Gum Recession

What is Gum Recession?

Gum recession, also known as gingival recession, occurs when the margin of the gum tissue that surrounds the teeth wears away or pulls back, exposing more of the tooth or the tooth’s root. This condition requires the presence of healthy alveolar bone, and without it, recession is more likely to occur especially if influenced by any of the factors described below.

Common Causes of Gum Recession

Several factors can lead to the recession of the gingival margins:

• Physical Impact: This includes traumatic contact from opposing teeth or incorrect tooth brushing techniques using a hard bristle toothbrush.
• Periodontal Issues: Such as periodontal disease, which can degrade the health of gums.
• Hygiene and Habits: Poor oral hygiene, plaque buildup, and intraoral use of tobacco products can all contribute.
• Genetics: Hereditary factors, including variations in periodontal and gingival biotype.
• Mechanical Stress: This can be from clenching or teeth grinding, or from teeth being moved excessively against the buccofacial cortical bone.

Recession & Clear Aligners

While gum recession is rare with clear aligners, it can occur with improper use of fixed braces and other orthodontic appliances. Excessive buccofacial tooth movement can stress the thin alveolar bone, potentially leading to recession. Addressing excessive orthodontic pressure promptly can halt further recession. However, once the bone is lost, it typically does not regenerate fully, which might necessitate gingival grafting before or after orthodontic treatment.

Recommended Actions

Upon noticing early signs of gum recession, it’s crucial to identify the cause. Factors to consider include:

• Soft Tissue Health: Check for any underlying tissue issues.
• Habits: Identify any harmful habits, such as tobacco use or teeth grinding.
• Trauma: Look for traumatic contacts or tooth movements.

Initial steps should include analyzing for traumatic occlusion, reviewing the patient’s brushing technique, and ensuring proper oral hygiene practices are followed. For severe cases, surgical intervention such as periodontal flap repositioning may be required.

Addressing Harmful Habits

Advising patients to stop harmful habits is essential. Regular use of tobacco products and bruxism can significantly contribute to recession. Using a mouthguard at night can help mitigate the effects of clenching or grinding teeth. Additionally, resolving any high or traumatic dental contacts through occlusal adjustment can promote healing and return the gums to a healthier state.

For moderate to severe cases of recession, consulting a periodontist for comprehensive management is recommended. They can assess the need for procedures like gingival grafting and provide specialized care.