Being “long in the tooth” isn’t something that’s a rite of passage into our golden years. It’s an actual clinical condition called “gum recession” or “receding gumlines.”
You see, your soft gingival tissues — or gums — are designed to be protective covers over your tooth roots and the bone that supports them. When your gums pull back or “recede”, they compromise the structures underneath. Since gum recession can come from a variety of different sources, identifying the early signs can help you prevent tissue loss from getting worse.
Most people notice receding gums by the darker, more yellowish layer of tooth being exposed. This portion of your root is covered in dentin, which isn’t as white as your tooth enamel. As the receding gum line makes its way down the root of your tooth, more dentin becomes visible. Usually you can see a stark difference in the white color of the enamel and where the receding gums once rested over the root. It can make your smile look darker, older, and unhealthier than it really is.
Depending on the severity of the gum recession, you’ll also notice gaps between your teeth (“black triangles”) and possibly even tooth mobility. Your teeth get looser naturally if you have receding gums, because the bone underneath the gum tissues is also shrinking away. Ask your dentist to see your bone levels on your X-rays and have them show you where the bone is supposed to be. If you have aggressive gum recession, there’s a good chance that the bone is receding as well.
Periodontal disease is an infection of the soft gingival tissues around your teeth. It’s frequently called gum disease. The more aggressive the infection is, the more severe the gum recession. The tissues physically detach from your root surfaces due to bacterial accumulation underneath. As your gums pull away, they take the bone tissue with them. That’s why early diagnosis and intervention is so important! If you catch periodontitis early enough while it’s still gingivitis, the condition is completely reversible.
Your oral hygiene habits have one of the biggest roles to play when it comes to gum recession. Since plaque buildup along your gums can cause infection, it’s also responsible for disease-induced receding gumlines. Similarly, flossing is what’s responsible for cleaning just under the edges of your gums, where a toothbrush can’t reach. Even if you’re a great brusher and flosser, there’s a chance that you have tartar buildup in certain areas. Over time, you’ll start to get buildup down below your gumlines, which in turn causes the tissues to recede.
Floss every day. No ifs, ands, or buts! On top of that, try to brush longer (at least two minutes minimum.) Investing in an electric toothbrush is a great choice. Maintaining a six-month checkup routine with your hygienist helps promote great oral health and gets rid of tartar buildup in hard-to-reach areas. You can think of it like a reset button between your appointments.
If you’re clenching and grinding in the daytime, being aware of it is the first step. Try to train your mouth to rest with your lips together but your teeth apart. If your bruxism is severe, a small daytime bite splint can help. Nighttime bruxing typically requires a large mouthguard for sleeping, to place a buffer between your upper and lower teeth so that your jaws aren’t fully engaged. It doesn’t hurt to get tested or screened for sleep apnea, either.
There are a lot of oral conditions that tend to “run in families.” Saying that dental problems are genetic is a double-edged sword, as many conditions are preventable, but your family history can also set you up for being predisposed to them. Gum recession is one of them. It may be that gum disease runs in your family, or you inherited crowded/crooked teeth from one of your parents (a smaller jaw from mom, larger teeth from dad, etc.) Knowing you’re prone to a particular problem can make it easier to find a solution for preventing it.
When dental issues run in families, you’ll want to talk through the concern with your dentist. Treatment could be as simple as a deep cleaning and ongoing periodontal maintenance or orthodontic therapy. Always be sure to share your family dental history with your oral health provider, as it allows for a more comprehensive approach to caring for your smile.
When it comes to toothbrushing, harder isn’t better. A lot of people tend to be overzealous with their toothbrush, using firm pressure or stiff bristles. Although your teeth are the hardest substance in your body, your gums aren’t. Brushing too hard will cause your gum tissues to start creeping back away from all of the pressure you’re applying. Over time, people who brush too hard can have gum recession as well as enamel abrasion, which is notches worn into the sides of their teeth.
Switch to a soft or extra-soft toothbrush right away. Only apply gentle pressure (just enough to make your tissue blanch.) If you invest in an electric toothbrush, simply hold it in place and allow it to do the work for you. Breaking an aggressive toothbrushing habit can be quite a challenge. Fortunately, with practice, you can get there.
Some women see changes in their gum tissues during times of hormonal shifts (including menses, pregnancy, or menopause.) Although hormonal gum changes usually cause symptoms of gingivitis, it may occasionally make it seem as if your gums are receding if the swelling is severe. By addressing the inflammation, all of that tension is released so that your gingiva can lay flat against your tooth again.
Typically, time is the best medicine. As hormonal levels begin to stabilize, the inflammation should improve. Always be sure to assess your oral hygiene routine, as plaque biofilm can amplify symptoms of gingivitis. Failing to identify true gingivitis and dismissing it as hormone-induced could allow oral infection to progress into more severe forms of gum disease.
When your teeth are out of alignment, the one that’s the top offender may start to exhibit gum recession, due to the tension on your soft tissues. The further away your tooth is, the more those tissues will pull. Over time it’s common to see the gingiva look thinner than normal and gradually recede down the root of the tooth. You’ll tend to see it the most in areas where one tooth is set further out than the others.
