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Gum Recession: What to Do When the Gum Recedes

Gum Recession What to Do When the Gum Recedes Photo 612

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Dental Therapist
Top-level dentist, orthodontist

Gum recession is the loss of soft tissue and a decrease in the thickness of the mucous membrane, leading to aesthetic discomfort, pain, chronic inflammation, tooth root exposure, caries and even tooth loss. Gum recession develops gradually, but over time significantly worsens the quality of life and needs treatment.

The Gum Recedes: What Is Next?

The gum recedes: what Is next?

Gingival recession or apical migration of the marginal gingiva is a pathology associated with a decrease in the volume of gingival tissue in the direction of the apex of the tooth, exposure of the cervical and root zones of the tooth. Patients complain about dissatisfying smile aesthetics and increased sensitivity of the tooth to external stimuli. The diagnosis is based on symptoms, oral and X-ray examination, and clinical history.

Treatment strategies depend on the localization of the problem and the severity of the clinical situation. In some cases, conservative therapy is sufficient. However, patients may require surgical periodontal therapy. In children, the disease occurs in 6-8% of cases, and adults in 47-50%, i.e. in every second case.

Why Do Gums Recede?

Why do gums recede?

Several factors contribute to the development of marginal gum recession, so it is impossible to single out any one cause of the disease. Crucial factors:

  1. Hard-mineral deposits and tartar on the enamel. Deposits on the teeth provoke a displacement of the epithelial layer, especially with a thin gum and pathological structure of the mucous membranes.
  2. Alveolar process anatomy features. Thinning of the cortical layer occurs in patients with massive root systems. Such patients suffer from insufficient blood supply and damage to the periosteal vessels.
  3. Failure to comply with oral hygiene. Insufficient or inadequate brushing of the teeth leads to damage to the gum tissue. In addition, regular trauma degrades the structure of soft tissues and provokes various periodontal diseases.
  4. Injuries to the teeth. Dislocation or root fracture, deep chips and cracks – all this contributes to gum recession.
  5. Pathological bite. Some structural features of the maxillofacial apparatus lead to a decrease in gum volume.
  6. Pathology of attachment of the frenum. The condition adversely affects the structure of the gums.
  7. Orthodontic treatment. In rare cases, braces thin the gum tissue under pressure and move the dentition in the right direction.

A recession is often the result of trauma due to arsenic paste. Contact with this composition on soft tissues destroys the structure of the gums, leading to severe diseases. Gingivitis, periodontal disease and periodontitis all contribute to pathology.

Classification and Types

Classification and types of gums recession

The recession of the gingival tissue is classified according to the severity, class and location. Integration by disease class is of clinical significance:

  •  Class I. There is a reduced marginal gum, and pathological changes in the interproximal regions are not observed or are negligible.
  •  Class II. Apical displacement of the gums is observed when examining the oral cavity. The height, structure of the bone of the interdental septa is not disturbed.
  • Class III. Apical migration is insignificant and is combined with manifestations of the 1-2 class of the disease.
  • Class IV. Circular bone loss is significant and visible to the naked eye when examining the oral cavity.

According to the prevalence of the pathological process in the gingival tissue, clinicians distinguish a local and generalized form. In the second case, the recession covers the entire dentition. Finally, there are traumatic, symptomatic or physiological recessions according to the etiological factor.

Why Does It Happen and How to Make Gum Grow Back?

Clinical aspects and symptoms differ depending on the aetiology, severity and class of the pathological process. Despite the fundamental differences, the apical migration of the marginal gingiva has several standard features:

  • gum margin lowering in the area of one tooth or throughout the entire jaw arch;
  • exposure of the root part of the tooth;
  • increased sensitivity to external stimuli: food and temperature factors;
  • development of the carious process;
  • pain and discomfort while eating or at rest.

Recession is often combined with periodontal disease. In this case, the symptoms of the underlying pathology come to the fore. The gums may turn whitish or bleed. In the first case, we talk about periodontitis; in the second – about periodontitis.

Prognostically, gingival recession is characterized by a complex course. Usually, a doctor is consulted at an advanced stage, when symptoms significantly worsen the quality of life and interfere with oral hygiene and chewing food. Only timely diagnosis and treatment helps to maintain the beauty and health of your smile.

An essential point in recession development is the negative impact of pathology on the patient’s appearance. The psycho-emotional state changes due to a decrease in self-esteem, social adaptation. Changes are noticeable when talking and smiling. Gum recession leads to the following physical disorders:

  •  hypersensitivity of enamel to temperature, food and chemical factors;
  •  caries of the root part of the tooth;
  •  wedge-shaped defect;
  • deformation of the dentition;
  • redness of the gums, cyanosis, bleeding;
  •  swelling of the mucous membranes;
  • pain, discomfort.

A severe complication of gum recession is the destabilization of the root in the bed and its subsequent loss. To avoid serious consequences, you must consult a doctor.

How to Restore Receding Gums

What can you do about receding gum? The treatment process involves conservative and surgical methods. In the absence of pronounced symptoms and complaints of the patient, it is sufficient to improve the oral hygiene routine, eliminate plaque and tartar, and regularly visit a periodontist or dentist.

Particular attention is paid to the choice of hygiene products, namely a soft toothbrush, the composition of the paste, and additional ways to maintain the oral cavity clean. If there is only an aesthetic defect, physiotherapy can be applied.

If the recession of the gum tissue is observed in the tooth under the crown, then replacement prosthetics is very often required. The need to remove the crown arises when the edges overhang or gingival margin does not cover the prosthesis. In case the pathology prevails, complex therapy of the major periodontal diseases is required. Treatment of periodontal disease in the early stages allows maintaining the stability of the tooth in the bed.

Reverse Gum Recession

Reverse gum recession

Surgery is performed with severe symptoms and complaints of the patient about enamel hypersensitivity, pain, bleeding.

Recession prevention is performed easier in case of the wide vestibule of the oral cavity, sufficient width and thickness of the gums, and high density of periodontal tissues. An essential condition for a successful surgery is an adequate and complete treatment of concomitant diseases and eliminating etiological factors. In this case, it is possible to maintain the stability of the root in the dental bed.

Treating Gum Recession at Home 

The prognosis for the prevalence of pathological changes in the gums depends on the completeness and success of therapy for the underlying disease. The presence of keratinized gingival areas contributes to the complete closure of local foci. Therefore, home treatment is not possible.

The prognosis is dubious and complicated in the case of prolonged epithelial attachment, which results from difficult wound healing. The appearance of signs of a change in the structure of the gums requires specialist advice. Do not self-medicate and do not ignore the problem – contact a specialist to maintain the beauty and health of your smile.