A Progressive Approach

Receding gums are a concern to many. Especially to those that are concerned about the appearance of their smile. Some of the more common concerns are: exposed root surfaces that have a higher gum line architecture leaving root surfaces uncovered, the presence of notches or abfraction lesions and grooves on particular root surfaces. Some of these exposed root surfaces are reported by some to be temperature sensitive, touch sensitive, and sensitive to certain foods (citrus, sugary sweet foods, etc).

The loss of gum line contour can be a result of: a mechanical trauma, bacterial factors, local irritating factors and/ or systemic factors.


Mechanical Factors (should be considered!)

  • Occlusal discrepancies
  • Presence of occlusal trauma
  • Para functional habits of the patient
Traumatic occlusion or excessive rubbing of teeth can result in gum recession. This type of trauma is the most overlooked and unrecognized since it is the least obvious! It is a major factor that brings instability to the surrounding gums and supportive bone.

A simple example is if you could picture digging a hole for a fence post. Place the post in the hole and fill the hole with surrounding soil, packing the soil down well and firmly. Begin rocking on the post, back and forth. It will become obvious that a mechnical torque and strain will eventually loosen the soil base. So it is with the bony support around our teeth. Any mechnical torque or skids on any tooth incline that does not harmonize with the balance of the surrounding dentition will result in a loosening of the bony base and a receeding gum line. This can occur naturally every time we swallow (2000-3000 times daily) or when chewing.

Gum recession is not only due to heavy brushing, although it is often blamed.

If that is the case, why does one or two particular tooth root surfaces often only exhibit erosion notches (abfractions) and not the adjacent teeth. Does one only brush one or two teeth in that region only?

REMEMBER: Gums (the pink tissue) only cover and protect the underlying bone. If the underlying bone has desolved or receeded up, then the covering gums/ tissue will also go up, since they need support from bone underneath.

The result is the exposed root surface of the tooth. Without bone to support the gum tissues, the tissues have no foundation to cover the bone.


Local Factors
  • Crowded or overlapping teeth
  • Missing teeth causing tipping
  • Overhangs
  • Defective restorative margins
  • Inadequate contours/ margins
  • Open contacts
  • Endodontic involvement
  • Root fractures
  • Unusual root anatomy
These factors act as chronic irritants to gums and underlying bone, the periodontium. Any rough or non-smooth surface contours will attract bacteria invasion to those sites thus leading to loss of proper tissue attachment, bleeding/ swollen gums and eventual loss of bone around the tooth.

Bacterial Factors
  • Presence of plaque on teeth
  • Caries
  • Mouth breathing
  • Various types of bacterial pathogens
If plaque is not removed each day, it accumulates and hardens into calculus. The gums may become puffy and red. There may be no discomfort at this stage but there is danger. If not treated, the resulting inflammation could destroy the periodontal fibers that hold the gums tightly against the tooth.

Other Systemic Factors
  • Metal allergies
  • Tobacco use
  • Drugs
  • Alcohol
  • Hereditary factors
  • Diabetes and other system diseases
  • Pregnancy and other hormonal related conditions
  • Stress
  • Compromised immune response
Treating and preventing gum disease brings great health benefits. By retaining your natural teeth, you can chew more comfortably and enjoy better digestion. You will keep your healthy smile, a natural asset to your appearance. Remember to brush, floss, and eat a balanced diet.

A stable even balanced bite that harmonizes with the chewing/ clenching muscles, can prevent further strain to the supporting bone and prevent gum recession!

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