Gum Recession

What are receding gums? How to Prevent and Treat Gum Recession

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Are you at risk for receding gums? As we age, gum recession becomes more common. But I’ve created the full guide on how to prevent receding gums… And what to do if it happens to you.

by Dr. Burhenne

Receding gums
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Gum recession can’t be reversed, but receding gums are preventable. If the signs and symptoms are caught in time, your gums and your smile can be kept in great shape!

In this article, I will attempt to provide some in-depth information about how our gums work and what their purpose is. We’ll discuss possible causes of gum recession and ideas for how to stop receding gums.

What are the gums? What do they do?

Gingivae, the technical term for gums, is the layer of pink tissue in your mouth that protects the roots of your teeth. They also cover the alveolar bone, which is the bone your teeth are connected to in the jaw.

The gums are a critical protective barrier to infection getting inside your body. Like your skin, gums protect the more sensitive parts of your mouth from bacteria.

Your gingival tissue is composed of a moist surface called a mucous membrane. This dense tissue has a lot of blood vessels underneath.

Healthy gums stop molecules from getting into your bloodstream that don’t belong there, but diseased gums may allow unsafe particles through.

What is gum recession?

Over time, a number of factors can lead to receding gums (which I’ll outline in the next section). Gum recession happens when your gum tissue starts to die off and your gum line shrinks higher and higher up the tooth.

Once this happens, small gaps (called “pockets”) open between the gum line and teeth, opening the way for bacteria.

Even a small eruption through gums is dangerous. Once the smallest amounts of bacteria get beyond the barrier of your gums, the body starts working harder to fight infection.

Your gums cannot heal or grow back once you’ve developed a receding gum line. The best way to stop gum recession is to prevent it before it ever starts.

Let’s take a look at how receding gums might start.

Causes and Risk Factors for Receding Gums

Some of the most common questions I’m asked revolve around the main causes of gum recession.

For example: do bacteria eat away at gums? What about gum disease actually causes recession? How does that work over time?

Gums recede in many ways, and the cause isn’t always gum disease.  For example, grinding your teeth can cause gum recession. Even if your gums aren’t infected, an edema (swollen area of infection) behind the gums can cause them to swell. This happens because there’s infection or change in the microbiome.

Gum disease causes gums to die off. As gum tissue dies, it shrinks.

Bacteria doesn’t actually “eat away” at gum tissue, like some believe.

There are tiny blood vessels in the gums, only matched in size by the fragile vessels in the kidneys. That’s why kidneys and gums both get in trouble when you develop high blood pressure.

Conditions that cause problems with blood flow to tiny blood vessels are:

  • High blood pressure
  • Diabetes
  • Heart disease

Secondary causes of gum recession include over-brushing and eating certain foods that wear away gum tissue over time. For example, one bite of sourdough bread or oat bran flakes at the wrong angle can cause damage to gums. Popcorn and super crispy pork rinds are also foods that can contribute to the problem.

I’ve seen patients require grafting for gum recession due to genetics, tongue tie, and lips or tongue attached aggressively. Foods are definitely the number two culprit. The leading cause of gum recession is gum disease, such as gingivitis or periodontitis.

Here’s the bottom line: if any of the below items apply to you, you’re at a higher risk for receding gums. The leading risk factors for gum recession are at the top of the list.

  1. Gum disease, such as gingivitis and periodontitis (marked by frequently bleeding gums)
  2. Eating gum-damaging foods (more details on specific foods below)
  3. Aging (the older you get, the higher your risk)
  4. Genetics
  5. Over-brushing your teeth
  6. High blood pressure
  7. Diabetes
  8. Heart disease
  9. Tobacco use
  10. Poor dental hygiene, which can lead to excessive tooth decay or infection
  11. Physical trauma to the teeth and gums
  12. Hormone changes like pregnancy and menopause
  13. Tongue tie and high frenum position
  14. Lip or tongue piercings

Signs and Symptoms of Gum Recession

The official diagnosis of receding gums by your dentist is called a “local mucogingival problem” or “gingival recession.” But before your dentist can measure visible recession, are there ways to tell if your gums are receding?

