It is a process in which the gums which surrounds teeth moves towards end of the root exposing more of tooth structure. There is apical shift in position of gums in case of gum recession which causes exposure of roots. It is a very frequent problem. Gum recession in front teeth can easily be noticed and it looks unaesthetic. Recession of gums may involve a single tooth or few teeth (Localized recession) or may involve all the teeth (Generalized recession). Gum recession occurs gradually. In case of gum recession, tooth looks longer than normal and causes sensitivity of the teeth. A notch may be felt on top of the tooth below the gum line in case of gum recession.
Causes of Gum Recession
Plaque induced Gingival inflammation
Plaque induced gingival inflammation is the primary cause for gingival recession. Gum infections will destroy the gum tissues and supporting bone which hold the teeth in place. To avoid gum recession, patient should maintain Good Oral Hygiene so that there are no deposits on the teeth.
Gingival Recession due to Inflammation
Faulty Tooth Brushing
Faulty tooth brushing is other common cause which causes gum recession. If a person is brushing his teeth too hard or if technique of tooth brushing is not correct, then it can cause erosion of enamel of teeth and will cause gums to recede. Brushing with hard bristles tooth brush also lead to gum recession. Patient should follow correct brushing technique to avoid gum recession.
Gingival Recession associated with Faulty Tooth Brushing
Tooth malposition or position of tooth in arch
In case of tooth malposition, any kind of trauma or frictional forces on tooth can lead to gum recession. If a tooth is more forwardly placed, then the periodontium that is the gums will be invariably thin in that portion. Any kind of forces will lead to recession of gums. If the tooth is in malposition in dental arch, then Dental Braces treatment should be done to correct the alignment.
Gingival Recession associated with Tooth Malpositioning
In case of traumatic bite, teeth don’t come together evenly and causes more of force on gums which causes gum recession.
Grinding or clenching of teeth
Clenching or grinding of teeth puts too much force on the gums which further leads to gum recession. Clenching of teeth at night is known as bruxism. To avoid gum recession, clenching of teeth should be corrected.
Gingival recession may be associated with periodontitis. Periodontitis is severe form of gingivitis in which loss of attachment and bone takes place.
Gingival Recession Associated with Periodontitis
Smoking and Tobacco products
Positive correlation exists between smoking and gum recession. Gum recession is more common in tobacco users than non-tobacco users. Chances of sticky plaque are more in case of tobacco users which further causes gum recession.
Tongue or lip piercing
Tongue or lip piercing can lead to gum recession. Piercing may irritate the gums by rubbing the gums and can cause wearing of gums and recession of gums.
Hormonal changes in women during pregnancy, menstruation and lactation can cause gums to become more sensitive and become more vulnerable to recession.
Aging was also thought to cause gum recession. However this idea was discarded because of lack of convincing evidence that aging cause’s shift of gingival attachment.
Gum Recession Symptoms
1. In case of gum recession, root surface is exposed and tooth becomes extremely sensitive because of gum recession.
2. Hyperemia of pulp may occur due to gum recession. Blood vessels which are present around the pulp of tooth will dilate and will cause painful pressure.
3. If recession occurs in interproximal area (Area between 2 teeth), then it causes oral hygiene problem by causing accumulation of plaque and calculus.
4. Recession of gums in front teeth will be aesthetically unacceptable.
Treatment of Gum Recession
If mild gum recession is present, then it can be treated by dental cleaning of the affected area. To remove the plaque and calculus deposits from the teeth, dental scaling and root planning is done. Root area which is exposed, is smoothened and it is made more difficult for bacteria to attach itself. Antibiotics may also be given to patient to treat gum recession. Any major dental surgery is not required in case of minor recession. If there is sensitivity present due to mild gingival recession, then desensitizing tooth paste can be given to the patient. Restoration may also be done to reduce the sensitivity.
If gum recession is severe and has caused excess of bone loss and deep pockets are present, then gum surgery may also be required to treat gum recession.
Gum Recession Surgery
Exposed and denuded root surfaces are covered for 2 main purposes. It is covered to solve esthetic problem for front teeth and to widen zone of attached gingival which will further solve mucogingival problems.
To treat gum recession, pocket reduction surgery, regeneration or gingival grafting may be required. Gum reduction surgeries are performed by periodontist who are gum specialists. In case of gum reduction surgery, harmful bacteria and other microorganisms are removed from the pocket and then gum tissue is secured over the tooth root. Pocket reduction surgery eliminates the pocket or reduces the size of pocket.
If excess of bone loss has occurred because of gum infection, then regeneration of bone is done. For regeneration of bone, membrane, graft tissue or tissue stimulating protein is used.
Gingival grafting procedure may be used to treat gum recession. Gingival grafting is gingival reconstruction procedure in which rebuilding of gums is done. In this procedure, local anesthesia is given to the patient and graft is taken for reconstruction. Graft can be taken from roof of patient’s mouth or can be taken from any nearby tissue from the patient’s body.
Prevention of Gum Recession
Best method to avoid recession of gums is to maintain good oral hygiene by brushing and flossing regularly. Dental visits should be scheduled twice every year. Soft bristled tooth brush should be used for brushing and patient should not use faulty technique of brushing. Patient can ask his dentist to teach him correct way of brushing teeth. If traumatic bite or teeth grinding is causing gum recession, then they should be corrected. If a person is in the habit of grinding teeth, then mouth guard may be given to the patient. In case of traumatic bite, cause of traumatic bite is found and bite of the patient is corrected. If traumatic bite is because of some missing teeth, then it should be replaced and if it is because of incorrect alignment of teeth, then alignment needs to be corrected. Person should quit smoking to prevent gum recession and should eat balanced diet.