Having healthy gums is important for maintaining good oral health. Gums provide a protective seal around the teeth and help hold them firmly in place. When gums recede or pull away from the teeth, it can expose sensitive tooth roots and lead to a range of problems.
What causes gum recession?
There are several potential causes of gum recession:
- Periodontal disease – Bacterial infections that damage the gums and supporting bone.
- Aggressive brushing – Brushing too hard can wear away gum tissue over time.
- Poor oral hygiene – Not brushing and flossing properly allows plaque to build up and irritate the gums.
- Grinding or clenching teeth – Putting excessive force on the teeth can cause the gums to recede.
- Genetics – Some people are genetically predisposed to thinner gums or gum recession.
- Smoking/tobacco use – Chemicals in tobacco can damage gum tissues.
- Crooked teeth – Teeth that are crowded or misaligned can cause uneven forces on the gums.
- Pregnancy – Hormonal changes during pregnancy can increase sensitivity and lead to swelling and recession.
- Mouth piercings – Jewelry rubbing on the gums can cause them to recede over time.
Gum recession is often a gradual process that gets worse over time without treatment. The earlier it is caught, the better chance there is to reverse or halt the recession.
Stages of gum recession
Gum recession is classified into different stages based on how much of the tooth root is exposed:
- Stage 1: Gums recede and expose less than 3mm of the tooth root surface.
- Stage 2: 3-4mm of the root surface is visible.
- Stage 3: More than 4mm, up to the height of the bone, is exposed.
- Stage 4: More than 50% of the root length is exposed due to severe loss of gum tissue and supporting bone.
The higher the stage, the more severe the gum recession. Stage 1 is mild recession that can often be reversed. Stage 4 indicates advanced recession with major loss of supporting tissue and bone.
Symptoms of receding gums
Signs that you may have receding gums include:
- Tooth roots becoming visible
- Teeth appearing longer than before
- Tooth sensitivity to hot or cold foods/drinks
- Notches developing in the gum line around teeth
- Spaces or gaps appearing between teeth
- Bad breath or bad taste that won’t go away
- Pain or bleeding when brushing or flossing
These symptoms often start gradually and increase in severity over time. The earlier gum recession is treated, the better the results. Advanced recession is harder to correct.
Problems caused by receding gums
Receding gums can lead to a range of oral health issues:
- Tooth decay: Exposed tooth roots are vulnerable to decay without the protective covering of gum tissue.
- Tooth sensitivity: Roots are sensitive and have no enamel, so receding gums can cause pain from hot/cold foods.
- Tooth mobility: Gums help anchor teeth firmly. Receding gums loosen this support and allow teeth to shift or loosen.
- Bone loss: The receding gums pull away gum tissue and bone that surround and support the teeth.
- Tooth loss: Severe gum recession coupled with bone loss can lead to tooth loss.
- Infection: Gaps from gum recession provide places for bacteria to grow and cause infection.
- Bite issues: Receding gums can disrupt the alignment of teeth and how the upper and lower teeth fit together.
- Poor appearance: Receding gums make teeth look longer and can create gaps, notches, and uneven gum lines.
While mild cases may have minimal effect, advanced gum recession can be destructive to oral health. Treatments aim to reverse recession and regrow lost gum tissue.
Risk factors
Factors that increase the risk of developing gum recession include:
- Poor oral hygiene – Not adequately brushing and flossing to remove plaque.
- Smoking – Chemicals in tobacco restrict blood flow to gum tissues.
- Genetics – Some people inherit thinner gums or gum recession tendencies.
- Grinding teeth – Putting excessive biting forces on the teeth and gums.
- Misaligned teeth – Crooked teeth with gaps rub and irritate the gums.
- Age – Gums naturally recede and thin out gradually with age.
- Hormones – Puberty, menstruation, pregnancy, and menopause alter hormone levels and increase gum sensitivity.
- Diabetes – High blood sugar levels interfere with the healing ability of gum tissues.
- Medications – Some drugs like antiseizure meds, calcium channel blockers, and cancer treatment drugs increase gum recession risk.
The more risk factors that apply to an individual, the higher their chance of developing receding gums over time. Managing modifiable risk factors like oral hygiene and smoking can help reduce gum recession risk.
Diagnosing receding gums
Only a dentist or periodontist can officially diagnose and monitor receding gums. They will examine the gums and may use the following methods:
- Visual inspection: Looking for signs of inflammation, swollen gums, plaque buildup, and movement of the gums away from the teeth.
- Periodontal probe: An instrument used to measure and determine the depth of gum pockets around the teeth.
- Measure gum recession: Using a tool called a PCPUNC probe to measure how far down the gum line has receded.
- Dental X-rays: Radiographs to visualize bone loss and changes under the gum line.
- Risk assessments: Evaluating medical history and risk factors like smoking that can influence gum recession.
These diagnostic tests help classify the current stage of gum recession and determine the best treatment options.
Treatment and prevention
Various treatments are available to address receding gums based on the severity:
- Improved oral hygiene: Better brushing and flossing habits to control plaque buildup.
