Recession of the gums and why it happens...

A lot of talk lately has been about recession...no not what you are thinking, not the economy, that thankfully seems to be on the uprise. I am talking about recession of the gums (gingiva) in the mouth. Recession simply put is the gums pulling downwards from where they would normally be connected to the tooth structure.

Sometimes recession can be caused by things that can be corrected, for example in the case if someone was using a too firm toothbrush with poor brushing technique. In many cases though it can be a combination of many factors.

Recession of the gums can be caused by malocclusion which is simply teeth meeting together in a fashion that is traumatic to the teeth, the tissues of the mouth and possibly even the jaw joint (TMJ). Over time, malocclusion may lead to recession of the gums. When teeth are not in proper alignment or certain teeth are hitting harder together than others, the first thing that may happen is recession.

Grinding and clenching the teeth can also cause gum recession. Once again it comes back to trauma. The excess forces that the teeth and jaw endure due to grinding and clenching can cause the gums to pull away from the natural gum line and move down and away. When someone is grinding or clenching typically a nightguard worn while you sleep will help prevent tooth to tooth grinding or clenching so it may help alleviate jaw strain and ultimately may prevent new recession from occuring.

Yet another example of what causes gum recession is bacteria. Just as bacteria in the mouth can cause cavities and gum infections, recession can also be bacterial related. When bacterial plaque is left behind on the tooth and below the gumline, certain types of bacteria can cause inflammation and infection thus causing the gums to almost want to withdraw from the bacterial trauma, thus they recede.

In some circumstances gum recession may be due to a tight or low lying frenum attachment. A frenum is simply a small band of tissue that connects the lip or cheek tissue to the gum tissue of the jaw. Occasionally the frenum is very tight or it connects quite low, adjacent to the teeth. When it connects very close to the gumline of the teeth it can put stress on the gum and causes it to recede. A situation likes may warrant altering how the frenum attaches to the gum tissue, in which case a laser would be used to painlessly separate it.


Gum recession can be a hazard to your mouth. When the gums recede away from their natural level they move downwards and start to expose the root of the tooth. The root of the tooth is made of what is called cementum and this cemenutm is soft and susceptible to being worn away. This cementum does not replenish itself so when dissapears it goes for good. The problem with cementum being exposed is an increased risk of developing cavities on the exposed root, sensitivity of the teeth to cold/hot/sweets because the stimulus is translated directly to the pulp inside the tooth and possible wearing away of the cemental surface (abrasion and abfractions).
Simply put, the cementum should not be exposed.

To protect exposed roots a few things may be recommended. At some times coverage of the root may be done with white bonding material, which can protect the cementum surface from the toothbrush, stimulus and may prevent decay from occuring on the surface. At other times coverage of the exposed roots may be done with tissue grafting. This tissue may come from the patient's own mouth (palatal tissue) or may be from donor tissue which is sterlized (similar to tissue grafting for burn victims). When tissue grafting is performed the hope is to achieve full coverage of the root and return the appearance of the tooth back to 'normal.' Before any of these procedures are performed it is essential that elimination of other factors as described above; malocclusion, grinding/clenching and bacteria infection are taken into account. These factors need to be corrected prior to bonding or grafting so either treatment has a chance to succeed.

Happy Thanksgiving to all!

Nathan