Gingival recession (receding gums) refers to the progressive loss of gum tissue, which can eventually result in tooth root exposure if left untreated. Gum recession is most common in adults over the age of 40, but the process can begin in the teenage years.
Gum recession can be difficult to self-diagnose in its earlier stages because the changes often occur asymptomatically and gradually. Regular dental check ups will help to prevent gum recession and assess risk factors.
The following symptoms may be indicative of gum recession:
Sensitive teeth – When the gums recede enough to expose the cementum protecting the tooth root, the dentin tubules beneath will become more susceptible to external stimuli.
Visible roots – This is one of the main characteristics of a more severe case of gum recession.
Longer-looking teeth – Individuals experiencing gingival recession often have a “toothy” smile. The length of the teeth is perfectly normal, but the gum tissue has been lost, making the teeth appear longer.
Causes of Gum Recession
Gum recession is an incredibly widespread problem that dentists diagnose and treat on a daily basis. It is important to thoroughly examine the affected areas and make an accurate diagnosis of the actual underlying problem. Periodontal disease, trauma, aging, over brushing, and poor tooth positioning are the leading causes of gum recession which can lead to tooth-root exposure in severe cases. When the roots of the teeth become exposed, eating hot and cold foods can be uncomfortable, decay is more prevalent and the aesthetic appearance of the smile is altered.
Once the cause of the gum recession has been determined, surgical and non-surgical procedures can be performed to halt the progress of the recession and prevent it from occurring in the future.
The most common causes of gingival recession are:
Overaggressive brushing – Over-brushing can almost be as dangerous to the gums as too little. Brushing too hard or brushing with a hard-bristled toothbrush can erode the tooth enamel at the gum line and irritate/inflame gum tissue.
Poor oral hygiene – When brushing and flossing are performed improperly or not at all, a plaque build up can begin to affect the teeth. The plaque contains various bacterial toxins which can promote infection and erode the underlying jawbone.
Chewing tobacco – Any kind of tobacco use has devastating effects on the entire oral cavity, chewing tobacco in particular. It aggravates the gingival lining of the mouth and causes gum recession when used continuously.
Periodontal disease – Periodontal disease can be a result of improper oral hygiene or caused by systemic diseases such as diabetes. The excess sugars in the mouth and narrowed blood vessels experienced by diabetics create a perfect environment for oral bacteria. The bacterium causes an infection which progresses deeper and deeper into the gum and bone tissue, eventually resulting in tooth loss.
Treatment of Gum Recession
Every case of gum recession is slightly different, therefore many treatments are available. The nature of the problem which caused the recession to begin with needs to be addressed first.
If overly aggressive brushing techniques are eroding the gums, a softer toothbrush and a gentler brushing technique should be used. If poor oral hygiene is a problem, prophylaxis (professional dental cleaning) may be recommended to rid the gum pockets of debris and bacteria. In the case of a severe calculus (tartar) build-up, scaling and root planing will be performed to heal gingival inflammation and clean the teeth.
Once the cause of the gingival recession has been addressed, surgery of a more restorative nature might be recommended. Gum tissue regeneration and gum grafting are two excellent ways to restore natural symmetry to the gums and make the smile look more aesthetically pleasing.
The main goal of soft tissue grafting is to either cover the exposed root or to thicken the existing gum tissue in order to halt further tissue loss.
The three different types of common soft tissue grafts include:
Free gingival graft – A strip of tissue is removed from the roof of the mouth and stitched to the grafting site in order to promote natural growth. This type of graft is most commonly used for thickening existing tissue.
Connective tissue graft – For larger areas or root exposure, subepithelial tissue is needed to remedy the problem. This subepithelial connective tissue is removed from a small flap in the mouth and sutured to the grafting site. This is the most common treatment for root exposure.
Pedicle graft – This type of graft involves the “sharing” of soft tissue between the affected site and adjacent gum. A flap of tissue is partially cut away and moved sideways to cover the root. The results of this type of graft are excellent because the tissue that is moved to the adjacent area includes blood vessels that are left in place.
Reasons for soft tissue grafting
Soft tissue grafting is an extremely versatile procedure that has many uses. Recent developments in dental technology have made soft tissue grafting more predictable and less intrusive. Here are some of the main benefits associated with soft tissue grafting treatment:
Increased comfort – Root exposure can cause substantial pain and discomfort. Eating hot, cold or even warm foods can cause severe discomfort. Soft tissue grafts cover the exposed root, decrease sensitivity and restore good health to the gum area.
Improved aesthetics – Gum recession due to periodontal disease can cause the smile to look “toothy” or the teeth to appear uneven in size. Soft tissue grafting can be used as a cosmetic procedure to re-augment the gums, and make the smile appear more symmetrical.
Improved gum health – Periodontal disease is a progressive condition that can destroy soft tissue very rapidly. When used in combination with deep cleaning procedures, soft tissue grafting can halt tissue and bone loss, and protect exposed roots from further complications.
If you have any questions or concerns about periodontal disease, periodontal treatments, or gum recession, please contact our office.