Very early stages of gum recession aren’t visible to the naked eye. You may notice sudden symptoms early in the process, such as specific sensitivities to cold, acidic, and sugary food or drinks. You may see inflamed, red gums. They can appear or feel swollen and may bleed easier when brushing and flossing.

If you don’t change your habits or treat the underly problem during these early stages, you may eventually start seeing the actual recession of your gums.

Ultimately, the real findings come with measurement. Dental professionals measure tooth height in millimeters and look at the ratio of attached to unattached tissue. A dentist or hygienist should notice any receding taking place. This is super important with older patients who are more likely to have receding gums. Don’t skimp on dental appointments as you age!

Consequences of Gum Recession

What are the basic short and long-term effects of gum recession? I touched on the short term effect in the last section. The long-term impact, however, can be pretty huge.

Gingivitis, the most common form of gum disease, happens when tartar builds up on your teeth and isn’t regularly removed by a professional. When this occurs, you can experience an increase in sensitive and bleeding gums.

The longer this is left unchecked, tartar will advance and cause the gums to pull away from the teeth. This in a condition called periodontitis. At that point, aggressive root decay becomes much more likely. Infection is now near a place where enamel and dentin aren’t thick and protecting nerves. Instead, they’re thin and offer little protection.

The body does all it can to protect the inside from the outside world. This stage of gum recession is precisely why. Not only are you likely to lose teeth, you can risk good health. Periodontitis has been linked to:

  • Diabetes
  • Heart disease (1)
  • Stroke (2)
  • Arthritis (3)
  • Giving birth prematurely (4)

With healthy gums, it’s relatively easy to prevent excessive tooth decay. By eating a Paleo-type diet the majority of the time and learning to breathe through your nose, you can even reverse some cavities. If you catch a cavity when it starts but after it’s too late to reverse, you can also get a filling.

But as gums recede, even a small amount of decay can require a root canal once the nerve is so close to being exposed. You may lose teeth, experience worsened sensitivity, or even need gum graft surgery. In a gum graft, gum tissue is taken from near the gumline and used to rebuild some of the gums that have died off.

Gum tissue that has died can’t be re-grown. Gum graft surgery, however, can be a receding gums treatment for end-stage gum recession that restores some of the protection your gums offer. Rather than re-growing gum tissue, this surgery involves re-attaching gum tissue from other places in the mouth.

Rapid gum recession can even cause bone loss. This isn’t just the loss of tooth structure, but a degradation of the actual bone connected to teeth at their root.

How do you fix receding gums? 6 Conventional and Natural Remedies for Receding Gums

Many aging patients ask me how to fix receding gums without surgery. If you’re here for that answer, I commend you. The best way to treat gingivitis, periodontitis, or receding gums is to prevent them happening in the first place.

After all, if you can treat periodontitis, or at least gingivitis, at home, wouldn’t that be better than progressive gum recession?

Unfortunately, some level of gum recession will occur as we age, no matter what. However, recession can get worse and happen sooner with the any of these factors:

  • Onset of gum disease (gingivitis/periodontitis)
  • Bruxism (teeth grinding)
  • Over-brushing or using a hard-bristled toothbrush
  • Defective dental work
  • Systemic diseases that impact blood vessels (high blood pressure, diabetes, and heart disease)
  • Crowded teeth

Grinding and gum disease are the largest contributors to recession over time.

The good news: Both of these are preventable, which means you can still be wise without being long in the tooth!

Here are some doable, practical actions you can take to prevent gum recession.

  1. Brush Properly, With a High Quality Toothbrush

Many of the articles on my site include a section on the vital importance of how to brush your teeth properly using the best equipment.

Not only should you use a decent, soft-bristled brush, you should find the easiest way to remember to change it out often. I recommend one month for hand-held brushes, 2-3 months for electric brush heads.

Brushing with a hard-bristled brush directly correlates with a higher risk for gingivitis, which can lead to periodontitis and receding gums. (5)

Instead, follow the basic steps for how to brush your teeth every day:

  • Brush gently; don’t dig
  • Use sweeping, circular motions instead of back-and-forth “sawing”
  • Brush for at least two minutes in the morning, at night, and after eating sugary, acidic, or processed foods

If you have receding gums, try an electric toothbrush and ultra-fine bristled brush heads like the Sonicare Essence with Sonicare Sensitive Replacement Heads. If you don’t want to go with an electric option, try the Nimbus Microfine brushes—just be very gentle.

