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Exposed Tooth Neck: How to Lift the Gum Back

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Exposed tooth neck or receding gum is a decrease in gingival volume toward the apex of various depths. A reduced gum thickness leads to an increased enamel sensitivity due to tooth root exposure. The recession causes tooth decay, root loosening and tooth destabilization. Patients’ complaints about gum recession are associated with unpleasant symptoms and a lower aesthetic perception.

This gum area is also called marginal gingiva. The gum recession occurs due to periodontal lesions. The treatment of periodontal disease is complex and aims to prevent tooth loss. Exposed tooth neck also occurs in other cases: fluorosis, shallow oral vestibule, periodontal disease, prolonged absence of a tooth. Some bite pathologies also contribute to recession. Doctors at the Clinic of Aesthetic Dentistry have answers to your questions about the gum recession and the reasons for its treatment.

Exposed Tooth Necks: Causes and Risk Factors

Gum recession is a multifactorial condition that either results from an underlying disease or is caused by a dental structure, bite, or poor oral hygiene.

A common cause of exposed neck is constant trauma to the gum line during brushing. In addition, excessive pressure, high bristle stiffness, or vigorous brushing can damage the gum line.

The mechanism of mechanical recession is associated with damage to the vestibular plate of the canines and poor blood circulation. Injuries lead to ischemic changes, bone loss, and a decrease in the height of the gingival line.

The disease progression is promoted by a deep bite, occlusal imbalance in some jaw line areas. This is due to the uneven distribution of the chewing load and the negative impact on the structure of the marginal periodontium. Other reasons why the tooth’s roots are exposed are: The development of the disease is facilitated by a deep bite, violation of occlusion in certain areas of the jaw row. This is due to the uneven distribution of the chewing load and the negative impact on the structure of the marginal periodontium. Other reasons for exposed tooth roots are: 

  • shallow oral vestibule;
  • teeth crowding;
  • protruding teeth;
  • formation of muco-epithelial bands;
  • prominent lingual frenum;
  • mucosal injury caused by a tooth crown;
  • complicated extraction;
  • burns of mucosa;
  • prolonged absence of a tooth.

Autoimmune conditions are associated with abnormal development and regeneration of mucous membranes, skin, and bone tissue.

Classes of Pathological Process and Reasons for Exposed Tooth Roots

The classification of gum recession according to the disease development class and tissue mass deficiency is of clinical significance. Here are several main classes:

  • Class 1. Lack of free gingival margin. There is no obvious pathology, including in the interproximal areas.
  • Class 2. Clinically, the attached gingiva is displaced downward to the cervical line. No pathology of bone or interdental septum is detected visually.
  • Class 3. Recession is combined with a slight reduction of the gingival margin to the apical part of the tooth and barely visible root exposure.
  • Class 4. Bone and gum loss are observed along the interdental spaces’ cervical circumference.

There is a classification according to localization and the nature of the occurrence. In the first case, the denudation of the tooth neck can be local or general. Recession can be traumatic (post-traumatic), symptomatic or anatomic.

Clinical Presentation

To understand the nature of the clinical signs, some aspects of the anatomical features should be considered. A healthy tooth consists of three parts: the root canal system, the neck, and the crown. Only the crown is identified visually, as the gingiva covers the neck, and the root is deep in the alveolar process. A gingival recession occurs when the tooth neck is exposed and becomes visible, along with the crown. The following symptoms usually accompany recession:

  • increased tooth sensitivity while eating, brushing, drinking, and breathing in cold air;
  • the darkened visible surface of the neck, tooth;
  • enlarged interdental space;
  • elongation of the crown surface – in the later stages of recession, teeth look unnaturally long;
  • bleeding gums;
  • changes in the colour and structure of the gingival line – tissues become bluish-grey or red, painful when pressed;
  • bad breath caused by rotting food trapped in periodontal defects.

The final stage of cervical lesions is the loosening of the crown due to tooth destabilization. A breakdown of tooth anatomy leads to poor gingival blood flow, worsening oral health, tooth loss and formation of extended edentulous defects.

