Definition and Diagnosis
Your gums play a bigger role in your overall health than you think. The gums are made of dense tissue with a good blood supply which protects and covers the roots of our teeth. Healthy gums fit snugly to the neck of each tooth. Receding gums occur when gum tissue wears away around the teeth, leaving pockets that serve as hosts for bacteria. You might notice some symptoms if you spit blood while flossing or brushing—and making sure you remove any food particles between the teeth can greatly improve this—but you may not know you have receding gums until your dentist or hygienist points it out.
Typically a dentist assesses your gum health by measuring the pockets of the recession on each tooth, one tooth at a time, with a dental probe marked off in millimeters. Recently UC San Diego nanoengineering professor Jesse Jokerst conceptualized and developed a method of imaging the pocket depth of all the teeth at once using squid ink and ultrasound.
Causes of Receding Gums
Here are four common causes of receding gums.
- Poor oral hygiene – Heed the advice, or gentle scolding, of your dentist or hygienist.
- Periodontal disease – This involves inflammation of the gums, and may require surgery.
- Over-brushing with a hard brush – Recession from over-brushing often happens on the opposite side of the mouth from the hand you favor. Your teeth and gums are delicate, and while you should brush for about two minutes, you don’t need to brush vigorously. Gentle strokes with a soft bristle will help your teeth a lot.
- Clenching or grinding teeth – Also called bruxism, this may be a stress reaction, or may be related to temporomandibular joint (TMJ) disorder. A silicone dental appliance worn at night is a common treatment for TMJ. Talk to your dentist if you find yourself clenching or grinding.
Risk Factors for Gums Receding
Oral hygiene is not the only thing affecting the health of your gums. Here are four common factors:
- Age – You can’t do much about getting older, but you can practice good oral hygiene.
- Tobacco use – The chemicals in tobacco are likely to build up on the teeth and attract and keep bacteria. Another good reason to quit now.
- Genetics – Thank your parents and practice good oral hygiene.
- Diabetes – The systems in our bodies are interconnected, so treating one can affect and help the health of others.
- Gender – Hormone level changes associated with puberty, pregnancy, and menopause can make women more susceptible to gums receding than men.
Pay attention to these common symptoms of receding gums:
- Sensitivity to heat and cold – Roots exposed by receding gums can be sensitive to hot and cold foods and liquids.
- Bad breath – This can be caused by bacteria building up in the gum pockets.
- Bleeding gums – Bacteria caught in pockets of recession can cause inflammation and bleeding. The gums are resilient, so getting rid of the bacteria can improve gum health quickly.
More importantly, receding gums may themselves be a symptom of gum disease, and can increase the risk of cavities.
Here are several ways to treat receding gum lines:
- Gentle brushing – Use soft bristles.
- Gentle flossing – Be sure to get the floss between tooth and gum, gently.
- Interdental brushes – These are like thin toothpicks with gentle bristles on the end. They work especially well to remove food that can get packed into gaps between teeth.
- Desensitizing treatments – Fluoride rinse or varnish, and some toothpaste can build up a protective layer over the roots of the teeth.
- Tooth Covers – Not crowns, these are of tooth-colored composite or gum-colored pink porcelain, and typically cover the front of the tooth. They can also be removable acrylic or silicone gum veneers.
- Repositioning – Orthodontics can reposition the teeth to treat a receding gum line.
- Tooth scaling and root planning – This involves cleaning the teeth below the gum line and smoothing the exposed root to make it harder for plaque to stick.
- Periodontal surgery – This surgical procedure peels back the gum to remove deeper plaque and tartar buildup, then secures the gums over the teeth again.
- Bone regeneration – This also involves peeling back the gum and removing bacteria, then applying regenerative material, such as a protein to stimulate tissue growth, a membrane, or a bone graft, then securing the gum again snugly.
- Graft surgery – Grafting tissue from the cheek or elsewhere in the mouth onto the gums.
The ultimate method of prevention for receding gum lines is practicing proper oral hygiene. Use gentle strokes with a soft toothbrush. You may be tempted to give your teeth a good scrubbing, but leave the high-energy treatments to your dental hygienist. Gentle strokes with soft bristles will do wonders. You can get in two minutes of gentle brushing by brushing 15 seconds on the inside and outside of each quadrant (and don’t neglect the tops).
Other Conditions Influenced by Gum Health
While people don’t usually connect their gums with their overall health, the systems in our body are connected to each other, so the health of the gums can influence the health of other parts of our bodies. Here are findings from recent studies looking at how healthy gums might improve four serious conditions.
A 2017 study conducted by the University at Buffalo looking at participants in the Women’s Health Initiative asked 65,869 postmenopausal women various health questions, including whether they had ever been told they had periodontal disease. Women with a history of gum disease showed a 14% higher risk of overall cancer, with breast cancer being the largest single type of cancer.
A recent study presented at the Annual European Congress of Rheumatology reported a link between gum disease and rheumatoid arthritis (RA). RA is an autoimmune disease, meaning the body attacks its own cells or tissues, in this case, citrullinated proteins. The link to gum disease was found in the sole human pathogen that is known to produce an enzyme which converts proteins to citrulline and comes from the mouth, the bacterium Porphyromonas gingivalis (Pg).
3. Heart Attack in Chronic Kidney Disease (CKD) Patients
A proposed study by Aston University researchers will seek to better understand the connection between CKD and inflammatory gum disease since earlier studies have shown that 85% of CKD patients have inflamed gums. If periodontal inflammations are allowing oral bacteria to enter the bloodstream and cause cells to malfunction, then treating the inflammation may lower the risk of heart disease in CKD patients.
4. Cirrhosis Patients
Cirrhosis is the severe scarring of the liver due to various liver problems. One complication of cirrhosis is hepatic encephalopathy from toxins building up in the brain, which can impair cognitive functioning, affect mood, and cause confusion.
A study recently reported in the American Journal of Physiology-Gastrointestinal and Liver Physiology looked at two groups of cirrhosis patients who also had mild-to-moderate gum disease. The group treated for periodontitis showed higher levels of beneficial gut bacteria and lower levels in saliva of endotoxin-producing bacteria.
The authors suggested that treating the inflammation lowered the amount of harmful bacteria being swallowed and harming the good gut bacteria.
The group receiving the periodontal treatment also showed improved cognitive functioning. This is important because the U.S. Food and Drug Administration has not approved any new medications to treat cognitive function in cirrhosis, so periodontal treatment could be an effective non-drug therapy to improve cognitive functions.For more information on the importance of our gums to the overall health of our bodies, and more about prevention and treatment, see our Receding Gums page.