Gingival Recession


Gums may recede for any of several reasons, including thin tissue, abnormal position of teeth in the dental arch; malocclusion; inappropriate expansion orthodontics; heavy bite stress; and periodontal disease.
 
Symptoms
Gum recession is not something that happens overnight. In most cases, receding of gums is a progressive procedure that happens gradually from day to day over the years. That explains the fact that it is common over the age of 40. Because the changes in the condition of the gums from one day to another are minimal, we get used to the gums appearance and do not notice the changes over longer periods of time. Receding gums may remain unnoticed until someone else talks about it or until the condition starts to cause other problems.

The following signs and symptoms may indicate gum recession:

  • Sensitive teeth – Teeth become sensitive to hot and cold or to sweet, sour, or spicy foods. If the cementum covering the root is not protected any more by the gums it is easily abraded exposing the dentin tubules to external stimuli.
  • Teeth may also appear longer than normal (a larger part of the crown is visible if gums are receding).
  • The roots of the tooth are exposed and visible.
  • The tooth feels notched at the gum line
  • Change in the tooth’s color (due to the color difference between enamel and cementum)
  • Spaces between teeth seem to grow (actually the space is the same but it seems larger because the gums do not fill it any more).
  • Cavities below the gum line

If the gum recession is caused by gingivitis, the following symptoms may also be present:

  • Puffy, red, or swollen (inflamed) gums
  • Gum bleeding while brushing or flossing
  • Bad breath (halitosis)

In some cases, it is the treatment of gingivitis that reveals a gum recession problem, that was previously masked by the gums swelling.

Treatment
Treatment should start with addressing the problem which caused the gum recession. If overactive brushing is the cause, the patient should consider purchasing a softer toothbrush and use a more gentle brushing technique. If poor plaque control was a contributing factor, improved oral hygiene must be performed, combined with regular professional dental cleanings as prophylaxis. If severe calculus (tartar) was the cause, then a procedure called scaling and root planing may be necessary to clean the teeth and heal inflammation in the gingiva (gums). If malocclusion (incorrect bite) was a factor, an occlusal adjustment (bite adjustment) or bite splint may be recommended.

If cause-specific measures are insufficient, soft-tissue graft surgery may be used to create more gingiva. The tissue used may be autologous tissue from another site in the patient’s mouth, or it can be freeze-dried tissue products or synthetic membranes. New research is focused on using stem cells to culture the patients’ own gums to replace receded gums.