Exposed Tooth Neck: Consequences

Doctors at the Clinic of Aesthetic Dentistry recommend solving the problem and reverting pathologic behaviour on time. The doctor can notice the changes during regular check-ups and start the treatment on time. However, the complicated course of recession often requires considerable effort and additional costs. The primary complications of a denuded tooth neck are:

  • a wedge-shaped defect causing aesthetic concerns;
  • tooth deformation;
  • purulent and infectious complications of soft tissues and bones;
  • chronic diseases of the oral cavity;
  • severe dental caries;
  • tooth loss.

Expansion of the tooth root is accompanied by pain and constant discomfort. Gingival recession proceeds. If a recession has already occurred, it is impossible to stop the pathological process without specialists’ assistance.

Exposed Tooth Neck: How to Lift the Gum Back

Today’s dental clinics offer advanced treatments for periodontitis, periodontal disease and other conditions that lead to gum recession. Doctors eliminate the pathology and give the gum back a healthy margin and the patient a beautiful smile. Treatment tactics are determined according to the triggering factor:

  1. Tartar. Large plaque and tartar deposits naturally lead to a gingival margin “sagging”. It is impossible to remove tartar and coarse deposits at home. Instead, we offer mechanical tooth cleaning with an ultrasonic scaler. Professional cleaning is an integral part of periodontitis treatment today. After cleaning, the doctor recommends applying regenerating and antibacterial ointments and antiseptic solutions.
  2. Injury from a toothbrush. If the cause of recession is associated with poor oral hygiene, remedial treatment and consultation with a dental hygienist are performed. The doctor explains the rules for selecting hygiene products and the peculiarities of the procedure at home. Interestingly, over 65% of patients brush their teeth incorrectly.
  3. Malocclusion. Severe malocclusion often causes periodontitis and dental caries and often leads to tooth neck explosion. Orthodontic appliances such as braces, aligners and trainers correct major bite problems;
  4. Absence of adjacent teeth. The absence of a tooth, let alone two or more teeth, increases the possibility of destruction of healthy teeth. Therefore, it is essential to restore the missing tooth urgently. Today’s modern replacement method for a missing tooth is an implant-retained denture.

As we can see, the recession problem can only be solved by combined treatment with the symptoms management and elimination of the underlying cause of the pathological gingival margin recession.

How to Treat Exposed Tooth Neck at Home

Trying to solve a problem as complex as an exposed tooth neck at home can only make things worse because a long-lasting chronic process, a missing tooth, or a previous complicated root extraction can ultimately lead to gum deformation. In addition, such changes do not allow achieving pleasing aesthetics in subsequent dental treatment and prosthetics. So how can you restore the beauty of your smile? In this regard, doctors suggest performing a gum plastic surgery – gingivoplasty. The goals of the surgery are:

  • aesthetics restoration of the gingival margin;
  • atrophic processes reversal;
  • prevention of tooth destabilization and loss.

Gingivoplasty is a flap surgery performed under local anaesthesia and is a single visit surgery. The flap is excised from the palatal space during the surgery: the doctor transfers it to the area of atrophic changes. The wound is sutured, and a bandage is applied.

If the gum defect is insignificant, a surgeon makes several incisions (two vertical and two horizontal “herringbone”) and slightly displaces the flap, moving it back a little. After rehabilitation, the restored area looks neat. The surgery takes 60-65 minutes.

The specialists of the Clinic of Aesthetic Dentistry warn that it is impossible to cure gum recession without professional help or using natural remedies. The known methods can only slightly relieve the unpleasant symptoms. After a while, the disease will relapse again. Do not self-medicate; consult a specialist.

Exposed tooth neck occurs for various reasons. In all cases, the ulatrophia and lengthened contact surface of the tooth crown are neither normal nor beautiful. The prognosis with timely treatment and elimination of triggering factors is favourable. Ignoring therapy sooner or later leads to tooth loss and progressive dystrophic changes in the jawbone.

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