When the tides recede, they expose the shells on the beach before rolling back in and covering everything up again. When your gums recede, they reveal the roots of your teeth -- but then they just keep on shrinking back. And, unlike nautilus and conch shells, the roots of your teeth aren't something anyone wants to display.
Gingival recession, the term for receding gums, is more than an aesthetic issue. Exposed roots make teeth sensitive to heat and cold and increase your risk of cavities, too.
Many people don't even notice that their gums are receding until the recession is advanced. It's a gradual process, and you might not discover the difference until your teeth seem to look a lot longer than they used to.
The soft tissues that anchor your teeth to the bone underneath them, when they're healthy, are coral-colored, and they hug your teeth like a turtleneck -- nice and snug.
In some people, the tissue around the bone is thinner. It's not their fault; it just grew in that way, possibly as a result of prominent roots, large or unfortunately placed muscle attachments or previous orthodontic work [source: Qualey and Valentine].
Thin gum tissue can also be caused by trauma, however, like overzealous tooth brushing and teeth grinding, or bruxism. Grinding and jaw clenching put your teeth under a lot of pressure, and that kind of pressure doesn't come without consequences. Besides headaches, sensitivity and a sore jaw, bruxism can also loosen the teeth's position in your gums. The solution is a night guard that you can get specially made for you by a dentist. Insurance usually covers part of it, and it will keep your sleeping self from crunching through the night.
As for the aggressive brushing -- that's an easier fix. Get a good toothbrush (a soft one), and learn how to brush properly. Here's a hint: If you're scrubbing away back and forth like your teeth are a washboard and your toothbrush is a heavily stained shirt, you're doing it wrong.
All tooth surfaces are not created equal:
- Outer and inner surfaces: Tilt your toothbrush to a 45-degree angle and use short strokes.
- Chewing surface: The part where it's OK to use the washboard technique! Go back and forth with your toothbrush held flat.
- Inside of front teeth: Brush up and down with your toothbrush held vertically.
Next up, let's look at some gingival recession treatments.
Gingival Recession Treatments
The other cause of gingival recession is something you can control: periodontal disease.
Gum disease all starts with plaque, the sticky film that forms on our teeth due to a combination of what we eat and bacteria. When you don't brush and floss properly, plaque eats away at your teeth, leads to cavities and irritates your gums.
Gingivitis is the least severe stage of periodontal disease, characterized by tender gums that bleed when you brush or floss. They're also shiny, much redder and softer than usual, and swollen-looking.
When the gums get inflamed, they move away from your teeth. (The gum turtleneck is now more of a cowl-neck sweater.) Usually, the depth of the little space around your teeth is up to 3 millimeters. (Dental hygienists measure this distance with a periodontal probe.) Four millimeters and greater of pocket depth means there's a problem.
Once bacteria have made their way into this gross gum moat, you need a dentist's help to get rid of it. Your toothbrush simply won't do the trick. What you need is root planing and scaling, procedures in which the roots are scraped clean. Sometimes, antibiotic threads are placed in the areas most affected by bacteria.
If your periodontitis has progressed further, a pocket reduction may be necessary. Your dentist or periodontist has to get a little more physical with your gums, pulling them way back to get at plaque and tartar before placing them where they need to be.
One treatment option may be a soft tissue graft,commonly used for gum recession caused by periodontal disease or thin gum tissue not caused by disease. During this procedure, tissue is taken from the roof of the mouth or nearby thicker gum areas and grafted onto the thinner places to cover exposed roots.
A regenerative procedure may also be employed, applying a substance like enamel matrix derivative to help new bone and tissue form where it's needed. One procedure, developed at Tufts University, involves a collagen membrane combined with a platelet concentrate gel that's dunked in the person's own platelets [source: Tufts University].
There's also a tunneling procedure that's more difficult to perform but doesn't involve a lot of incisions like traditional grafting [source: Brant]. (Click here for a video of the tunneling procedure.)
Which one is right for you? That's a lengthy discussion you should be having with your dental clinician. Luckily, we've got lots more information on the next page to help you prepare.
- American Academy of Periodontology. March 2, 2011 (Sept. 27, 2011) www.perio.org
- Brant, Edward. "Gum Grafting: Root Covering Tunnel Procedure." (Sept. 27, 2011) http://www.longislandreconstructiveperiodontics.com/video/video_periodontal_tunneling.html
- Crest.com. "How to Brush Your Teeth." (Sept. 27, 2011) http://www.crest.com/dental-hygiene-topics/how-to-brush-your-teeth.aspx
- Kassar, Moawia M. and Robert E. Cohen. "The etiology and prevalence of gingival recession." The Journal of the American Dental Association. 2003 (Sept. 27, 2011) http://www.adajournal.com/content/134/2/220.full
- PubMed Health. "Gingivitis." A.D.A.M. Medical Encyclopedia. Feb. 22, 2010 (Sept. 27, 2011) http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002051/
- Qualey, C. Thomas and Randall L. Valentine. The Gum Recession Project. 2000 (Sept. 27, 2011) http://www.gumrecession.com/
- Saadoun, Andre P. "Current Trends in Gingival Recession Coverage -- Part I: The Tunnel Connective Tissue Graft." August 2006 (Sept. 27, 2011) http://www.aero-dental-club.com/fichiers/SaadounCurrent_trends_in_gingival_recession_part_1.pdf
- Tufts University. "New Treatment for Receding Gums: No Pain, Lots of Gain." July 1, 2009 (Sept. 27, 2011) http://news.tufts.edu/releases/release.php?id=111
- Turner, Tom. "Measuring gum recession -- why pocket depth is important." May 16, 2011 (Sept. 27, 2011) http://kennesaw-dentist.com/peridontal-disease/measuring-gum-recession-pocket-depth-important/
- WebMD. "Receding Gums." June 6, 2010 (Sept. 27, 2011) http://www.webmd.com/oral-health/guide/receding_gums_causes-treatments