Why does gum recession happen?
The underlying process is removal of bone just below the gum, allowing the gum to move away from the crown, leaving the root exposed. That leaves us wondering why the bone was removed, and there may be different reasons for each person. These include the following:
- Unusual pressure on teeth, particularly individual teeth, which are misplaced, or tilted.
- Thin bone structure around teeth, so smaller forces encourage early loss.
- Individual response to bacteria, and possibly the type of bacteria present. Some respond by swelling of gum, with little bone loss initially, while others appear to have little gum swelling, but rapid loss of bone. These seem to be at different ends of a disease spectrum, and the treatment for both is removal of bacteria.
- Local factors can lead to recession, such as poorly finished fillings and crowns, inneffective brushing, and sometimes reaction to metals in crowns and bridges
What can be done about it?
We don't have a way of replacing lost bone. Some attempts can be made involving surgery to position the gum further up the tooth, but this is not predictable, particularly over the longer term.
So treatment is directed to preventing the situation worsening, or at least slowing it down.
Initial treatment is removing local food-traps, and sometimes adjusting the bite. It is then largely up to you. Every day, you need to brush carefully along the gum line to keep growing bacteria to a minimum.
With some people who are struggling, we have successfully used QSIant along the gum line to remove infection, and this gives them a fresh start, making it easier to maintain.
What are the possible complications of gum recession?
- The major one is tooth sensitivity
- Appearance is compromised, and attempts may be made to improve appearance by using plastic fillings and veneers, although giving improvement initially, may promote further recession. Great care is required to minimise this, and is the reason that good fillings take time to complete, particularly when they finish close to the gum line.
- Continual irritation of the root surface may cause the root canal (where the nerve and blood vessels are) to close down. This can create problems for root treating the tooth, if it becomes the only possibility of saving the tooth.
- Occasionally there are canals passing from the inside of the tooth to the root surface. If the gum recedes exposing a canal, bacteria may make their way in causing the tooth to die off, and perhaps leading to a painful abscess.
A major problem with gum recession is tooth sensitivity.
The root is exposed to hot, cold and sugary foods and drinks. During the winter it may be worse as cold air is breathed in. Avoiding those extremes can prevent pain.
Recently introduced desensitising toothpastes are very effective for many people, but remember they won't prevent further gum recession, so it's important to brush carefully, even if your pain has disappeared.
If you are using desensitising paste, just before bedtime brush your teeth carefully, then rub a little along the gum line using your fingertip. Don't wash it off. Allow it to soak in during the night. For many people this improves the effectiveness.