DISCLOSURE: Noelle Copeland RDH is the oral care specialist and dental consultant to the Brilliant and Baby Buddy oral care lines through Compac Industries. See terms below
Receding gums can happen to anyone and have several causes as culprits. Oftentimes called recession, receding gums are a commonly discussed dental problem.
Recession occurs over time. So unless sensitivity has become an issue, most people don’t realize their gingival margin is slowly receding away. Some people never get sensitivity with recession and only realize they have receding gums when a dental professional mentions it at a checkup.
The first noticeable symptom of gum recession for most people is usually tooth sensitivity, right at the gumline, typically to cold foods or liquids. Another more telling sign happens when you suddenly realize a tooth looks longer than it used to. That’s because more of the tooth becomes exposed as the gum line recedes.
Causes and Prevention
Because people are genetically susceptible to periodontal disease, and periodontal disease can cause gum recession, if you have a family history of gum disease then you’re more likely to have gum problems. Knowing this risk factor is your preventive knowledge. Stay on top of your homecare routine and make visiting the dentist a regular part of your overall healthcare protocol.
- Understand your risk factors.
- Practice excellent home care routines.
- Visit your dentist regularly.
- Treat dental problems early.
- Use therapeutics as needed and when prescribed.
Cause: Aggressive Tooth brushing
Aggressive tooth brushing is probably the number one reason why people get recession. Seen mostly in adults, it usually takes place after years of brushing a little too hard. In dentistry we often call these patients “Scrubbers”.
They know they scrub their teeth because it feels like it gets their teeth cleaner, but they don’t know they are literally scrubbing away their gums and tooth enamel.
I have to say that reversing the ”heavy-handed, Scrubber-Brusher” is probably the hardest conversion to professionally assist with. It’s an ingrained habit, and takes very purposeful habit shifting on their part.
Aggressive tooth brushing can also happen when someone uses a toothbrush incorrectly, especially an electric toothbrush. If you have gum recession already, you need to consult with your dental professional about the right type of toothbrush to use that best suits your specific needs. More than likely, those with recession will be instructed NOT to use an electric toothbrush.
For anyone that can use an electric toothbrush, follow the manufacturer’s brushing instructions on any electric toothbrush model you intend to use. There is a big difference in how you brush with different types and designs, such as an “Oscillating-Rotary” toothbrush versus a high VPM Sonicare toothbrush.
One tactic that I’ve used successfully over the years with my patients is telling them to brush with their non-dominant hand. This slows down the brushing routine for scrubbers since they tend to brush rapidly, in a vigorous fashion around the mouth. Switching hands forces them to acclimate to a different routine. Plus, it feels different, and this elicits a new mental process that helps to bring awareness to changing how they brush.
- Use the non-dominant hand to brush the teeth.
- Consult your dentist about using an electric toothbrush.
- Use proper brushing techniques to ensure you arent brushing incorrectly.
- Don’t over brush or brush too often.
Cause: Poor Oral Hygiene
Poor oral hygiene causes recession when the gums become chronically infected. The gum tissue wants to be pink and healthy; tightly hugging the teeth, all-the-while enjoying an adequate supply of oxygen.
When plaque biofilms don’t get removed on a daily basis, the build up becomes sticky and thickens, eventually hardening to a tarter and firmly adhering to tooth enamel. The gums do not like this situation, so they warn you by becoming inflamed and swollen, tender and sensitive, bleeding easily to light stimulation. If left untreated, this type of bacterial infection destroys the gum tissue and eventually the bone that supports the teeth.
Practice regular and effective daily oral care. Visit the dentist regularly, and get professional dental cleanings at least twice a year.
- Brush twice a day, everyday. Preferably in the morning and at night before bedtime.
- Choose the right toothbrush for your mouth.
- Don’t smoke or use nicotine in any form.
- Limit sugary drinks, snacks.
- Don’t forget to brush the tongue.
How to brush your teeth:
- Wash your hands with hot soapy water before beginning.
- Wet the bristles with warm water and apply a small amount of gel or paste to the bristles.
- Hold the brush and place it in the mouth, preferably starting in the back of the mouth, top or bottom, it doesn’t matter.
- Angle the bristles to 45 degrees by tilting the brush slightly up, toward the gumline, this applies to all standard flat, one-sided toothbrushes.
- Brush every tooth, with small back and forth strokes if using a manual toothbrush. If you have a sonic or electric toothbrush please follow the directions for brush strokes that came with your brush.
- Reach each tooth individually and one at a time. Do not use long sweeping motions, but rather short brushing strokes, focusing on one tooth at a time.
- Moving from the back of the mouth, to the front of the mouth, and then back again on the opposite side, repeating this sequence on the tongue side of the teeth.
- Brush every surface of every tooth, including the top chewing surfaces and don’t forget the tongue.
- Follow up with a water rinse to remove any toothpaste residue.
- Finish with a mouthwash rinse, for thirty seconds, to give a glistening antiseptic finale.
- NOTE: This entire process should take you at least 2 minutes. That’s about 30 seconds of brushing per quadrant, plus the tongue. You have 4 quads in your mouth. Upper left, upper right, and lower left, lower right.
Gum recession is not something to ignore, it will only get worse and it threatens the longevity of the teeth. The gingival tissues will not regenerate either, so once it recesses, it’s pretty much gone for good. The only way to get tissue coverage back is through surgical interventions. If you think your gums are receding, make an appointment with your dentist. There are treatments that can repair the gum and prevent further gum loss.
- Gingival Flap Surgery with regeneration= Used most often to treat gum disease that has infected the tissue and the bone. This procedure aims to reduce the pocket depth underneath the gums, where bacteria are flourishing and rapidly destroying the tooth, tissue and the bone.
The gum tissue is flapped or folded back, exposing the infection. The surgeon then removes the infection and buildup and inserts new synthetic bone, membranes, or grafts. Once finished, the tissue is secured with sutures and allowed to heal.
- Soft Tissue Graft= This is where a surgeon will use a donor site from elsewhere in a patient’s mouth, usually from the roof of the mouth, to graft onto an area where recession is an issue.
Restorative therapy for recession can include the following.
- Resin-Based cervical composites- Usually the same color as the tooth.
- Aesthetic gingival composites- Pink colored composite to match the gum tissue.
- Crowns or Veneers.
If recession is due to overcrowded and overlapping teeth, or an uneven bite plane, then orthodontic braces can help straighten out the teeth, helping to prevent localized recession. Orthodontics won’t directly treat recession. Instead, it helps fix what is contributing to the problem in the first place. Once the teeth are straightened and the bite is balanced, a patient may need restorative or surgical therapy to esthetically correct the areas with the most recession.
The best place to start when it comes to receding gums is at the dentist. Preventively, take care of your teeth and gums and find your perfect toothbrush by looking for the best toothbrush for sensitive gums.
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Noelle Copeland RDH is an Oral Care Specialist and Dental Consultant who provides content for Brilliant Oral Care and Baby Buddy.