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RECEDED GUMS

What are receded gums?

Receding gums are quite often seen, but unfortunately this is irreversible condition. Treatment is very difficult, because the long-term prognosis is not very promising. Teeth at the gum level automatically become optically longer than the neighboring teeth, because of exposed roots. These teeth can become sensitive to cold, sweet, sour food and toothbrushing. This situation changes the overall appearance of smile and esthetics.

What are causes?

  1. Mechanical factors (too aggressive, incorrect toothbrushing with hard toothbrush).
  2. Chemical agents. Acids accelerate receding gums.
  3. Poor prosthetics.
  4. Ageing. Within 10 years gums recede by an average of 1 mm.
  5. Tooth eruption on the wrong places or teeth crowding. Most often this occurs at upper canines and lower incisors.
  6. Thin gums. This depends on genetics.
  7. Bruxism.
  8. The long-term inflammation of the gums (periodontal disease) due to poor hygiene.
  9. Orthodontic treatment. We can often see receding gums on lower incisors.
  10. Surgeries on gums. Flap operations can reduce periodontal pockets, but side results are receding gums.

What are consequences of receded gums?

  1. Sensitive teeth. Exposed tooth roots are covered with cement, which can easily be demineralised and removed from roots and underlying dentin starts to becomes even more sensitive. Tingling usually worsens when eating cold, sweet and sour food, so it is advised to rinse oral cavity with water after consuming that kind of food.
  2. Poor dental aesthetics. Tooth with receded gum becomes optically longer, which ruins the symmetry of a smile. Receded gums are not always evenly distributed and in the same amount in one’s mouth.
  3. A higher risk of caries on dental roots. Exposed root cement is softer than tooth’s enamel and so it is more subjected to acids in the oral environment, that is why tooth decay can start to develop.

What is the treatment?

  1. Proper brushing. Treatment of receded gums begins with the proper selection of brushing techniques, which means you have to stop with horizontal brushing. Use a soft toothbrush and minimally abrasive toothpaste.
  2. Mouth guard. It is recommended in the case of night bruxism.
  3. Reduce consumption of acidic food and drinks. Tooth’s enamel is more resistant to acid than cement, so it can be more quickly damaged.
  4. Coatings. In advanced cases of teeth sensitivity, roots can be coated with special adhesive, but this is usually just temporarily solution.
  5. Dental fillings. Longer lasting solution is to make dental filling over exposed tooth roots. The disadvantage of fillings is that they often fall off and that aesthetic result is achieved with only minor recession of gums.
  6. Surgical treatment. It is possible to cover exposed tooth roots with help of periodontal surgical procedures. Overlaping the roots is the most successful with small recedings of gums.

How is the surgery treatment done?

All oral surgery procedures are carried out under local anesthesia, so the procedures are not painful. There are several techniques of covering the roots, depending on the seriousness of gum recession. Some techniques have better results than other (for example free connective graft from palate). Surfaces of uncovered roots are cleaned well before surgery and dental fillings are removed. It is often used special technique where surrounding gum tissue is tried to be pulled on bare tooth roots. Surfaces of bare roots are coated with enamel matrix, which allows new gum tissue to merge with roots better. Gums are then fixed in new position with stitches, which are very thin, usually unobtrusive and can be removed after about 2 weeks.
The first day after surgery can be slightly painful, so painkillers may solve the problem. It is possible, edema will form, but this is often rare. The first few days after surgery patients should not talk too much or smile widely. Patients can immediately return to their work. Antibiotic therapy is sometimes required with larger operations, depending on the patient. The end result is visible after 5 months when the root is covered and aesthetics achieved. It is necessary to do a proper brushing technique, since this is essential to prevent receding gums to happen again.    

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