  1. Wear a Night Guard (or better, treat your sleep apnea!)

If grinding teeth is an issue for you, your dentist may fit you for a night guard. This simple solution may accomplish treating some symptoms and can help somewhat, but it’s actually better to treat the underlying problem. The real reason you grind your teeth is probably sleep apnea.

Improve your sleep quality and reduce snoring and other sleep apnea symptoms. This is one of the best ways to protect yourself from gum recession.

  1. Stay Away From Acidic Foods and Drinks

Enamel is more resistant to acid, but dentin in the roots is not. Acids speed up gum recession. The root can be dramatically injured in a short period of time when exposed to wine, soda, lemonade, orange juice, and other acidic substances.

Buffer these acids by drinking a neutral drink (water) alongside the acidic drink. Europeans practice this regularly and traditionally drink mineral water with their wines.

If you’re going to consume acidic foods or drinks, do it in a small portion of time (don’t snack on acidic things throughout the whole day). Make sure to rinse your mouth or drink water afterwards.

  1. Treat and Prevent Gum Disease

Gum disease will guarantee quick and irreversible gum recession. Many of the same hygiene tips mentioned above act as prevention of gum disease. They’re also proactive approaches to stopping or slowing the level of gum recession. Let’s recap how you can prevent gum disease before it starts.

  • Brush your teeth gently in the morning, at night, and after eating or drinking anything sugary, acidic, or processed
  • Rinse your mouth with water after drinking anything acidic
  • Floss each day
  • Try an electric toothbrush like the Boka brush that use sonic vibrations to break up plaque
  • Deal with teeth grinding (potentially caused by sleep apnea) (6)

But what happens if you already have gingivitis?

Unlike most dentists, I don’t recommend using alcohol-based mouthwashes. While these can kill some bacteria, they also dry out your mouth. I believe dry mouth is the number one cause of cavities—even before diet and other dental hygiene issues.

Avoid conventional mouthwash risks by using alternatives like natural mouthwash.

Because your oral microbiome is sensitive, you shouldn’t try to kill all the bacteria in your mouth on a regular basis. You need a balance of good bacteria to stop cavities from forming.

When you’ve got an infection like gingivitis, though, it can be good to get rid of more bacteria to give your mouth a chance to heal.

Ways to kill bad bacteria and heal gum damage caused by gingivitis include:
Warm salt water (7)
Mouthwash made with lemongrass, tea tree, or sage essential oils* (8, 9, 10)
Aloe vera mouthwash (11)
Coconut oil pulling (12)
Clove spice and essential oil, which are also anti-inflammatory and may reduce pain (13)
Turmeric gel (14)

I created a turmeric mouthwash that incorporates both turmeric and clove for a powerful gum-healing solution.

If your dentist sees that at-home methods haven’t cured your gingivitis, s/he may prescribe a round of antibiotics to fight the infection.

*Don’t use essential oils in your mouth for more than a few days at a time. Because of how well they kill bacteria, essential oils can mess with the balance in your oral microbiome.

  1. Avoid Foods that Damage Gums

Sharp foods can easily damage your gums. Foods high in acid or sugar can also break down gum tissue. Some of the foods you should avoid (or eat very carefully) to prevent gum recession are:

  • Sourdough bread
  • Popcorn
  • Pork rinds
  • White bread
  • White pasta
  • Dessert foods
  • Ice cream
  • Alcohol
  • Soda
  • Energy drinks

These foods are healthy but, in excess, could cause problems with your gums. Enjoy foods on this list in moderation, and always rinse your mouth with water afterwards:

  • Citrus fruits
  • Fermented foods and drinks
  • Coffee
  1. See Your Dentist

Regular, six-month visits to your dentist are great for many reasons. You get to keep open lines of communication about your oral hygiene and dental health. Your teeth are cleared of calculus and plaque to prevent gum disease and tooth decay.

