MY GUMS ARE RECEDING, WHAT DO I DO?

Receding gums are also known as gingival recession. The pink gum tissue normally covers the root of the tooth. This can become exposed when the gum is pushed back or if the tooth is in an abnormal position.

Receding gums are common and often unnoticed at an early stage. There are many risk factors, but age is a main one - 88 percent of people older than 65 have receding gums in at least one tooth. However, recession can be seen developing as early as the teen years.

The main concern with receding gums is that when the roots of the teeth become exposed, they are at risk for decay, infection, and loss. Treatment can stop or reverse the process of gum recession if begun at an early stage.

If the recession is severe and the patient has symptoms such as tooth sensitivity, pain, or infection, a variety of treatment options are available. These include deep cleaning, medicine to fight infections, and even tissue grafts.  In fact, tissue grafts done by your periodontist are the most natural way of treating lost gum/gingiva.

What is gum recession?

The gums protect the fragile tooth roots from bacteria, plaque, and other forms of decay.

Gingival recession is the exposure of the roots of teeth after experiencing a loss of tissue in the gum.

The gums are also known as the gingivae. The gingiva is the moist pink tissue in the mouth that meets the base of the teeth. There are two such gums - one for the upper, and one for the lower set of teeth.

The gingiva is a dense tissue with a good supply of blood vessels beneath a moist surface. The surface is called mucous membrane. It is joined to the rest of the mouth lining but is pink instead of shiny red.

The gums tightly surround the teeth up to the neck of each one and are firmly attached to the jaw bone. The gums usually cover the roots of the teeth, protecting them as they are more fragile than the rest of the teeth.

Gingival recession  causes a loss of the tight firm gum tissue at the neck of the teeth which exposes the fragile mucous membrane to the harsh environment that the gingiva is designed to protect. Thus  allowing the tooth roots to be directly exposed to bacteria, plaque, and food making the tooth more susceptible to decay of the root. Bone loss occurs as the recessions progresses and the end result can be the loss of tooth or teeth.

Causes

Poor oral hygiene and periodontal disease are linked to gingival recession. But 

receding gums can happen in people with good standards of oral hygiene, too.

Broadly, there are two causes of receding gums:

• Physical wear of the gums
• Inflammation of the gum tissues - this is a reaction of the immune system

Some people are more prone to receding gums because of inherited factors. These factors include their tooth position and gum thickness.

Physical wear of the gums by vigorous tooth brushing or use of hard bristles is a     common cause of receding gums.

The two main causes of receding gums are physical wear and inflammation of the gum tissue.

People with this problem otherwise have good oral hygiene. The teeth and gums otherwise appear healthy when receding gums are caused by over-brushing.

This type of recession often affects the left side more. This is because most people use a toothbrush in their right hand and so put more pressure on the left gums. The pattern also tends to affect the side gums more than the front.

Other physical factors that push the gums back include lip piercings, misaligned teeth, and damage caused by dental treatment.

Some people are more prone to the inflammatory causes of receding gums. Thinner gum tissue makes inflammation caused by plaque more likely. The gums are more delicate in some people.

Periodontal disease is a common cause of gum recession. Periodontal disease causes the loss of the supporting bone around a tooth through an inflammatory reaction. The gum recession tends to affect all the teeth in a similar way.

Periodontal disease is caused by plaque buildup. Plaque is a sticky film that forms on the teeth. Bacteria, mucus, cells, and other particles are involved in the formation of plaque.

When plaque builds up on teeth, it causes:

• Inflamed gums known as gingivitis. This condition can lead to periodontitis
• Periodontitis results in spaces between the gums and teeth and loss of connective fibers and bone around the tooth roots. This leads to receding gums

Tartar is hardened plaque and cannot be removed by tooth brushing. Instead, it must be removed at a dentist's office.

Effects

Many people with receding gums have no concern about them early on. Many others are unaware that they have recession.

For some, though, the concern may be about:

• Appearance
• Fear of tooth loss
• Sensitivity due to exposed tooth roots

Assessing concerns about the way gums look may include checking how much of the gums are on show.

For some people, the gums show when talking and smiling. Others have a different lip line that does not expose the gums to view.

Treatment

Most cases of mild gum recession do not need treatment. Dentists may simply give advice about prevention and offer to monitor the gums. Teaching people how to brush gently but effectively is a good early intervention. It is always advisable to visit a periodontist to evaluate your recession. This is because the periodontist can intervene with minor surgical treatments that can stop further recession and may be able to replace lost gum tissue if the reccession is treated early enough.

For people who do need treatment, a number of options are available:

Orthodontics are one method of treatment for receding gums.

• Desensitizing agents, varnishes, and dentine bonding agents: These aim to reduce any sensitivity that may develop in the exposed tooth root. This treats the nerve symptoms and helps to keep normal oral hygiene by allowing brushing of sensitive teeth to continue. However, when the sensitivity does not respond to these treatments a periodontist may be able to recover the exposed root with specialized gum grafting techniques.
• Composite restoration: Tooth-colored composite resins are used to cover the root surface. They can also close black gaps between teeth.
• Pink porcelain or composite: This is the same pink color of the gums. This is done when the recession is so severe that root coverage can not be achieved with grafting procedures.
• Orthodontics: Treatments designed to move the position of teeth can correct the gum margin.
• Surgery: Tissue is grafted from elsewhere in the mouth and heals over the gum recession. This is the most natural method of replacing the lost biologic tissue. You simply replace what was lost with what nature intended to be there in the first place.

How to prevent receding gums

Some of the causes of gingival recession are preventable.

The most obvious preventable cause is brushing the teeth too harshly or by using hard-bristle toothbrushes. People should avoid doing this to prevent receding gums

Plaque buildup leads to periodontal disease, so careful oral hygiene can also help prevent receding gums.