Gum Recession

Gum recession is a fairly common pathology that occurs in both adults and children.

At the dental clinic of authorial prosthetics "Kiadent," we successfully solve this problem, restoring the beauty of the smile and eliminating the hypersensitivity of exposed teeth.

Recession is a periodontal pathology characterized by the lowering, loss of gum tissue, and exposure of the tooth root.

Most often, it occurs on the outer side of the upper premolars, canines, incisors, and less frequently on the molars from the palatal or buccal side.

Root exposure is a symptom that occurs with recession, periodontitis, and also periodontosis. But what is the difference between these diseases?

Let's start with the fact that recession is not an independent disease but merely indicates the presence of another problem, such as malocclusion, a shallow vestibule of the oral cavity, or tight frenum or folds. Inflammation is absent, except in cases of complications where gingivitis or periodontitis develops.

Periodontitis and periodontosis are diseases accompanied by the atrophy of gum and bone tissue. In the first case, the pathology has an inflammatory nature, accompanied by swelling, redness, and gum bleeding. In periodontosis, inflammation is absent, but dystrophic changes occur, and the mucosa becomes pale.

Only a doctor can make an accurate diagnosis after a comprehensive examination! To prevent the pathological process from progressing and avoid losing teeth, we recommend scheduling a consultation at the first signs.

Indications

• Tooth hypersensitivity to thermal and chemical stimuli
• Presence of an aesthetic defect — exposure of the cervical part of the tooth
• Complications such as gingivitis, periodontitis

Contraindications

• Unsatisfactory tooth cleaning — hygiene education is provided
• Dental deposits — ultrasonic or air-abrasive cleaning is recommended
• Incorrect tooth positioning — occlusion correction is needed to address the root exposure

Full list of services for gum recession:

Dentist consultation
Closed curettage in the area of one tooth
Surgical treatment of periodontal pockets (gingivectomy)
Upper lip frenulum plastic surgery
Lower lip frenulum plastic surgery
Vestibuloplasty
Recession closure (gingivoplasty)

Recession can be visible or hidden, which the dentist can only detect during probing. It can also be localized, affecting one tooth, or generalized, involving several teeth.

Recession Classes:

• First: Tissue loss in the area of free gum.
• Second: Attached gingival tissue is involved.
• Third: Additionally, bone destruction occurs in one interdental space with or without involvement of the adjacent tooth.
• Fourth: Loss of gum and bone tissue on all sides.

There are also three severity levels: mild (defect no more than 3 mm), moderate (no more than 5 mm), and severe (from 6 mm).

How can I tell if I have gum recession? Only a doctor can make the diagnosis, but you can suspect the pathology if you notice the following signs:

• root exposure;
• "lengthening" of the tooth crown;
• thickening of the gum margin in the form of a ridge;
• increase in interdental spaces in the form of "black triangles";
• heightened sensitivity to hot, cold, sour, sweet;
• gum bleeding during brushing, hyperemia — these signs appear in complicated forms due to gingivitis, periodontitis.

Gum Trauma

Gum loss around the tooth neck can occur due to using a hard-bristled toothbrush, toothpicks, or constantly biting on objects like pencils. Trauma can also result from poor-quality removal of dental deposits — read about the dangers of tartar and how to remove it. In rare cases, trauma can be caused by mental disorders.

Improper Brushing

Excessive pressure with the brush and horizontal back-and-forth movements can lead to root exposure. It has been found that left-handed people typically experience gum recession on the right side of the jaw, and vice versa. The cause is strong pressure from the dominant hand on the toothbrush. In this article, you'll learn how to brush your teeth correctly.

Restoration Procedures (Fillings, Veneers, Crowns)

If the restoration has an overhanging edge, plaque accumulation in that area will be impossible to clean. Over time, an inflammatory process, gingivitis, and later periodontitis may develop in this area. This gradually leads to the atrophy of the gum margin around the composite restoration, veneer, or crown, eventually exposing the tooth root.

Malocclusion Pathologies

Crowding and tooth deviation from their axis are not just aesthetic problems. In malocclusion, teeth experience uneven load — some teeth are underused in chewing, while others are overloaded. Those under excessive load may develop enamel fractures, wedge-shaped defects, and root exposure.

Orthodontic Treatment (Braces)

Forced orthodontic treatment, especially labial (towards the lips) tooth movement, can cause bone thinning and gum tissue recession. Poor hygiene exacerbates the condition, leading to gingivitis. Cleaning becomes difficult due to braces, wires, ligatures, and retainers.

Individual Anatomical Features

Recession can be caused by short frenula, folds, and a shallow vestibule. These features cause the mucosa to pull away from the tooth during chewing, eventually leading to root exposure. You can observe these features by pulling the lip, where tension and whitening of the gum margin are visible. Thin gum biotype also plays a crucial role in the formation of recession.

To make a diagnosis, a comprehensive examination is conducted:

There are several methods used to address the causes of the pathology, close the defect, and reduce tooth sensitivity.

Surgical Treatment of Recession

This includes plastic surgery of frenula, folds, pulling the mucosa, as well as vestibuloplasty (expanding the vestibule of the oral cavity). These operations eliminate the cause of root exposure so that the problem does not recur. Then, gingivoplasty (gum plastic surgery ) is performed to close the exposed root.

Steps in Closing Recession

The operation lasts about 40–60 minutes and includes five steps:

Preparation and anesthesia

Recession closure

The periodontist removes the sutures in 7–10 days and photographs the recession area to capture the surgical result.

Conservative Treatment

With minor exposure of the cervical area and enamel hypersensitivity, this zone is treated with a desensitizer. The product blocks the permeability of dentinal tubules, and the patient no longer feels pain when consuming hot, cold, sour, or sweet foods.

Conservative treatment also includes removing dental deposits pressing on the mucosa, replacing fillings, crowns, or veneers with overhanging edges. If the cause of the pathology is malocclusion, orthodontic treatment is prescribed. Braces or aligners will restore the normal position of the teeth, eliminate tooth overload, and root exposure.

If the main cause of the disease is addressed and gingivoplasty techniques are followed, the prognosis for treatment is favorable. Soft tissues regenerate within two weeks. The gum around the tooth looks aesthetic, and hypersensitivity disappears. If the treatment strategy is incorrect, the defect will reappear, and the symptoms will worsen.

To prevent the development of recession, follow these recommendations:

• Brush your teeth correctly to avoid injuring the gum.
• Visit the dentist when the first signs of the pathology appear.
• Visit the dentist twice a year for preventive checkups.
• Start orthodontic treatment if malocclusion is detected.
• Choose your dentist responsibly for treatment, prosthetics, and implantation of teeth.

• Can I treat this on my own?

  No. If the gum recession has occurred, it will not grow back on its own. However, you can stop the process by eliminating its cause. To determine the cause, a consultation with a dentist is necessary. It’s best to see a doctor at the first signs before the defect becomes so severe that surgery is required.

• How long does it take for the gum to heal after surgery?

  Primary healing of the mucosa occurs within 7 days, and the patient comes for suture removal. In 2 weeks, the soft tissues almost completely recover and acquire a pale pink color. At this stage, the patient no longer feels discomfort and forgets about the surgery.

• Is surgical treatment painful?

  The operation is performed after administering a local anesthetic, so the patient does not feel pain during the procedure. Discomfort may occur after the anesthesia wears off, but it typically subsides within 1–2 days. To manage this, the dentist prescribes pain relievers.