These visits give your dentist the opportunity to keep a measurement of your gums. To prevent and fight gum recession together, you need regular dental visits.

Also, communication is a two-way street. Listen to your dentist and share your concerns, but don’t hesitate to stay informed yourself. If you feel the need, get a second opinion. Any confident dentist, truly concerned about the welfare of his patients, will not be offended by this.

What happens if your dentist finds you have receding gums? S/he or your hygienist will perform a deep cleaning to clear bacteria from pockets caused by recession.

Can receding gums grow back?

Once gums begin to recede, you can’t regrow them. Your gum material is not like the skin on the back of your hand that you can pick up and stretch a bit. It would not be able to offer the same type of protection to your teeth if it were like that.

There is a patented process called the pinhole surgical technique that claims to actually help gums to grow back. (15) I haven’t seen substantial research to prove it actually works to reverse receding gums, but time will tell.

For extremely damaged gums, gum graft surgery can help restore some lost tissue. But it’s not truly a reversal of gum recession. The best way to treat gum recession is to prevent it happening in the first place.

How is gum recession treated?

When gingival recession is diagnosed, the first step is a deep cleaning by your dentist or dental hygienist. S/he will work to clear bacteria from open pockets by performing this special cleaning procedure, called open flap scaling and root planing.

From that point, you should be careful to follow the six steps I listed above to prevent further gum recession. Receding gums can’t be reversed, but their progress can be slowed and even stopped.

As recession progresses, your dentist may recommend a number of methods for preventing damage to sensitive tissue.

  • Desensitizing agents: These products, sometimes in the form of varnish or dentin-bonding agents, help to reduce the sensitivity of any tooth roots that may be exposed by receding gums.
  • Orthodontics: Mechanics that slowly shift tooth position over time can help compensate for some lost gum tissue by readjusting where your gum line stops.
  • Veneers or Porcelain/Composite Caps: Composite or porcelain covers for teeth and gum space can be created to protect the area of your teeth gums no longer protect. Veneers are another option to accomplish the same thing, but are often made of problematic materials like silicone or acrylic.

Two surgical methods may be suggested for advanced gum recession:

  • Gum graft surgery: This procedure uses gum tissue from elsewhere in the mouth to rebuild areas where the gum tissue has died off most. Gum grafting doesn’t actually grow new gum tissue but repurposes it to protect the most sensitive exposed spots. It’s sometimes referred to as a soft tissue graft.
  • Pinhole surgery: The pinhole surgical technique hasn’t been around very long. However, supporters of this technique say that it may be a novel new way to regrow gums.

Final Thoughts

The subject of gum recession is a tricky one, especially because we will all face it at some point.

Unlike demineralization of teeth, gum recession is relentless and can’t (yet) be reversed. However, its progress can be slowed.

Be as proactive as possible to protect yourself from gum recession, especially as you age.

The best ways to do this are to:

  • Brush properly (not aggressively), with a high-quality toothbrush
  • Deal with the root cause of teeth grinding (which is likely sleep apnea)
  • Avoid acidic foods and drinks (and rinse with water afterwards)
  • Treat and prevent gum disease
  • Avoid foods that damage your gums
  • Regularly visit your dentist

Once you’ve been diagnosed with receding gums, your dentist might recommend one or more of the following treatments:

  • Desensitizing agents
  • Orthodontics
  • Veneers or porcelain/composite caps
  • Gum graft surgery
  • Pinhole surgery

Have you experienced gum recession? Do you have questions about your dentists recommendations? Use the “Ask Me A Question” button below to send in your question.

