Gum Recession

added on: December 3, 2015

A very common oral condition is gingival or gum recession. Many patients can tell they have a problem from experiencing sensitivity on the roots of their teeth when brushing or eating or by just looking at their changing gum line. Receding gums can affect one tooth or many teeth and can be caused from anatomic variations in the bone covering the roots of the teeth; from bacterial infection of the gums and bone support; trauma to the gums; from muscle attachments that pull at the gum line; orthodontic treatment; grinding and/or clenching of the teeth or from an unstable bite/jaw joint.

The treatment of some types of receding gums can begin with prevention. When brushing, use only a soft toothbrush and non-abrasive toothpastes. Strong pressure while brushing is also not recommended. Using a typical manual toothbrush and gentle small round circular motions at the gum line will sufficiently clean the teeth. If using an electric toothbrush of any type, use a very light touch in order to allow the brush to do the work for you.

If you do have a tooth with gum recession, the cause should be discovered to properly decide on the treatment indicated. It is very possible that you have simply brushed too hard in the area causing the gums to recede, exposing the root surface with associated sensitivity. Exposed root surfaces are more prone to decay and as they are softer than enamel, also more prone to damage from brushing. Treatment for this type of recession consists of using toothpaste for sensitive teeth in conjunction with changing brushing techniques. If this is not sufficient to stop the sensitivity or if a defect exists in the root surface, a small tooth colored filling can be bonded over the surface which would stop the sensitivity and protect the root from further damage. If the recession is extensive, a gum graft can be surgically placed at the site to cover the root surface and restore the anatomical contours.

At times, thin, fragile gum tissue associated with orthodontics can result in gum recession. If the recession covers multiple teeth, surgical intervention would be the best choice of treatment. At times, a potential problem can be identified prior to orthodontics and a surgical procedure could be completed before braces were started to prevent gum recession.

Gum recession can be caused by periodontal disease, which is a bacterial infection that affects the gingival tissue and the bone supporting it. As part of your evaluation for gum recession, we have examined you for gum disease and considered whether that is a factor for you.

Another common cause of gum recession is an unstable bite, which means too many teeth are “bumping” or “rubbing” against each other during chewing.  The teeth and gums are subjected to excessive lateral forces and the gums respond by shrinking away.   An unstable bite can also lead to grinding and/or clenching of teeth during sleep and TMJ problems like myofacial pain, headaches, and limitation of opening of the mouth. Gum recession often occurs with a condition called abfraction. Abfraction occurs when the excessive lateral biting pressure results in the enamel at the gum line to pop off the tooth, leaving exposed root surface. Both abfraction and gum recession are often due to an unstable bite – so how we evaluate your bite?

Your bite can be evaluated by making three dimensional study models of your teeth along with measurements of how your bite fits so it can be studied further on a bite simulator.  On your back teeth, you will notice that there are points (cusps) and valleys (fossae). In an ideal bite, the cusps of your back teeth fit tightly into the fossae of your opposing teeth while the two jaw joints (TMJ’s) seat completely in their sockets. This is the least stressful and least destructive bite relationship for your teeth, bone, gums, TMJ’s, jaw muscles, and your existing dental work. The human bite is capable of generating forces measuring up to 900 pounds per square inch – so when your bite does not line up correctly, damage can and will occur.  Clenching or grinding with a bad bite can make existing gum recession worse.

 

Posted In: Dental Health