The most effective receding gums treatment is gingival (gum) grafting from a healthy area in the mouth or with artificial grafts. But to get the maximum benefit out of this treatment, you need to follow all required post-operative care. (1)
The only natural receding gums treatment is the massage of gums. Receding gums is irreversible damage to our gums. Once there is a substantial amount of gum loss and even after surgical treatment, like grafting, may not be of much help.
Gum recession occurs in various stages. If we can identify the early signs like swelling in gums and bleeding gums, we might be able to avert the recession.
Gum health is directly proportional to tooth health. Unhealthy, swollen and receding gums lead to loss of teeth support and ultimately lead to teeth falling out of the sockets.
So, a proper gum care routine and preventive measures can resist gum diseases including gum recession.
Gum or gingival recession is a periodontal problem. It involves surrounding tooth structures like ligaments attached to the tooth and underlying bone along with gums. Gums provide nourishment to the ligaments of the tooth with blood vessels in it, which in turn hold the teeth in place.
Thus, needless to say, if the gums are diseased and receding, the blood flow to the ligaments is cut off. The ligaments then start to disintegrate, ultimately leading to loosening of teeth in the socket. Therefore, prevention and treatment of receding gums are essential.
The gums recession does not hit you without any prior warning signs. (2)
Warning signs pre-recession
Primary signs and symptoms to look for before the final gum recession begins goes as follows-
- Starts with bad breath
- Inflammation/swelling of gums
- Bleeding gums with or without touching them
- Mobility or rotation of teeth
- Spacing in between teeth
- Visibility of root or tooth structure beyond the height of gum (elongation of teeth)
- Color change in the gums- reddish to bluish purple
- Pus discharge coming out of the gingiva or tooth pocket
- Painful gums
- Increasing sensitivity of teeth to hot or cold because of exposed roots
When you spot one or more of these problems mentioned above, you should consult a dentist, or this will worsen and lead to recession of gums and eventually falling off of teeth from gums.
Conventional receding gums treatment
Soft tissue grafting and flap surgery is the only valid conventional receding gums treatment. A graft is a part of live tissue cut out from a healthy area in the oral cavity, which replaces lost gingiva.
Various techniques are used for soft tissue grafting and they are –
Connective tissue graft
This technique can be used when there is deep tissue loss such as loss of gingiva along with blood vessels in it. Oral home hygiene plays a crucial rule during the healing time and patient compliance as well.
Free gingival graft
This technique is the most commonly used when there is gum recession or fragile gingival tissue loss around teeth or dental implants. This graft has the best results for increasing the gingival thickness.
This technique used when there are several teeth, more than three teeth, are involved in gum recession. The alloderm is a sterilized human tissue graft which replaces lost gingiva.
Pinhole surgical technique
There are many ongoing studies to investigate the feasibility of this novel surgical approach to root coverage. The pinhole surgical technique is a promising new approach. For this no secondary surgical site is necessary. (3)
Natural receding gums treatment
The only effective home remedy for mildly receding gums falling under class one or two of recession is gum massage. In this, you have to do a gum massage post tooth brushing.
You can use the tip of your index finger to perform massage. The motion should be circular and mild pressure should be applied.
Repeating this process once every day increases blood flow to the gums which in turn might reduce the swelling and delay recession.
Prevention of receding gums
Once gingiva is lost, no matter with how much surgical skill it is restored, it will still lack the original consistency and functionality. There is also always a scope of relapse. So, the only option is to prevent gums recession.
Maintain oral hygiene
To prevent gum recession, regular brushing, i.e. twice a day, is recommended with daily use of floss and mouthwash. A proper technique for brushing is implemented in cases of recession. In this, small circular motions are made while cleaning the tooth surface.
The bristles should be swept over the sides of the teeth towards their upper surfaces in a single motion rather than repeated scrubbing.
