Perio Other – Gingival Recession

Gingival recession, or receding gums, occurs when the roots of the teeth are exposed. This condition is caused by the loss of gum tissue in addition to the retraction of the gingival margin from the tooth’s crown. Gum recession is especially common issue in adults over the age of 40, however, it can occur in patients who are just 10 years old.

Classification

There are various classification systems which are used to classify gingival recession. Miller’s classification system which is most often used. Many cases of recession are not able to be effectively classified based on the criteria of the standard classification systems. Kumar & Masamatti's classification is another system used which gives a comprehensive depiction of recession defect. It can also be used to properly include cases which are not accurately classified based on the existing classification systems and overcome limitations associated with Miller’s classification system. A separate classification system for palatal recessions is also available. A new comprehensive classification system classifies the recession based on the position of interdental papilla and the buccal, lingual and/or palatal recessions.

Causes of Gingival Recession

While there are various causes for gingival recession, below are few of the most common causes:

  • Abnormal tooth position or overcrowding
  • Acute necrotizing ulcerative gingivitis
  • Aggressive brushing
  • Chewing tobacco, impacts the mucous membrane which lines the mouth and over time can lead to receding gums
  • Gum disease
  • Incorrect flossing, such as flossing in an aggressive manner
  • Intentional gingival retraction
  • Lip or tongue piercings which can wear away the gum from constant rubbing
  • Scurvy or vitamin C deficiency
  • Self-inflicted trauma or habits such as sticking objects into the gums
  • Thin, fragile or insufficient gingival tissue which is often hereditary

Symptoms

Gum recession is not typically considered an acute condition. In most cases, receding gums are a progressive condition which slow occurs over a period of time. Because of this, gum recession is especially prevalent in patients over the age of 40. Because the change in the gums is minimal, condition is not always noticeable right away and patients can get used to their slowly changing gums. Receding gums can go unnoticed for a while before the condition starts to cause symptoms.

Below are signs and symptoms which may indicate the presences of receding gums:

  • Cavities exist below the gum line
  • Change in the color of the teeth. Often occurs due to the color difference between the enamel and the cementum
  • Movement of the teeth
  • Overly sensitive teeth. This may include short and sharp pain.
  • Roots of the teeth are visibly exposed
  • Spaces or gaps develop between teeth. Although the space between the teeth actually stays the same, it appears larger because the gums do not fill in the space as they normally do
  • Teeth might appear longer than usual. For example, a larger part of the crown is visible when the gums are receding
  • Tooth has the sensation of ridges at the gum line

In cases where the gum recession is caused by gingivitis, the following symptoms may be present:

  • Bad breath or halitosis
  • Bleeding gums when brushing and/or flossing
  • Puffy, swollen, inflamed, or red gums

In some cases, when gingivitis is treated, it reveals that a gum recession problem previously existed but was not apparent due to the swollen gums.