What is Gum Recession / Gingival Recession?
Gum recession is a gum disease (periodontal disease) in which the root of the tooth is exposed due to migration of the gum margin above the cementoenamel junction (CEJ), the junction of the tooth with its root. The fibers that attach the gum to the tooth and the bone get detached or are compromised, thus exposing the root.
Gingival recession also known as “receding gums” can be localized to a particular tooth or generalized affecting more than one tooth. Receding gums may or may not cause tooth sensitivity.
Receding gums are commonly observed in adults, mainly above the age of 40 years, but this dental problem is also seen in teenagers or children.
The causes of gingival recession are as follows:
- Brushing or flossing the teeth very hard or for a long time.
- Gum disease (Periodontal disease)
- Improper flossing, which may injure the gums
- Hereditary factors
- Thin gum (biotype)
- Scurvy (Deficiency of vitamin C)
- Acute necrotizing ulcerative gingivitis
- Use of teeth braces in adults
- Use of dipping tobacco
- Cigarette smoking
- Gutkha chewing
- Poor oral hygiene
- Periodontal pocket reduction surgery
- Abnormal tooth positioning like crooked teeth or misaligned bite
- Bruxism (Grinding of teeth), which can worsen any pre-existing gum disease
- Lips and tongue piercings which can damage the gums by rubbing against them
- Self-induced trauma such as putting a pencil or fingernail into the gums. This habit is mainly observed among children or people with psychiatric problems
- Traumatic injury to gums due to any accidental injury or due to poorly fitted dental appliance in the mouth such as a removable partial denture, crowns or bridgework
Gum recession is a progressive condition that worsens gradually over the years. As it is a slow process, gingival recession can go unnoticed for many years until its symptoms get worse and cause discomfort.
The signs and symptoms of gum disease are:
- Exposed root surfaces
- Loose teeth
- Bleeding gums
- Inflamed gums
- Longer tooth line
- Tooth sensitivity
- Cavities below the gum line
- Spaces between the teeth seem to be more due to lack of gums
- Difference in tooth color (due to exposure of the root which has a different color as compared to the enamel)
- Bad breath
Gingival recession is diagnosed by a periodontist, dentist or dental hygienist at the time of periodontal examination. This type of dental examination should always be a part of your regular dental check-up.
A periodontal probe is used to measure the sulcus (space) depth present between the tooth and the gums. Normally, the depth of a healthy sulcus is three millimeters or less and does not bleed.
In few cases, x-rays may be required to know the condition of the tooth and the jawbone. Tooth sensitivity is examined near the gum line which may be present in receding gums.
Your dental doctor will check the sulcus depth, bleeding, inflammation and mobility of tooth to conclude any gum disease such as gingivitis, periodontitis or advanced periodontitis. In the presence of a periodontal disease, the pockets are usually deeper than normal.
The aim of a periodontal treatment is to completely clean the pockets surrounding the teeth and prevent damage to the surrounding jawbone. This dental treatment can be performed by a dentist, a dental hygienist or a periodontist. It is also important on your part to maintain good oral hygiene for a successful treatment outcome.
There are two types of treatments involved, which include non-surgical treatment and the surgical treatment.
Non-Surgical Treatment – If the gum disease is in its initial stage, then few procedures are followed, including:
- Scaling and Root Planing– Scaling is a non-surgical periodontal therapy, which removes dental plaque and calculus from tooth surfaces. During the procedure of root planing, the root surfaces are smoothened.
- Antibiotics – Your dentist may suggest topical or oral antibiotics to treat the existing bacterial infection. Topical antibiotics consist of gels, which can be used between the tooth and the gums.
- Surgical Treatments – The surgical treatments include:-
- Flap Surgery (Gingivectomy, Pocket Reduction Surgery, Osseous Surgery) – In this procedure, your dentist makes small incisions in the gum tissue and pulls it back to clean infection-causing bacteria over the root surface. In few cases, the underlying damaged bone is smoothened to prevent bacterial accumulation. After the cleaning process is over, the gum tissue is sutured back into its place.
- Soft Tissue Grafts – To replace the loss of gum tissue due to periodontal disease, a small amount of tissue is taken from your palate or any other donor source and is attached to the affected site. This procedure restores the exposed roots and gives your teeth an attractive appearance.
- Bone Grafting – This surgery is performed when your jaw bone is lost due to periodontitis. The graft consists of small fragments of your bone, or the bone can be donated or synthetic. Bone graft procedure helps preserve your tooth by holding it in place.
- Tissue Regeneration – This facilitates the bone or the tissue that was damaged by the periodontal disease to re-grow. After cleaning the periodontal pocket, the doctor will keep a regenerative material to stimulate re-growth of tissue or bone in that particular area.
- Pinhole Surgical Technique (PST) – It is a scalpel-free, suture-free procedure for treating receding gums. This method was invented by Dr. John Chao. It is performed by incising a small opening with a needle in the gum tissue. Using special dental instruments, the dentist operates through this opening to bring the underlying tissue over the receded part of the tooth and thereby restore the gum line to a normal level.
- Follow proper brushing and flossing techniques
- Avoid tobacco
- Go for regular dental check-ups
- Use a soft toothbrush
- Eat a balanced diet
- Avoid putting foreign objects in your mouth that can cause gum recession
- Maintain good oral hygiene
- Gum recession treatment and gum contouring - (http://www.perioimplants.co.uk/gum-treatments/gum-recession-contouring)
- Gum disease - (http://www.nhs.uk/Conditions/Gum-disease/Pages/Introduction.aspx)
- Periodontitis - (http://www.mayoclinic.org/diseases-conditions/periodontitis/basics/tests-diagnosis/con-20021679)
- PERIODONTAL POCKET REDUCTION PROCEDURES - (https://www.perio.org/consumer/pocket-reduction-procedures.htm)
- Gum Recession Treatment Options - (http://www.implantdocs.us/gum-recession/gum-recession-treatment-options.aspx)
- Gingival recession - (https://en.wikipedia.org/wiki/Gingival_recession)
Latest Publications and Research on Gum Recession
- Periodontal disease might be a risk factor for graft versus host disease. A systematic review. - Published by PubMed
- Considerations in the replacement of over-retained primary teeth with implant restorations in the esthetic zone: A case report. - Published by PubMed
- Extraction of a malpositioned maxillary anterior implant and simultaneous flapless ridge augmentation: a case report. - Published by PubMed
- A modified combined approach to harvest connective tissue grafts with high quality, less morbidity, and faster healing. - Published by PubMed
- Ligature induced periodontitis causes atherosclerosis in rat descending aorta: an experimental study. - Published by PubMed
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Dr. Rashmi Singh Thakur. 2021. Gum Recession | Gingival Recession - Causes, Symptoms, Diagnosis and Treatment. Medindia, viewed May 22, 2022, https://www.medindia.net/patients/patientinfo/gum-recession.htm.
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