This is known as the Charter’s method of toothbrushing, which effectively cleans in between teeth without hurting the gums. A soft bristle toothbrush is advisable for cases of receding gums.
Refrain from smoking and any forms of tobacco
Smoking or chewing tobacco in any way can cause trauma to your gums. So, quitting such habits is highly recommended.
Get a regular dental check-up
A regular visit to the dentist, preferably once in six months, for regular cleaning and treatment of other teeth related issues is required.
Because many other ailments like malaligned teeth can also create undue pressure on gums leading to recession. Always watch out for teeth sensitivity as it is a vital sign for unhealthy oral tissues.
Causes of receding gums
There are multiple causes of gingival recession –
Low-level but a long-lasting trauma
You can damage the fragile gingiva over the period by brushing very hard or using fast and intense motions while brushing. Since brushing is a daily activity, the damage is long lasting as the gingiva doesn’t get time to heal.
Chronic inflammatory periodontal disease
Periodontal diseases, characterized by long-standing swelling of the gums and surrounding tooth structure, lead to loss of gingiva. This happens as a result of digestion of the tissue by enzymes, with bone loss.
If the condition is not treated in time, then there may be massive bone loss and ultimately falling off of teeth from the sockets.
Many periodontal treatment procedures imply considerable tissue damage due to the need for surgical tissue replacement. After a surgical procedure, there is a decrease in periodontal tissue swelling but with a loss of original elastic tissue.
Any trauma caused to a tooth, such as a blow, might induce symptoms characterized by pain combined with a modest increase in tooth mobility. It can last for days, weeks or even months. Ultimately, the condition may lead to inflammation followed by the recession of the gums. (4)
Classification or degrees of recession
Gum recession is a part of a bigger disease called periodontitis. This term means inflammation of surrounding teeth structure. Gum recession is one of the classic features of Periodontitis. Various forms of periodontitis are –
- Juvenile periodontitis – affecting children only
- Aggressive periodontitis – fast-progressing
- Acute periodontitis- short -lived but painful
- Chronic periodontitis – long-term disease of gums, less painful than acute form
- Localized periodontitis – affecting six or less than six teeth
- Generalized periodontitis – affecting more than six teeth
The classification of receding gums is based on the extent of recession beyond mucogingival junction or MCJ.
MCJ is nothing but the junction or line between the upper margin of the gingiva that we can see and the underlying mucosa or vascular tissue. We can grade gums recession according to loss of gums from its margins extending beyond the crown part of the tooth, exposing the roots.
The grading ranges from class one to four, one being the best and four the worst gum condition.
A marginal gingival recession occurs but does not extend to the mucogingival junction. There is no loss of bone and soft tissue from around the teeth. Here, we can just see the margins dipping with little or no exposure of the roots. This type of recession is a reversible damage.
A marginal recession occurs but extends beyond the Muco Gingival Junction (MCJ). There is no loss of soft-tissue or bone. In this case, we can see a small root portion. There is still no mobility in the teeth.
Marginal tissue recession occurs and extends beyond the MGJ. There is a loss of interdental bone or soft-tissue. Here, we see a substantial portion of the root with noticeable mobility in the teeth when touched. This is an irreversible damage.
Marginal tissue recession occurs and extends beyond the MGJ. There is a loss of interdental (between teeth) bone. There is a loss of bone structure between two adjacent teeth.
Hence, we can see more than two-thirds of the root with spontaneous movement of teeth in the socket. Bone and gum grafting may be needed to improve this damage.
Final words on Treatment and Prevention for Receding Gums
Maintaining good oral hygiene is the best way to prevent receding gums. This ailment is not completely curable but can be controlled. Also, the damage can be controlled by grafting.
However, grafts often fail due to improper patient compliance. So, it is must that you follow all the post-operative instructions given by your dentist.
Healthy gums are a gateway to healthy teeth and a healthy body. Many diseases like Diabetes Mellitus have a relationship with gum health.