Receding Gums

Gum recession is the process in which the margin of the gum tissue that surrounds the teeth wears away, or pulls back, exposing more of the tooth, or the tooth's root. When gum recession occurs, "pockets," or gaps, form between the teeth and gum line, making it easy for disease-causing bacteria to build up. If left untreated, the supporting tissue and bone structures of the teeth can be severely damaged, and may ultimately result in tooth loss.

Gum recession is a common dental problem. Most people don't know they have gum recession because it occurs gradually. The first sign of gum recession is usually tooth sensitivity, or you may notice a tooth looks longer than normal. Typically, a notch can be felt near the gum line.

Gum recession is not something you want to ignore. If you think your gums are receding, make an appointment with your dentist. There are treatments that can repair the gum and prevent further damage.

Why Do Gums Recede?

There are a number of factors that can cause your gums to recede, including:

Periodontal diseases. These are bacterial gum infections that destroy gum tissue and supporting bone that hold your teeth in place. Gum disease is the main cause of gum recession.

Your genes. Some people may be more susceptible to gum disease. In fact, studies show that 30% of the population may be predisposed to gum disease, regardless of how well they care for their teeth.

Aggressive tooth brushing. If you brush your teeth too hard or the wrong way, it can cause the enamel on your teeth to wear away and your gums to recede.

Insufficient dental care. Inadequate brushing, flossing, and rinsing with antibacterial mouthwash makes it easy for plaque to turn into calculus (tartar) -- a hard substance that builds on and between your teeth and can only be removed by a professional dental cleaning. It can lead to gum recession.

Hormonal changes. Fluctuations in female hormone levels during a woman's lifetime, such as in puberty, pregnancy, and menopause, can make gums more sensitive and more vulnerable to gum recession.

Tobacco products. Tobacco users are more likely to have sticky plaque on their teeth that is difficult to remove and can cause gum recession.

Grinding and clenching your teeth. Clenching or grinding your teeth can put too much force on the teeth, causing gums to recede.

Crooked teeth or a misaligned bite. When teeth do not come together evenly, too much force can be placed on the gums and bone, allowing gums to recede.

Body piercing of the lip or tongue. Jewelry can rub the gums and irritate them to the point that gum tissue is worn away.

How Is Gum Recession Treated?

Mild gum recession may be able to be treated by your dentist by deep cleaning the affected area. During the deep cleaning -- also called tooth scaling and root planing -- plaque and tartar that has built up on the teeth and root surfaces below the gum line is carefully removed and the exposed root area is smoothed to make it more difficult for bacteria to attach itself. Antibiotics also may be given to get rid of any remaining harmful bacteria.

If your gum recession cannot be treated with deep cleaning because of excess loss of bone and pockets that are too deep, gum surgery may be required to repair the damage caused by gum recession.

What Type of Surgery Is Used to Treat Gum Recession?

The following surgical procedures are used to treat gum recession:

Open flap scaling and root planing: During this procedure, the dentist or periodontist (gum doctor) folds back the affected gum tissue, removes the harmful bacteria from the pockets, and then snugly secures the gum tissue in place over the tooth root, thus eliminating the pockets or reducing their size.

Regeneration: If the bone supporting your teeth has been destroyed as a result of gum recession, a procedure to regenerate lost bone and tissue may be recommended. As in pocket depth reduction, your dentist will fold back the gum tissue and remove the bacteria. A regenerative material, such as a membrane, graft tissue, or tissue-stimulating protein, will then be applied to encourage your body to naturally regenerate bone and tissue in that area. After the regenerative material is put in place, the gum tissue is secured over the root of the tooth or teeth.

Soft tissue graft: There are several types of gum tissue graft procedures, but the most commonly used one is called a connective tissue graft. In this procedure, a flap of skin is cut at the roof of your mouth (palate) and tissue from under the flap, called subepithelial connective tissue, is removed and then stitched to the gum tissue surrounding the exposed root. After the connective tissue -- the graft -- has been removed from under the flap, the flap is stitched back down. During another type of graft, called free gingival graft, tissue is taken directly from the roof of the mouth instead of under the skin. Sometimes, if you have enough gum tissue surrounding the affected teeth, the dentist is able to graft gum from near the tooth and not remove tissue from the palate. This is called a pedicle graft.

Your dentist can determine the best type of procedure to use on you based on your individual needs.

How Can I Prevent Gum Recession?

The best way to prevent gum recession is to take good care of your mouth. Brush and floss your teeth every day and see your dentist or periodontist at least twice a year, or as recommended. If you have gum recession, your dentist may want to see you more often. Always use a soft-bristled toothbrush and ask your dentist to show you the proper way to brush your teeth. If a misaligned bite or teeth grinding is the cause of gum recession, talk to your dentist about how to correct the problem. Other ways to prevent gum recession include:

• Quit smoking if you smoke.
• Eat a well balanced and healthy diet.
• Monitor changes that may occur in your mouth.

By taking good care of your teeth, you can have a healthy smile forever.

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