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.

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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. We recommend soft circular brushing with a soft toothbrush or an electric toothbrush with a pressure sensor to avoid this issue.

Insufficient dental care. Inadequate brushing and flossing makes it easy for plaque to turn into calculus (tartar) — a hard substance that can only be removed by a professional dental cleaning — and build up on and in between your teeth, causing 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, which can cause gum recession. “Chew” has particles that cut your gums for better absorption. This causes major recession in those areas and also creates a higher risk for oral cancer.

Grinding and clenching your teeth. Clenching or grinding your teeth can put too much force on the teeth, causing gums to recede. Often the teeth that touch the most are the ones with the most recession. Often a bite adjustment and an occlusal guard can help control future issues.

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.

Orthodontics. When teeth are moved to align your bite, sometimes the roots are moved slightly outside your jaw. It is bone that keeps your gums in place. It the bone is not present, the gums will recede, even with the absence of the above issues. In these situations, we sometimes suggest revisiting orthodontics as a way to restore the harmony in your mouth and reduce the risk of early tooth loss.

Body piercing of the lip or tongue. Jewelry can rub the gums and irritate them to the point that gum tissue is worn away. In our office we have seen tooth loss and bone loss from piercings, so extensive that even dental implants are not an option. If you want to save your teeth, loose the oral piercing!

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. Sometimes antibiotics will also be given to get rid of any remaining harmful bacteria.

If your gum recession cannot be treated with deep cleaning because of the 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:

Pocket depth reduction: 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.

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