Gingival Recession

Gingival recession is the term that is used when the tissue of the gums retracts or is lost and the roots of the teeth become exposed. It is also referred to as receding gums. Gingival recession is a common concern in adults, though it may also occur in young people.

The most common cause of gingival recession is periodontal disease, though there are many other causes. Brushing the teeth incorrectly can also cause gingival recession, either because of the force of brushing, the direction of the brushstrokes, or a combination of both. It is also important to use a soft-bristled brush, to reduce the risk of damaging the gum tissue while brushing. Flossing incorrectly may also damage the gum tissue. Using chewing tobacco, or dip, causes the gums to recede over time, as it damages the soft tissues in the mouth. Certain habits that involve chronic chewing or biting can also lead to gingival recession, as can friction caused by piercings in the lip or tongue. Gingival recession may also occur due to tooth crowding or other abnormal positioning of the teeth, vitamin deficiency, or a condition called acute necrotizing ulcerative gingivitis, and, in some people it arises simply due to a genetic predisposition to have thinner or more fragile gum tissue.

Gingival recession usually occurs over the span of several years, which is the primary reason it is most evident in older people. It may also happen so gradually as to be unnoticeable until symptoms arise, and, when it is a symptom of gum disease, recession may not even become clearly visible until inflammation is treated, as swelling may create the appearance of fuller, more robust gums. One of the first symptoms of gingival recession is hypersensitivity that manifests as sharp pain when the teeth are exposed to food or drink that is extreme in temperature, acidity, or sugar content. This arises as the sensitive roots of the teeth lose their protective gum layer and become more vulnerable to all sorts of stimuli. The teeth may also become mobile when the gums recede, in addition to appearing longer than normal. It may be possible to see the line where the cementum and enamel meet if the gums recede sufficiently, and this cementoenamel junction may also be detectable by touch, as a notch that can be felt at the gum line. Gingival recession also contributes to a greater likelihood of cavities forming below the gum line. When gingivitis is the cause of gingival recession, receding gums may be accompanied by visible inflammation, bleeding upon brushing or flossing, and bad breath.

Depending on the levels of recession and other damage in the oral cavity, treatment may require gum grafts. These grafts may use adjacent gum tissue to compensate for areas of recession, or they may use tissue from the roof of the mouth. More recent innovations in gingival grafting techniques have led to the development of a processed allograft called acellular dermal matrix, which may be used instead of tissue from the patient’s own mouth. This cellular matrix can be combined with a bone-graft material called platelet-derived growth factor, helping grafted tissue integrate more completely with the patient’s own healthy tissues. Whatever the procedure, once a gingival graft has healed, a final sculpting procedure helps achieve optimal results, and, in many cases, complete coverage of a previously receded area is possible.