Gum Recession

Overview

What is Gum Recession?

Gum recession (gingival recession) is the gradual exposure of the tooth root due to loss of gum tissue and/or positional changes of the gum margin. This exposes the root surface, which can cause sensitivity and aesthetic concerns.

• Affects 50% or more of adults over 30
• Exposes tooth root surfaces
• Causes sensitivity to temperature and touch
• Can be localized or generalized
• May indicate underlying periodontal disease

Overview of the Condition

Recession occurs when the gum margin moves away from the crown toward the root. The exposed root surface is covered by cementum, which is softer than enamel and more susceptible to decay and sensitivity. Multiple factors contribute to recession.

References

• NCBI - Gingival Recession
• AAP - Gum Recession

Symptoms and Causes

Symptoms

• Visible elongation of teeth (teeth look longer)
• Exposed root surfaces
• Sensitivity to hot, cold, or touch
• Notching at the gum line
• Aesthetic concerns
• Food impaction between teeth and gums
• Root surface decay (in advanced cases)

Causes

• Aggressive toothbrushing
• Periodontal disease
• Thin gingival biotype (genetic)
• Tooth malposition or crowding
• Orthodontic tooth movement
• Trauma from piercings
• Grinding or clenching (bruxism)
• Tobacco use
• Hormonal changes

Diagnosis and Treatment Options

Diagnosis

• Visual examination of gum margins
• Measurement of recession (from CEJ to gum margin)
• Assessment of gingival thickness
• Periodontal probing
• Evaluation of underlying causes

Treatment Options

• Desensitizing agents for sensitivity
• Modification of brushing technique
• Gingival grafting (root coverage)
• Connective tissue grafts
• Free gingival grafts
• Pedicle grafts
• Allografts or xenografts

Non-Surgical Care

Conservative Management

Mild recession without sensitivity or aesthetic concerns may be managed conservatively. Addressing the cause (e.g., brushing technique) and monitoring for progression is appropriate for many cases.

Home Care Recommendations

1. Use a soft-bristled toothbrush
2. Employ gentle, circular brushing motion
3. Use desensitizing toothpaste
4. Avoid abrasive toothpastes
5. Treat bruxism with night guard
6. Regular dental monitoring

Surgical Care

When is Surgery Needed?

Gingival grafting is indicated for progressive recession, root sensitivity not responding to conservative care, root decay risk, or aesthetic concerns. The goal is root coverage and increased attached gingiva.

Surgical Options

• Connective tissue graft (gold standard for root coverage)
• Free gingival graft (for increasing tissue thickness)
• Coronally advanced flap
• Pedicle (lateral) graft
• Acellular dermal matrix (allograft)
• Tunnel technique

Anatomy and Affected Areas

Anatomy Overview

The cementoenamel junction (CEJ) marks the boundary between crown and root. Recession is measured from the CEJ to the gum margin. Exposed root surface lacks protective enamel.

Common Areas Affected

• Facial surfaces of teeth (most common)
• Canines and premolars (prominent position)
• Lower incisors (thin tissue, malposition)
• Any teeth subjected to trauma or disease

Frequently Asked Questions

Frequently Asked Questions

QuestionAnswerCan gums grow back on their own?No, receded gums do not regenerate without surgical treatment.Will my teeth fall out?Recession alone doesn't cause tooth loss, but underlying disease might.Is gum grafting painful?Discomfort is manageable with proper anesthesia and post-op care.How successful is gum grafting?Root coverage success rates can be 80-100% for many cases.How do I prevent more recession?Gentle brushing, treat underlying causes, regular dental care.Why are my teeth so sensitive?Exposed root surfaces lack protective enamel.

Prevention Tips

Prevention Strategies

• Use proper brushing technique (gentle, circular motions)
• Use a soft-bristled toothbrush
• Don't brush immediately after acidic foods
• Treat gum disease early
• Address teeth grinding
• Regular dental check-ups

Related Conditions

Related Conditions

• Periodontitis
• Toothbrush abrasion
• Dental hypersensitivity
• Root caries
• Mucogingival defects

Prognosis

Gum grafting has high success rates when properly performed and maintained. Addressing underlying causes is essential to prevent recurrence. Long-term stability depends on good oral hygiene and regular maintenance.