Receding Gums

Receding gums can occur when the gum tissue gets pushed back or wears away along the surface of the tooth, leaving an exposed root surface. 

Although a receding gumline is common, it happens so gradually that many people don’t realize it’s happening until a later stage. 

Not only can gum recession be unsightly, but it can also become a health concern. When the gums pull back and expose the roots, you risk infection, decay, and even tooth loss. 

There are six main causes for receding gums. 

• Clenching or grinding. According to Dr. Zachary Linhart, a dentist in New York City and Greenwich, Connecticut, a person who clenches or grinds their teeth puts pressure on the tooth structure and causes it to flex. This flexing can cause gum recession and abfraction, the process in which the tooth gets a notch at the receded area. This notch can grow larger and deeper until the tooth fractures, or a root canal is needed. In addition, the exposed root surface from recession is softer than the normal enamel, so it is much more likely to get eroded away by the acidic environment that can occur in the mouth.

• Aging. “Some people's gums recede as they age, causing unsightly ‘long in the tooth’ issues,” says Dr. Linhart. In fact, the California Dental Association asserts that receding gums are incredibly common in adults over 40, and 88% of people aged 65 and older have recession in at least one tooth.

• Brushing too hard. Many people are guilty of brushing their teeth too hard, which can cause gum recession, abrasion, and all sorts of other issues. 

• Poor oral health. Inadequate brushing and skipping your nightly floss sessions can lead to a buildup of plaque and tartar, and contribute to gum recession. This inflammation, known as gingivitis, occurring in unhealthy gums can lead to periodontitis, which is when space between the teeth and the gums grow, allowing the connective tissue to deteriorate. This is often accompanied by bleeding gums and tooth sensitivity. 

• Mouth breathing. Another cause of a receding gumline could be excessive breathing through the mouth, according to Dr. Ramin Tabib, a dentist and co-founder of NYC Smile Design in New York City. “Mouth breathing is not a normal process—it contributes to crowding of the teeth because of poor tongue position and lack of upper palate development,” explains Dr. Tabib. Crowded teeth can lead to clenching and grinding, which can exacerbate the problem of gum recession.

• Eating disorders. Finally, eating disorders (especially bulimia) can also be causing receding gums, as the acid wears away at tooth enamel.

Unfortunately, there isn't a whole lot of variety in your treatment options for fixing gum recession. However, the options that are available generally work very well.

	Gum Graft surgical	Pinhole Gum Surgery surgical
Worth It Rating	100%	Not yet available
Average Cost	$2325	Not yet available
Downtime	Up to 1 week of downtime	1 week of downtime
Anesthesia	Topical and local anesthesia	Local anesthesia

• Gum graft surgery is the most common treatment for a receding gumline. Gum graft surgery (also called a gingival graft or periodontal surgery) covers exposed tooth roots caused by receding gums. In order to do this, a periodontist takes tissue from the roof of the mouth and attaches it to the gumline to cover the areas that have worn away. Gum surgery protects teeth from the damaging effects of gum recession, and it can also improve the appearance of your smile.  Recovery takes a few weeks, during which you will be instructed to eat soft foods and avoid anything too spicy or acidic. While healing, your periodontist will recommend not brushing or flossing on the side of the gum graft. After the gum graft has healed, you’ll be able to resume your regular habits. Find doctors who offer gum graft surgery
• Pinhole gum surgery, also called the Chao pinhole surgical technique (PST), is a relatively new, minimally invasive procedure that restores soft-tissue coverage to exposed roots without the need for scalpels or sutures used in gum grafting. A dentist or periodontist will create a small hole in the gum, then insert a special tool to free the gingiva from the underlying bone and tooth. Then they reposition the gum tissue over the exposed root, restoring the gumline. Find doctors who offer pinhole gum surgery
• Collagen gum grafting uses a collagen matrix, instead of your own tissue, to cover exposed roots due to receding gums and helps build gum tissue back up. Unlike traditional gum graft surgery, collagen gum grafting doesn’t require cutting open the roof of the mouth in order to get tissue to attach to the gumline. Studies have found that this option to be both successful in reducing gingival recession and less invasive for patients.

Brush your teeth gently in circular motions with a soft toothbrush, practice good oral hygiene, and make sure to keep an eye on your gums. If you see the beginnings of recession occurring, see your dentist and discuss why it's happening.

Depending on the cause, recession can sometimes be stopped—especially if you take action at the first sign. If brushing too hard is the culprit, you must train yourself not to brush so hard. If the recession is due to clenching or grinding, try using a mouthguard at night.

Unfortunately, if the recession is genetic and due to aging, not much can be done to avoid it.

Dr. Tabib also recommends trying to breathe more through your nose, rather than your mouth. If your gum recession is caused by an eating disorder, seek a medical professional for support. 

RealSelf Tip: Botox can treat bruxism, a condition where you frequently and unconsciously grind or clench your teeth. This can help prevent receding gums or keep them from getting worse. 

Studies show that Botox can reduce teeth grinding, and because increased grinding or clenching of teeth could be causing a receding gumline, getting Botox injected directly into the masseter muscle could help. Injecting this muscle with botulinum toxin weakens it enough to stop involuntary grinding of the teeth and clenching of the jaw.