Have you ever noticed your gums retracting and your teeth becoming longer and longer? And you get so upset because you are part of the Oral Hygiene Fan club and own 5 toothbrushes, both electric and manual, and floss after EVERY MEAL? How come life is not fair? You blame your genes and your dentist for not giving good advice, diagnosis or treatment… and your darn luck. But perhaps you should just visit your dentist or your periodontist who can help detect the root cause of your problem. (Hehe I just love bad puns)

exposed root due to gum recession illustration

Causes of gum recession

The major cause for receding gums is brushing too hard or too lightly! Most people just brush their teeth mindlessly while thinking about their day at work. Brushing in the proper position with the correct technique is super important.

There is an optimum pressure that you should put on your gums with your toothbrush.

If you brush too lightly, the bacteria (plaque) is not removed from the gum line and the bacteria can cause gum disease, like Gingivitis or Periodontitis. If you brush in the wrong position, (say you just brush your teeth and not your gums) the bacteria in the mouth can remain at the gum line and can cause gum infection. Once there is a gum infection, inflammation can destroy the bone and gum tissue and thus the gums will retract. This will can lead to gum recession. Left untreated, this can result in gum disease, tooth loss and other complications that arise in the mouth. Do read this article for more information on treatment for gum infection.

However, the most common cause of gum recession is when we brush TOO HARD! We usually brush our teeth too with hard, when we use toothbrushes that are too abrasive for the gum tissue. We can also mindlessly apply too much pressure. So if you are one of those obsessive people that brush their teeth repeatedly… you may be doing yourself and your teeth more harm than good. You may cause trauma to the gum tissue and it very sadly retracts to expose more tooth structure and the beginnings of mild gum recession. (Deltadentalins.com, 2019)

As a dentist, one of the most common questions I receive is, “Can receding gums grow back or gum recession be reversed?”

Unfortunately, no. Gum tissue is quite unlike the other types of bodily tissue (like your skin) that are able to regenerate.

Signs and symptoms of receding gums

  • Lengthening of a tooth or several teeth
  • Increased sensitivity to hot and cold water or foods.
  • Discomfort — You might feel an unpleasant “nerve-like” sensation when you brush or floss near the exposed root surface. This is due to the toothbrush bristles or floss coming in contact with the inner layer of the teeth (dentine) and stimulating the nerve endings in the tooth pulp. (mayoclinic.com, 2016)

Receding Gums Treatment

The most important treatment step in treating gum recession is to correct the brushing technique or toothbrush that is causing the issue.

If the recession is mild, one possible treatment for receding gums is to cover the exposed tooth/teeth surface with a tooth coloured filling. The sensitive, ditched areas on the affected tooth/teeth may be filled in with a resin by the dentist as an attempt to reduce tooth sensitivity. However, this just helps alleviate tooth sensitivity somewhat and in certain cases, the recession around the gums continue.

repaired cavity - before and after

If it is very severe, a connective tissue graft (gum grafting surgery), will be necessary. (perio.org, 2019)

How is it done?

This gum grafting technique is a very predictable procedure. It is also termed Periodontal Plastic Surgery.

The Periodontist first gives local anaesthesia to the tooth/teeth with gum recession and the palate.

He/She then prepares the recipient site where gum recession is observed. A gum pouch is created to house the donor tissue.

The periodontist then goes to the palate to remove some underlying soft tissue from the mouth. This piece of palatal tissue is now carefully trimmed and transferred to the recipient site. This soft tissue is then stitched and transplanted into the pouch created. The gums are also hiked “upwards’ to correct the gum defect.

Is it painful?

Most patients find the injections to numb the area slightly uncomfortable and report no pain during the procedure and some even fall asleep when I am stitching! Right after the receding gums treatment is completed though… dentists recommend that heavy physical activity or sports need to be avoided so the graft will not come loose from physical contact.

1 week later, you should be able to see new blood vessels coming in to colonise the grafted soft tissue at the recipient site. This new soft gum tissue graft should become fully integrated into the recipient site with the receding gum area fully treated and healed in 6 weeks! Do ask your Dentist or Periodontist for before and after photos of their previous cases so you can see the beautiful results of soft tissue grafting!

Conclusion

In my opinion, the best treatment option to correct receding gums is still a connective tissue graft/soft tissue graft. Teeth sensitivity may be treated with a filling, but it does not correct the gum line or reverse the problem. A connective tissue graft not only thickens the gums so it is less susceptible to future trauma or abrasion but reverses the process for receding gums too. Of course, you might need to correct your toothbrushing techniques as well to improve overall oral health. So the recession does not recur. So please ask your dentist for more information!

References

  1. https://www.deltadentalins.com/oral_health/overbrushing.html
  2. https://healthletter.mayoclinic.com/issues/june-2016/gum-recession
  3. https://www.perio.org/consumer/gum-graft-surgery
  4. Tatakis, Chambrone, Allen, Langer, McGuire, Richardson, Zabalegui, Zadeh (2015, Periodontal soft tissue root coverage procedures: a consensus report from the AAP Regeneration Workshop)
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