- Root planing: Deep cleaning under the gums to smooth rough spots and remove bacteria.
- Medications: Prescription antimicrobial mouthrinses to reduce infection and inflammation.
- Gum grafts: Surgical grafting to replace lost gum tissue and cover exposed roots.
- Flap surgery: Repositioning gum tissue to cover more of the tooth.
- Bone grafts: Grafting bone to reinforce lost gum and bone tissues.
- Soft tissue enhancement: Procedures to thicken gums and reduce sensitivity.
- Quit smoking: Stopping tobacco use improves gum blood flow and healing ability.
Treatment goals focus on halting further recession and regrowing enough gum tissue to cover tooth roots. Excellent at-home oral care and regular professional cleanings are key to preventing more recession.
Gum grafting surgery
Gum grafting is a common and effective surgical treatment for receding gums. It involves:
- Taking a small piece of tissue from the roof of the mouth (palate).
- Shaping and suturing this graft into place over the exposed tooth root.
- Securing the grafted tissue with sutures or specialty biodegradable strips.
Over several weeks as the graft heals, new blood vessels form into the transplanted gum tissue. It becomes pink and firm like healthy gums. Grafting provides greater tissue thickness to protect tooth roots and fill in gaps from recession.
There are several graft options with pros and cons:
| Graft Type | Pros | Cons |
|---|---|---|
| Connective tissue graft | – Predictable results – High success rate |
– Extra graft site – Longer recovery time |
| Pedicle graft | – No donor site needed – Maintains blood supply |
– Limited tissue available |
| Free gingival graft | – Simple procedure – No palatal wound |
– Color mismatch – Higher failure rate |
The periodontist will determine the most appropriate graft based on the individual case, gum recession severity, and amount of tissue needed.
Aftercare and recovery
Proper aftercare following gum grafting helps ensure the best results:
- Take any prescribed medications like antibiotics or pain relievers as directed.
- Use ice packs on the surgery site to minimize swelling.
- Rinse carefully with saltwater but avoid disturbing the grafted area.
- Avoid brushing or flossing around the grafted site until it heals fully.
- Follow a soft food diet and avoid chewing on the grafted side.
- Quit smoking to allow optimal healing and blood flow.
Typical gum graft recovery takes 2-3 weeks. Temporary sensitivity and discomfort are normal and resolve gradually as the gums heal. Proper graft aftercare reduces the risk of complications like infections and graft failures.
Results and outlook
With successful gum grafting, the transplanted tissue should:
- Integrate with the existing gum tissue
- Re-establish adequate width and thickness of gum tissue
- Cover and protect exposed tooth roots
- Fill in gaps from gum recession
- Improve gum contour around teeth
It takes about 8-12 weeks to see the full effects of gum grafting. In some cases, a second graft is needed to achieve the desired results. Properly cared for, grafted tissue can last for years.
However, gum recession can return without ongoing prevention. Smoking, poor oral hygiene, and grinding teeth increase the risk of recurrent recession. Regular dental exams, cleanings, and at-home care help preserve graft results.
Can receding gums grow back on their own?
In mild cases of gum recession, improving oral hygiene is sometimes enough for the gums to rebound on their own. But moderate to severe gum recession often requires surgical grafting for the gums to effectively grow back.
When should you see a periodontist?
See a gum specialist or periodontist if you notice:
- Gum recession of 2mm or more
- Ongoing gum inflammation and swelling
- Pus around the teeth
- Loose or separating teeth
- Persistent bad breath or taste
- Receding gums that keep getting worse
A periodontist can assess the gum recession, determine if grafting is needed, and perform procedures to restore damaged tissue.
Does insurance cover gum grafting?
Dental insurance plans often cover a portion of gum grafting costs, which can range from $600-$2,500 per tooth depending on the graft type and number of teeth treated. Coverage levels depend on the individual insurance policy.
Prevention
Preventing gum recession involves:
- Brushing properly twice daily with a soft or extra-soft toothbrush.
- Daily flossing to remove plaque from between teeth.
- Getting regular dental cleanings and checkups.
- Treating any gum disease or cavities early.
- Using an antimicrobial mouthrinse if prone to gingivitis.
- Wearing a mouthguard if you grind your teeth.
- Stopping tobacco use.
Avoiding recession triggers like smoking and being vigilant about oral hygiene helps keep gums healthy and in place around teeth.
Conclusion
Receding gums are a common problem that occurs when gums pull away from teeth. As more of the tooth root becomes exposed, gum recession can lead to sensitivity, decay, and loosening of teeth. Mild cases may be reversible with improved oral hygiene. But moderate to severe recession often requires surgical grafting to regrow enough gum tissue to cover exposed roots.
Preventing gum recession relies heavily on daily brushing and flossing. Regular dental visits and prompt treatment of any gum inflammation can also halt recession in the early stages. Left untreated, receding gums tend to gradually get worse over time. That’s why it’s important to see a dentist or periodontist if you notice signs of gums pulling away from your teeth.