Receding gums
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Receding gums (gingival recession) refers to a loss of gum tissue resulting in an exposure in the roots of the teeth. Gum recession is a common problem in adults over the age of 40, but may also occur starting from the teens.
Causes
- Overaggressive brushing - often gum lines recede due to toothbrush abrasion. The enamel at the gum line is worn away by scrubbing the sides of the teeth in a washboard fashion.
- Inadequate brushing or flossing - by allowing the bacteria to sit in between the teeth, bacteria can build up. The enzymes which the bacteria release can cause the bone to be eaten away from the teeth. This erosion is very harmful.
- Periodontal disease
- Dipping snuff - by "dipping" snuff in between your lip and teeth it affects the mucus membrane lining in your mouth and overtime will cause your gums to recede.
- Inadequate placing of lip or tongue piercings.
Treatment
Treatment should start with addressing the problem which caused the gum recession. If overactive brushing is the cause, the patient should consider purchasing a softer toothbrush and use a more gentle brushing technique. If poor plaque control was a contributing factor, improved oral hygiene must be performed, combined with regular professional dental cleanings (prophylaxis). If severe calculus (tartar) was the cause, then a procedure called scaling and root planing may be necessary to clean the teeth and heal inflammation in the gingiva (gums).
Gum (gingival) grafting (Also called Periodontal Plastic Surgery):
Depending on the shape of the gum recession and the levels of bone around the teeth, areas of gum recession can be regenerated with new gum tissue using a variety of gum grafting "periodontal plastic surgery" procedures performed by a specialist in periodontics (a periodontist). These procedures are typically completed under local anesthesia with or without conscious sedation, depending on patient desires. The may involve repositioning of adjacent gum tissue to cover the recession (called a pedicle graft), or use of a free graft of gingival or connective tissue from the roof of the mouth (called a Free Gingival Graft or a Connective Tissue Graft). Alternatively, a material called Acellular Dermal Matrix (processed donated human skin allograft) may be used instead of tissue from the patient's own palate.
Healing from such procedures requires 2-4 weeks. After a few months the results can be evaluated and in some cases the new tissue needs to be reshaped in a very minor procedure to get an optimal result. In cases where recession is not accompanied by periodontal bone loss, complete or near complete coverage of the recession area is achievable.