read next: Love Your Gums Neem Toothpaste

References

  1. Southerland, J. H., Taylor, G. W., Moss, K., Beck, J. D., & Offenbacher, S. (2006). Commonality in chronic inflammatory diseases: periodontitis, diabetes, and coronary artery disease. Periodontology 2000, 40(1), 130-143. Abstract: https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1600-0757.2005.00138.x
  2. Dörfer, C. E., Becher, H., Ziegler, C. M., Kaiser, C., Lutz, R., Jörß, D., … & Grau, A. J. (2004). The association of gingivitis and periodontitis with ischemic stroke. Journal of clinical periodontology, 31(5), 396-401. Abstract: https://www.ncbi.nlm.nih.gov/pubmed/15086623
  3. Mercado, F. B., Marshall, R. I., Klestov, A. C., & Bartold, P. M. (2001). Relationship between rheumatoid arthritis and periodontitis. Journal of periodontology, 72(6), 779-787. Abstract: https://www.ncbi.nlm.nih.gov/pubmed/11453241
  4. Jeffcoat, M. K., GEURS, N. C., REDDY, M. S., CLIVER, S. P., GOLDENBERG, R. L., & HAUTH, J. C. (2001). Periodontal infection and preterm birth: results of a prospective study. The Journal of the American Dental Association, 132(7), 875-880. Abstract: https://www.ncbi.nlm.nih.gov/pubmed/11480640
  5. Khocht, A., Simon, G., Person, P., & Denepitiya, J. L. (1993). Gingival recession in relation to history of hard toothbrush use. Journal of periodontology, 64(9), 900-905. Abstract: https://onlinelibrary.wiley.com/doi/abs/10.1902/jop.1993.64.9.900?_ga=2.78668497.450634737.1542232687-2105597533.1542232687
  6. Oksenberg, A., & Arons, E. (2002). Sleep bruxism related to obstructive sleep apnea: the effect of continuous positive airway pressure. Sleep Medicine, 3(6), 513-515. Abstract: https://www.ncbi.nlm.nih.gov/pubmed/14592147
  7. Huynh, N. C. N., Everts, V., Leethanakul, C., Pavasant, P., & Ampornaramveth, R. S. (2016). Rinsing with saline promotes human gingival fibroblast wound healing in vitro. PloS one, 11(7), e0159843. Full text: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0159843
  8. Dany, S. S., Mohanty, P., Tangade, P., Rajput, P., & Batra, M. (2015). Efficacy of 0.25% lemongrass oil mouthwash: A three arm prospective parallel clinical study. Journal of clinical and diagnostic research: JCDR, 9(10), ZC13. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4625327/
  9. Rahman, B., Alkawas, S., Al Zubaidi, E. A., Adel, O. I., & Hawas, N. (2014). Comparative antiplaque and antigingivitis effectiveness of tea tree oil mouthwash and a cetylpyridinium chloride mouthwash: A randomized controlled crossover study. Contemporary clinical dentistry, 5(4), 466. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4229754/
  10. Beheshti-Rouy, M., Azarsina, M., Rezaie-Soufi, L., Alikhani, M. Y., Roshanaie, G., & Komaki, S. (2015). The antibacterial effect of sage extract (Salvia officinalis) mouthwash against Streptococcus mutans in dental plaque: a randomized clinical trial. Iranian journal of microbiology, 7(3), 173. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4676988/
  11. Vangipuram, S., Jha, A., & Bhashyam, M. (2016). Comparative efficacy of aloe vera mouthwash and chlorhexidine on periodontal health: A randomized controlled trial. Journal of clinical and experimental dentistry, 8(4), e442. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5045693/
  12. Peedikayil, F. C., Sreenivasan, P., & Narayanan, A. (2015). Effect of coconut oil in plaque related gingivitis—a preliminary report. Nigerian medical journal: journal of the Nigeria Medical Association, 56(2), 143. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4382606/
  13. Pulikottil, S. J., & Nath, S. (2015). Potential of clove of Syzygium aromaticum in development of a therapeutic agent for periodontal disease: A review. South African Dental Journal, 70(3), 108-115. Full text: http://www.scielo.org.za/pdf/sadj/v70n3/10.pdf
  14. Singh, V., Pathak, A. K., Pal, M., Sareen, S., & Goel, K. (2015). Comparative evaluation of topical application of turmeric gel and 0.2% chlorhexidine gluconate gel in prevention of gingivitis. National journal of maxillofacial surgery, 6(1), 67. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4668736/
  15. Chao, J. C. (2012). A novel approach to root coverage: the pinhole surgical technique. International Journal of Periodontics & Restorative Dentistry, 32(5). Abstract: https://www.ncbi.nlm.nih.gov/pubmed/22754900

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