use (smoking or smokeless tobacco).
• Misaligned teeth or bite issues.
• Teeth grinding or clenching (bruxism).
• Genetic predisposition.
• Hormonal changes (e.g., pregnancy, menopause).
• Medications that cause dry mouth (xerostomia).
• Certain medical conditions (e.g., diabetes).
• Aggressive tooth brushing.
• Ageing (as gum recession can be a natural part of ageing).

When should I see a doctor

• Tooth sensitivity, especially to hot or cold temperatures.
• Noticeable changes in the length of your teeth.
• Bleeding gums, especially during brushing or flossing.
• Notches or grooves on tooth surfaces near the gumline.
• Visible tooth roots or an uneven gum line.
• Pain or discomfort in your gums.
• Bad breath even after maintaining good oral hygiene.
• Loose or shifting teeth.
• Increased risk of cavities, particularly near the gumline.

Summary

Gum recession is a dental condition where the gum tissue around teeth wears away, leading to various symptoms like tooth sensitivity and increased risk of dental problems. Preventive measures include good oral hygiene, avoiding tobacco, and managing contributing factors. It's relatively common and can affect anyone, with certain risk factors increasing susceptibility. If you experience symptoms or have concerns, consult a dentist. Regular dental check-ups are essential for early detection and prevention.