Receding gums: why they pull back and what helps

How do I know if my gums are receding?

It creeps along over years, so it is easy to miss in the mirror. The usual clues:

• Teeth that look longer than they used to.
• A sharp twinge from cold, sweet things or brushing, right at the gum line.
• A notch you can feel with a fingernail where the tooth meets the gum.
• A band of yellower tooth near the gum, where the root is showing.
• New gaps between the teeth near the gums, where food starts to catch.

What causes receding gums?

Usually more than one thing, and the cause decides what will stop it:

• Gum disease, one of the most common causes. Inflammation below the gum line breaks down the bone that holds the tooth, and the gum follows the bone down. It rarely hurts early on, so bleeding gums may be the only warning.
• Brushing too hard, or with a hard brush. Scrubbing back and forth wears the gum away over time and can wear a notch into the tooth.
• Grinding and clenching, which can play a part in recession and in notches at the gum line.
• Tobacco, smoked or chewed. Holding chewing tobacco or snuff in the same spot can leave the gum there receded.
• Thin gums. Some people are born with thinner gum tissue, which recedes more easily.
• Crowded teeth, where one sits outside the line of the others with little bone over its root.

Is gum recession serious?

The root of a tooth has no enamel over it. Once exposed, it is more sensitive, and because it is softer, it wears and decays more easily than the rest of the tooth.

When gum disease is behind it, the recession you can see is only part of the story. The bone underneath is being lost as well, and bone lost to gum disease does not grow back on its own.

Mild recession that is not getting worse is common, though, and often all it needs is gentler brushing and a watchful eye at each check-up.

What you can do at home

Most of what stops recession going further happens at home:

• Use a soft brush with light pressure, angled toward the gum line, in small circles rather than scrubbing. An electric brush with a pressure warning can help.
• Clean between your teeth every day, with floss or small brushes, whichever you will actually use.
• Brush with a fluoride toothpaste, which helps protect exposed roots from decay.
• If you use tobacco, stopping is one of the most useful things you can do for your gums.

How are receding gums treated?

The first step is finding out why. At a visit to the office in Pearisburg, the hygienist measures the gum around each tooth and records the numbers, so later visits show whether it is holding steady. X-rays show the bone underneath. Then treatment matches the cause:

• Gum disease: a deep cleaning, called scaling and root planing, under local anesthetic, with laser therapy and ARESTIN where they help, then cleanings every 3 to 4 months. Gum disease treatment explains each step.
• Brushing damage: a soft brush and a gentler technique, which we will show you.
• Grinding: a custom night guard, when it is likely to help, so the teeth press against the guard instead of each other.
• Sensitive roots: fluoride varnish, or a thin protective coating sealed over the exposed root.
• A notch worn at the gum line: a tooth-colored filling that covers and protects it.

Can receded gums grow back?

Not on their own, and no toothpaste or rinse will make them. Lost gum can sometimes be replaced with a graft: a gum specialist, called a periodontist, moves a small piece of gum tissue, often from the roof of the mouth, over the exposed root.

A graft is not needed for every receded area. It is worth considering when an area keeps receding despite treatment, a root stays very sensitive, or the recession shows when you smile and it bothers you. If we think a graft could help, we will tell you why and refer you to a gum specialist.

When should you call?

Call and arrange a visit if the sensitivity is getting worse, your gums bleed, a tooth feels loose, or you can see the recession moving from one month to the next.

A swollen gum with pain or a bad taste can be a dental abscess, and that needs seeing soon. Go to an emergency room for swelling that is closing an eye or spreading down the neck, or for difficulty breathing or swallowing.

Questions patients ask