An Overview of Receding Gums

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The gums consist of the pink tissue in the mouth that holds the teeth in place and protects the root of the tooth. Gums are also called gingivae. Receding gums occur when the gums pull back from the teeth exposing more of the tooth than is typical; sometimes even the root of the tooth is exposed, which can lead to serious problems. The gums are attached to the jaw bone, and problems with the jaw bone (such as thinning) can be associated with receding gums.

Symptoms

Most people do not notice receding gums until the situation has advanced to a later stage. Early signs of gum recession may include:

  • Bleeding gums when you brush or floss
  • Swollen, painful gums 
  • Bad breath

This may progress to other symptoms of gum recession such as:

  • An elongated abnormal appearance of the tooth
  • Tooth pain
  • Sensitivity of the tooth in response to things like cold or hot temperatures, or even exposure to air
  • Plaque and tooth decay

If the recession progresses even further it may result in infections and tooth loss.

Causes

There are several causes of receding gums, and your gum recession may be due to a combination of factors including:

  • Genetics (thinner gum tissue, the position of your teeth, or abnormalities in the bone that the gums are connected to)
  • Over-brushing your teeth or over-flossing your teeth (common)
  • Gum inflammation
  • Poor oral hygiene (this is common but even people with great oral hygiene can still get gum recession)
  • Misaligned teeth or teeth in an abnormal position
  • Damage from dental work
  • Piercings of the lip or tongue
  • Trauma from excessive teeth grinding or clenching
  • Periodontitis
  • Partial dentures that cause trauma to the gums or make it difficult to remove plaque

Additionally, there are certain factors that can increase your risk of developing receding gums, including:

  • Age (the older you are the more likely you are to have receding gums)
  • Smoking
  • Health conditions such as diabetes, hormonal changes, and conditions or medications that cause dry mouth

Treatment

If you or your dentist are fortunate enough to recognize gum recession early on in the process you may be able to take steps to stop or slow gum recession before further treatment is necessary. These steps typically involve: 

  • Using a soft toothbrush and avoiding excessive oral hygiene
  • Replace your toothbrush often as worn out bristles can make recession worse
  • Do not use abrasive toothpastes (toothpaste that is labeled for tartar control tends to be more abrasive than other types)
  • Floss regularly but not excessively

If these measures are not enough to control your symptoms you may need other treatments.

Desensitizing Agents

Your dentist may be able to recommend special toothpaste, varnishes, or other products that are desensitizing to decrease the nerve pain associated with the exposed root. It may be helpful to use your finger to apply a desensitizing toothpaste over the exposed root and leave it there for around a half-hour.

Composite Restoration

Composite restoration is when your dentist uses porcelain or resin to cover the gap between the neck of the tooth and the gum line. This restores a more normal appearance and also covers and protects any exposed root.

White porcelain is commonly used, but pink or reddish colored resins or ceramics that match your gums can also be used depending on what might look best in your specific case.

Veneers

Another option is removable veneers that match your gums. These can be made from many different materials, including silicone or acrylic, and can restore the appearance of your teeth and gum line.

Orthodontic Treatment

Orthodontic treatments to reposition maligned teeth can be helpful in some cases. Depending on the severity of gum recession, further treatments may be necessary once orthodontic treatment is complete.

This treatment is generally effective for individuals whose gum recession was specifically caused by the position of a certain tooth (or teeth). It can help to restore normal bone growth and subsequently result in thicker gum tissue.

Tissue Grafts

For severely recessed gums the best option may be oral surgery and tissue grafts. This is usually performed by a periodontist in the office and you can go home the same day. It is a common procedure and fairly simple.

While there are different methods to perform a gum graft it usually involves the removal of tissue from the roof of your mouth which is then stitched to your gums over the area of recession. Less commonly tissue from a tissue bank is used.

You will likely have stitches in one or two areas of your mouth. Once the area heals a normal appearance of the gum line is achieved and the root is successfully covered and protected.

You will need someone to drive you home after the procedure since you will be given medications to make you more comfortable which can alter your judgment and ability to drive safely following your surgery.

Recovery

You may need to refrain from eating for a period of time before your surgery to avoid complications associated with these medications.

Eating cold food and fluids will help to reduce pain and inflammation during your recovery. You may also need to stick to a soft diet for a little while and avoid foods that are hard, acidic, or could be irritating.

Sometimes antibiotics are prescribed after this surgery. If so, make sure you take them exactly as your doctor tells you for the entire length of time prescribed.

You may also need to avoid brushing and flossing at the surgical site until it heals. Sometimes a special mouthwash is prescribed to help with your oral hygiene and prevent plaque buildup while you are unable to brush and floss as you normally would.

You may be given other instructions to aid in your recovery before leaving your doctors office. For example, you may be told to avoid strenuous activity for a time or sent home with prescription medications to help with any discomfort following surgery. Any instructions given by your oral surgeon should supersede the information found in this article and be followed carefully to ensure the best possible outcome.

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Article Sources

  1. Patel M, Nixon PJ, Chan MF. Gingival recession: part 1 Aetiology and non-surgical treatment. Br Dent J. 2011 Sep 23;211(6):251-254. doi:10.1038/sj.bdj.2011.764

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