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Receding gums is a condition that occurs on both the upper palate and lower palate of the mouth. The gums, the protective tissue around the teeth, are pulled back and receded towards the roots.

Primary causes of receding gums

There are several possible causes for recession.

Toothbrush abrasion. This condition can occur over time with the use of improper hard-bristled toothbrushes. In this case, the protective enamel of the teeth is worn down by overly-aggressive scrubbing of the sides of the tooth surfaces at the gum line.  This combined with abrasive ingredients in many toothpastes and caustic mouthwashes used in the home speeds up the erosion process. 

When enough of the protective enamel is worn away it exposes the nerves inside the tooth area called the dentin.  The dentin is made up of tiny tubes which travel from the nerve of the tooth to the exterior surface. These tubes act as a conduit transferring the sensations of cold foods and liquids to the nerves where they are perceived as pain.
 
Periodontitis. An inflammatory disease that affects the tissues that support the teeth. It is caused by bacteria and enzymes that live and thrive on the surface of the teeth. It is diagnosed by the inspection of the gums and the pockets formed between the gum and the teeth. X-rays can indicate the extent of bone loss and help determine the necessary treatment.

Improper dental hygiene. Allows food particles to decay in the pockets between the teeth. The decaying food matter then causes toxins to be released by the bacteria which in turn attack the bone socket anchoring the teeth to the mandibles, or jaw bones. In time, as the gums recede further and more bone is lost, if periodontal treatment isn’t started, teeth will loosen and be lost as well.

Secondary causes of receding gums

Bulimia. An eating disorder characterized by a craving for food, followed by self-induced vomiting. The regurgitated stomach contents contain hydrochloric acid which is corrosive to the teeth and gums

Tobacco. All forms of tobacco can contribute indirectly to recessed gums. Especially dangerous is chew tobacco, where the compact tobacco leaf is in constant contact with the mucous lining of the mouth.

Teeth grinding. Occurring mostly during sleep, the enamel on the sides of the teeth is grated down, exposing the nerves and predisposing the mouth to gum recession disease.

Piercing. Metal ornamental jewelry for the mouth and tongue has given us another method to wear away at the teeth and mouth tissues causing premature gum recession among the teenagers, faddists and counter-culture groups.   

Symptoms of periodontal disease

It may be a silent disease, but there are some tell-tale symptoms that make it easy to suspect. Gums that are chronically sore, swollen, red or bleeding— along with bad breath may be warning signs.

Old age, in itself is not a factor - it can start as early as adolescence with bone erosion taking place before awareness of the condition occurs. As food pockets get deeper and deeper, they become more difficult to clean out and contribute millions more bacteria to destroy even more bone.

Tooth sensitivities to temperatures and touch are another symptom of possible gum disease. Not to be ignored, once they have been noticed and reported to the dentist, they can be reduced by several methods:

  1. use of a toothpaste containing ingredients that desensitize the teeth
  2. bonding with resins over the worn areas of the teeth
  3. gum grafting with self-donated tissue to cover the exposed areas

Conservative treatment of Receding gums

Receding gums may not be so easy to detect but as soon as gum disease is suspected—treatment should begin.  A dental examination will reveal loose teeth and the size and depths of the food pockets. Early treatment can stop the disease from progressing and in some cases even where there has been bone loss— pocket depth have been reduced to a degree where previously loose teeth will actually tighten in their sockets.

Treatment should consist of reversing, or ceasing to do those dental habits that caused gum recession in the first place:

  • Overzealous brushing can be corrected with the gentle use of a soft-bristled brush
  • Allowing plaque to build up, can be controlled with better oral hygiene and more frequent cleanings
  • Allowing plaque to harden into tartar, can be removed with periodical deep scaling and root planning
  • Gum infections and inflammations are treatable by oral and topical antibiotics
  • Stop smoking or use of chewing tobacco
  • Correct all teeth misalignments which may be irritable to the gums

Surgical treatment of receding gums or gingival grafting 

Gingival grafting. Periodontal plastic surgery is another option when more drastic treatments are called for. Depending on the degree of gum recession and the amount of bone loss present, new gum tissue can be grafted to the areas where the recession occurred.

There are a few different methods of gum transplantation surgery ranging from repositioning the existing gum tissue, or taking gum tissue from either the patient or a donor to fill in the space left by the receding gums.

In either event, this is considered oral surgery and must be done by a qualified and certified periodontist. It is performed using a local anesthesia with or without sedation, depending on the patient’s wishes. There is also a new emerging science of using stem cells to grow new gum tissue, which though still experimental, promises to be a valid method to restore gum tissue without the need for surgery and long recovery times.

Healing from surgical procedures averages about three weeks, depending on the overall condition of the patient’s health. In few months, after the swelling diminishes and the tissue color returns to normal, the results can be evaluated. In some instances, there may be a second procedure necessary to resculpt the replacement tissue. This is a relatively minor adjustment to get the best possible result. If there has not been a great deal of bone loss, it is even possible to achieve complete restoration of gum to the recessed area.

  • Nutritional Healing, Third Edition, J.F.Balch, MD, Periodontal Disease, 1998
  • Guide to Good Health, K.W. Donsbach, Dr., Long Shadow Books, 1995
  • Family Medical Guide, Kunz and Finkel, MD’s, Teeth and Gums, 2001