Orthodontic therapy is best for correcting tooth misalignment and eliminating the source of the tension. Either braces or clear aligners are appropriate, depending on the person’s age and the severity of their malocclusion. Treatment reduces the pulling on your gum tissues, so that they can continue covering your tooth roots.
A cessation plan. In other words, kicking the habit. Talk with your dentist and/or physician about what’s worked for other people, what methods you’ve tried before (if any), and possible medications that are available to help. The only way to truly treat tobacco-induced gum recession is to give it up for good.
The best treatment for a receding gum line is prevention. Soft toothbrushing, correcting misaligned teeth, and avoiding trauma (like biting at your nails or chewing on a pencil) are key. But seeing your dentist for regular checkups and dental cleanings at least every six months is one of the most important preventative steps you can take.
Once you’ve passed the point of prevention, your next treatment option is to discuss some type of graft or recession treatment with your dentist. Traditional gum grafting involves re-covering your exposed tooth roots with tissue taken from a donor site. With time and gentle care, the new tissue attaches to your tooth and makes it appear as if gum recession wasn’t ever there.
In some situations, there are less-invasive types of tissue therapies that can be used to cover your roots without an actual graft. Pinhole is one. The type of treatment your dentist recommends will likely depend on their training, experience treating similar cases, and what specialists they work with in their area.
If your recession is because of a gum infection, then periodontal therapy will also be necessary. Most people call these “deep cleanings.” In most cases, one half of your mouth is numbed and cleaned, then the other side is completed at a separate appointment. In other situations, laser therapy (also known as “LANAP”) may be incorporated into the procedure.
When gum recession is mild, some dentists can place composite “bonding” over the exposed root area. This method is more for minimizing tooth sensitivity or cosmetic purposes, as it covers the yellow dentin with a tooth-colored material that blends in with your enamel. It’s similar to a white filling but is placed onto a tooth rather than inside of it. Usually, bonding is a short procedure that may not even require anesthetic.
Mild gum recession that isn’t very visible but still creates sensitivity can sometimes be managed with fluoride or other desensitizing treatments. Depending on the product that’s used, most people see results that last anywhere between 3-6 months per application. Desensitizing treatments are preferred when your gum loss is minimal but the fraction of tooth that’s exposed is prone to hypersensitivity.
Gum surgery is typically only reserved for more severe stages of gum disease or tissue loss. Here are some of the most common types of soft tissue procedures and when they’re used:
Really aggressive periodontal disease typically requires more than your routine deep cleanings. It might actually involve retracting the gum tissue to clean tartar that’s deep down under the gingiva (and not accessible to standard instruments.) Once this type of procedure is completed, the gums are sutured back into place around the teeth. Although it’s not typically for recession per se, it is a procedure that’s used to treat the cause of periodontitis-induced receding gums.
Gum grafts involve moving soft tissue from one area to another, to cover the exposed tooth where the original gums receded. Grafts can come from different places. Some people have tissue taken from another part of their mouth, while others may take advantage of donor tissue. If you need to get a graft, your dentist will explain the type of tissue that’s recommended (and why.)
An up-and-coming gum recession treatment that’s gaining a lot of popularity is something called “pinhole” surgery. The pinhole technique involves creating a tiny opening (surprise: the size of a pinhole) further up on the gums. A small instrument is inserted to loosen the attached gum tissue in that area, then the gums are stretched over the tooth to cover it. It’s sort of like pulling the sheets up over your mattress when you’re making your bed.
When you schedule regular checkups with your dentist, you can intercept early signs of a receding gum line, before it’s even noticeable to other people. If you schedule regular dental cleanings it will prevent heavy tartar buildup from forming under your gums, limiting the chances of periodontitis-induced gum recession.
Additionally, make sure you’re brushing properly. Overzealous brushing or using a medium to stiff-bristled toothbrush can cause receding gums. Only use a gentle, soft toothbrush or electric brush. On top of that, only apply just enough pressure so that your tissues gently blanche when you’re brushing. Anything harder than that isn’t good for your gum tissues.
If you smoke or use any type of tobacco products, now is a great time to quit. Tobacco users tend to see gum recession first, since other signs of periodontal disease aren’t as noticeable (due to the impaired blood flow in their mouth.)
Rotated or tilted teeth should be brought into alignment with their neighbors so that the gum tissues don’t stretch and pull on their own. Even though hyper-aggressive orthodontic therapy can contribute to gum recession, it’s more likely that crooked teeth will first.
Finally, if you happen to have any habits such as clenching your teeth, biting on things, etc., all of that irritation is cumulative. Over time, it can cause your gums to pull back. Go ahead and make a point to try to kick those habits to the curb.
A lot of people don’t make a fuss about their receding gum lines until their gum recession has reached a fairly significant state. Knowing the warning signs and causes of receding gums can prevent a lot of worry and treatment later on down the road. Although gums cannot “grow back” on their own, there are treatments out there designed to help re-cover exposed tooth roots for oral health and aesthetic purposes. Bottom line, gum recession is something that’s best to prevent before it gets too bad.
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