Alvin H. Danenberg, DDS • Nutritional Periodontist
March 13, 2017
When Ken came to me as a patient over a year ago, he had one question, “Why do I have receding gums?” He is one of many patients who thought he was brushing too hard. Brushing too hard could damage weakened gum tissue, but it may not be the underlying reason for gum recession. There are generally 5 reasons for receding gums.
Here’s how I helped Ken understand about the gum tissue in his mouth and receding gums.
Gum Tissue
The gum tissue that covers the tooth is generally attached to jawbone that surrounds the root. The jawbone keeps the tooth solid in your mouth. The gums are like window dressing. They are important but don’t support the strength of the teeth. As long as the bone is healthy and continues to function as a scaffold for the gum tissue, the gums will not recede. However, once the thin bone on the cheek side of a tooth is absent for any reason, the gum tissue would become vulnerable. The gum could recede leaving an exposed root surface.
5 Common Reasons For Receding Gums
- Gum disease and inflammation can cause gum recession. Disease and inflammation could spread under the gums and dissolve the thin bone on the surface of the roots that face the cheeks. Once this bone is broken down, it will not regrow. Gum recession is frequently the result of this type of gum infection.
- Pressure on your teeth could cause gum recession. You might be grinding or gritting your teeth. While you may not realize it, you may be doing this when you sleep.The tooth root is anchored in the jawbone just like a pole is anchored in the dirt. If you continuously wiggled a solid pole in the ground, it probably would become loose. The reason it would loosen is because the side-to-side rocking of the pole would push the dirt aside. Assume the pole was your tooth and the dirt was your jawbone. If you wiggled that tooth in the bone by grinding or clenching your teeth, you could weaken the surrounding bone. Since the bone around the tooth root on the cheek sides of the teeth is extremely thin, it is very vulnerable. Any wiggling of the tooth in the bone could cause that very thin bone to melt away. Once the bone is gone, it is gone for good. With the bone gone, the gum tissue covering that area of the tooth would no longer have a scaffolding to attach to. The gum would become unstable. The gum could then recede exposing the root because the bone would no longer be there to hold the gum in place.
- Sometimes, bite treatment (orthodontic treatment) could cause gum recession. Bite treatment might put too much pressure on teeth and damage the thin bone on the root surfaces facing the cheeks. As I mentioned above, if that thin bone were destroyed, it would not regrow. The gum tissue in the area would become weakened. Gum recession then could occur in those areas where the bone was lost.
- Poorly fitting dental appliances or continuous trauma from something else could cause gum recession. If an appliance like a partial denture or a “lip piercing” was rubbing the surface of the gum causing trauma and inflammation, the bone under the gum tissue could melt away. Without the supporting bone, the gum could recede.
- Bone defects at birth could cause gum recession. On some occasions, the very thin bone on the cheek surface of the roots of the teeth may be missing congenitally. If that is the case, then the gum tissue will not be attached strongly to the root surface, and the gums could recede.
Bottom Line
Even if the gums recede, additional treatment may not be necessary. As long as the roots are not sensitive and the receded gum remains firm and healthy, no other gum treatment would need to be done. If grinding and gritting habits caused the recession, then these habits should be addressed and treated correctly. Also, if exposed roots are sensitive or the receded gums are not sealed or healthy around the roots of the teeth, gum grafting or a gum lift could be the treatment of choice to correct the problems.
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