What Causes Gum Recession & Can It Be Reversed?

What Is Gum Recession?

The recession of gum margins is when gum margins pull back from the teeth, wearing down the gum around the teeth; this exposes more of the tooth or even part of the tooth's root.

Gum recession is a common dental condition rather than a rare one. Studies have shown that an estimated 85% of adult populations in most countries have some level of gum recession on at least one tooth.

Healthy, undamaged gum margins help:

• Protect the roots of the teeth.
• Serve as a protective barrier for bacteria.
• Help keep the supporting structures of the teeth strong.

However, once there has been a recession of the gum margins, the exposed roots become more susceptible to decay and sensitivity and/or progression of gum disease.

Why Gum Recession Matters

Even moderate recessions have a few serious repercussions for the public:

• Sensitivity to food (especially heat, cold, or sugar) — the dentin is exposed due to lost enamel, as well as roots are at risk from decay.
• Aesthetic issues — recession tends to result in gum lines that do not align with the rest of the teeth, which can negatively impact your smile.
• Risk of bone loss — if left untreated, there is a possibility of losing support for your teeth, which could result in unstable teeth.
• The progression of gum disease — as gums recede, you may be at an increased risk of developing advanced gum disease and may need treatment.

As a result of the above, gum recession should be viewed as a health issue rather than simply being cosmetic in nature.

What Causes Gum Recession? (Root Causes Explained)

Gum recession rarely has a single cause. In most cases, multiple factors combine to affect gum tissue loss.

Here are the most common causes:

1. Periodontal (Gum) Disease

Periodontal disease (periodontitis) is the most common reason for receding gums. It results from an infection of the gums caused by bacteria found in plaque. The plaque and tartar that builds on the teeth causes irritation to the gums as well as chronic inflammation to those areas of the mouth. Chronic inflammation can lead to the breakdown of tissue and loss of the supporting bone around the tooth root. If left untreated, it will continue to cause the gums to slowly pull away from the roots of the teeth.

As a periodontist, you are a specialist in the health of the gums. Therefore, your first concern when treating receded gums would be to treat the underlying periodontal disease which is usually the primary cause of receding gums.

2. Aggressive or Improper Brushing Techniques

It is astonishing to realize that brushing your teeth too much or with an extremely hard bristled toothbrush will cause damage to your delicate gums. Brushing frequency is only one of many factors; in addition to how frequently you brush, you should also be careful about how you brush. The best way to avoid damaging your gums is by using a soft-bristle toothbrush and by employing a gentle circular motion when brushing your teeth.

3. Genetics and Thin Gum Tissue

Some people have a natural tendency toward thinner gums (gingiva). They may be at risk of developing gum recession even if they practice good oral hygiene.

The genetic component that contributes to this is:

• The thinness of the gingiva.
• A weaker attachment of the gingiva to the tooth.
• A greater likelihood of experiencing rapid recession when another force is acting upon it.

4. Teeth Grinding or Clenching (Bruxism)

Over time, grinding/clenching your teeth (especially while sleeping) can cause an increase in the amount of pressure that is being put on the soft tissues surrounding your teeth. This can contribute to a faster rate of recession.

Grinding/Clenching: Grind/Clenching can be defined as the unconscious habit of gnashing, grinding or crushing your upper and lower teeth together to relieve stress. The most common time for this activity to occur is during sleep.

Excessive Pressure: Excessive pressure refers to the increased amount of force that is being placed on the periodontal tissue when you grind/clench your teeth. The longer you grind/clench your teeth, the more pressure will continue to be placed on the supporting structures of the tooth.

Accelerated Recession: Accelerated recession occurs when the periodontal attachment and/or bone loss are occurring at a rate greater than normal. When you grind/clench your teeth excessively, it creates a greater amount of tension and pressure on the periodontal tissue which can lead to accelerated recession.

5. Orthodontic Issues and Misaligned Teeth

Crowded teeth, as well as other abnormal placements of the teeth may increase the pressure that is placed upon the gums which could lead to increased recession of the gum tissue.

6. Tobacco Use

Whether using cigarettes or chewing tobacco, use of tobacco increases the formation of plaque as well as gum inflammation (which are two contributors to recession).

7. Poor Oral Hygiene

Basically, a lack of proper brushing and flossing as well as overall oral health creates an environment that allows plaque to build up in the mouth; thus, creating the conditions for periodontal disease and recession.

Warning Signs: How to Spot Gum Recession Early

A recession typically will begin to develop slowly. Therefore, most of our patients do not become aware of it until the recession is relatively far developed.

The following are some common indicators of a recession:

• The lengthening of the teeth as compared to before.
• Sensitivity of the teeth.
• Gumline notches.
• Redness of the gums; swelling of the gums; bleeding from the gums.
• Pain from brushing; pain from flossing.

Prompt evaluation by a dental professional is indicated if you experience any of the above symptoms.

Can Gum Recession Be Reversed?

