Also known as ‘gingival recession‘, receding gums refers to exposure of the roots of the teeth. The roots are normally covered by healthy tissue, also known as the gingiva. This article will explain the causes, prevention and treatment of the problem.
Gum recession is a common problem in adults over age of 40. Although in some cases the condition may start as early as the teens.
It is important not to ignore the problem, as it is one of the common signs of gum disease. As such, it may indicate loss of the underlying tissues holding the teeth in place.
It is also difficult to repair (it won’t grow back!) and therefore early detection, and correction, of the causes is very important.
Some symptoms of receding gums. Note how the tissue is stripped away from the lower teeth. These then appear to be longer, and the exposed root is darker than the tooth crown above.
Common Receding Gums Causes
Here’s a list of some of the causes of gingival recession:
This close up image shows plaque build-up, gum disease and resultant recession
- Periodontal disease (a progression from gingivitis), which itself has many causes including;
- Poor oral hygiene
- Smoking
- Certain medical conditions
- One may also experience rapid recession following the treatment of periodontal disease. This is due to the success of the treatment, in that it will reduce any swelling in the tissues. Swollen gums may hide the fact that they are in fact stripping away from the teeth. Once the swelling is gone, this will uncover any structural loss that was otherwise ‘hidden’ by the engorged gingival tissue.
- Some people have a genetic predisposition to having thin or insufficient gingival tissue, which is thus more easily lost over time. Similarly, some develop a high ‘frenum‘ (the little tags that connect your gums to the cheek/lips) can pull the gum from the teeth.
- Over-aggressive brushing can lead to a receding gum line (and tenderness) and also wears down enamel. Make sure you take care when brushing otherwise you may cause a lot of damage in the long term. Read more here.
- ANUG, a nasty acute infection that is more common in younger years.
- Crowding can lead to one or more of the teeth lying out of the line of the ‘arch’. Such teeth may therefore lie where the bone is thin, and recession may occur easily
- Grinding or clenching, over the long-term, is another possible cause.
- Dental treatments can lead to the gums receding. This may be intentional (for example to expose a tooth that is buried in the bone, or make a tooth ‘longer’ to allow for better fitting crowns). Unintentional causes include ill-fitting crowns or dentures.
- Trauma to the tissues, for example an oral or lip piercing.
Compare healthy gums to recession
What are the symptoms to watch for?
Symptoms will generally occur relatively slowly over time. One may not be aware that there is a problem, as it often occurs so gradually.
When gums recede this makes the teeth appear longer, the roots are made visible (and are typically slightly darker) and inter-dental spaces will become visibly larger. If you have any crowns or bridges in place, the margins (where they meet the underlying tooth) may become exposed. See pictures…
Apart from the obvious changes in appearance, other symptoms may include
- Sensitivity, as the roots do not have a protective enamel layer
- A notch on the tooth surface may be felt at the gum line
- As the root surfaces are less well protected, tooth decay may set in here
Where there is disease, gingival tissues appear swollen – bleeding gums and bad breath may also be present.
Recession around old dental crowns, exposing their margins (dark line)
Receding Gums Treatment
The treatment (and prevention) of receding gums will first involve ascertaining the cause, then finding out how to stop – ie reducing or eliminating this.
For example:
- Treatment and prevention of further gum disease (improved oral hygiene, use a mouthwash, floss, stopping smoking, dental scaling).
- If you are over-brushing the teeth you will need to alter your brushing technique to prevent further damage.
- Where ill-fitting dental work is causing the damage, this will need to be fixed accordingly.
- Treating any symptoms like sensitive teeth.
It is not easy to reverse tissue loss. But minor surgery such as a gum graft can be used to cover up exposed roots. In a grafting procedure, a periodontist or oral surgeon will take a flap of gum tissue, for example form your palate, and suture it to the offending area. Thus the area can be ‘bulked’ up to repair lost gum and re-cover the roots.
Treatment begins with eliminating the causes
Summary
There are several causes of receding gums, including gingival diseases and over-aggressive toothbrushing. Thus one’s oral care routine has a major input into the development of recession in many cases.
It is always important to get any concerns addressed with your dentist, as early detection and prevention of further damage is much easier than curing severe recession.