No, gum tissue that has already receded will not typically "grow back" on its own.

Why Won't Gums Grow Back on Their Own?

Gum tissue and other structures of the periodontium do not grow or regenerate after they are lost. This is why recessions cannot repair themselves like cuts to the skin.

That's Why Early Detection Is Important

If you detect and treat periodontal disease (before the loss of too much tissue) your dentist can prevent further recession as well as restore function and appearance for most patients.

There Is Still Hope

Although gums do not naturally grow back there are now numerous ways dentists can stop recession from getting worse and restore healthy gums and aesthetics for their patients.

So, What Can Be Done? Treatment Options Explained

A treatment plan will begin with an accurate evaluation performed by a periodontist and will be determined based upon:

• The degree to which the tooth is exposed.
• Whether the cause was due to gum disease or some form of trauma.
• Any symptoms that the patient may be experiencing.
• Any history of the tooth and gums.

In this section we will look at the treatments that are generally the most successful:

1. Scaling and Root Planning (Deep Cleaning)

The primary treatment to remove plaque and tartar from below the gumline, this procedure smooths the root of the teeth to create an environment for gum attachment. It is typically used as the initial treatment in cases where the recession has resulted from periodontal disease.

2. Non-Surgical Periodontal Therapy

Mild to moderate recession can often be treated with antimicrobial therapies (if an infection is present) or localized treatments to eliminate the source of the infection/inflammation.

3. Gum Grafting Procedures

Surgical Grafting is a procedure to replace lost gum tissue when recession has occurred, therefore protecting the exposed tooth roots and improving the aesthetic appearance of your smile.

There are several different types of grafts, including:

• Grafting Gum Tissue (Free Gingival Graft) - The surgeon takes gum tissue from one area of the mouth and transplants it to the area where the gums have receded.
• Grafting Connective Tissue (Connective Tissue Graft) - This type of graft is used most often for both cosmetic and functional root coverage.

Both grafting procedures protect your tooth or teeth from sensitivity and further recession in addition to enhancing the look of your smile.

4. Minimally Invasive Gum Grafting Advances

Recent methods employ microsurgical instruments to minimize damage and expedite recovery.

5. Specialized Regenerative Therapies

Early research into emerging therapies (stem cell-based regeneration and advanced biologics) indicates that these may be used in the future to regenerate lost periodontal tissues. Emerging therapies — including stem cell-based regeneration and advanced biologics — are being researched to rebuild periodontal tissue. Early studies show promising results for future clinical use.

6. Addressing Underlying Causes

Stopping recession means fixing what caused it. A periodontist may also advise:

• Smoking cessation programs
• Soft bristles for brushing
• Home oral hygiene routines
• Gum protectors from grinding your teeth

Home Care & Prevention: What Patients Should Know

Prevention is far better than corrective treatment. Patients can dramatically reduce risk of recession by:

Brush Gently but Thoroughly

Use a soft toothbrush when brushing to prevent damage to your gums from excessive pressure.

Brush in Circular Motions

Clean all surfaces of each tooth, both front and back.

Floss Daily

Remove plaque from teeth while it is still loose. This will help keep it from becoming tartar that cannot be removed with regular brushing.

Get Regular Professional Cleanings

Help to remove any tartar that has formed on your teeth as well as to remove plaque that you were unable to get out by yourself.

Wear a Night Guard to Prevent Grinding and/or Clenching

Grinding and/or clenching can cause excessive wear on your teeth and may lead to an uneven bite. Stress can also contribute to grinding/clenching.

Stop Using Tobacco Products

Tobacco products are one of the most common ways to increase your risk of periodontal disease. Eat A Healthy Diet and Drink Adequate Amounts of Water. This will support overall gum and immune system health.

Frequently Asked Questions (FAQs)

Q: Does gum recession produce bad breath?

A: Yes, gum recession creates a greater opportunity for bacteria to become trapped in exposed root surfaces and gingival pockets that can cause bad breath (halitosis).

Q: Is gum graft surgery painful?

A: Because modern dental techniques are now used (including minimally invasive procedures), both the post-operative pain and the recovery period have been significantly decreased. In fact, many of our patients say they have a very easy, if not an acceptable, recovery from gum grafting.

Q: Can children/teens experience gum recession?

A: Yes, children and teenagers can experience gum recession. Gum recession has been known to occur when there is vigorous tooth brushing, orthodontic appliances are in place, etc. Early detection and treatment will help avoid potential problems in the future.

Gum Recession Is Serious — But Treatable

Gum recession will NOT heal by itself. This does not mean that the patient has no control over this process.

Early detection, professional treatment of periodontal disease, and continued at-home oral hygiene will allow for gum recession to stop (i.e., stabilize), restore (for aesthetic and functional purposes) and manage long-term so as to maintain an aesthetically pleasing and healthy smile.

Do not delay in seeking professional periodontal evaluation if you or someone you know has gum recession.