Gingival recession: causes, symptoms, and treatment

Gingival recession is a consequence of periodontal disease in which the gums recede to the point where the surface area of the tooth in the oral cavity is much larger than the surface area of the tooth in the jaw. This makes the teeth appear larger in the mouth and reduces bone support.

 

Causes of gingival recession

1. Occlusal imbalance (the bite is not balanced) due to the fact that the chewing forces are transmitted poorly to the tooth axis. Teeth can withstand a number of kg of force in their axis. Gingival retraction causes a greater force to act on a tooth than the tooth root can withstand, causing it to suffer.
2. Occlusal imbalance due to missing teeth. In this situation, the teeth that are still present on the arches will bear a force at least double that which they were created to bear. The most common cause of tooth loss is periodontal pathology . In advanced periodontal diseases (marginal periodontitis or periodontosis as it is known to patients), due to bacteria, initially gingival inflammation appears (edema, the color changes from pink to red or purple, the gum loses its dotted engraving appearance and becomes shiny). Then bone damage appears, manifested by the retraction of the bone supporting the teeth.

 

Symptoms of gingival recession

 

Regardless of the cause that led to gum and bone retraction, at the tooth level the following is observed:

• The tooth begins to have a greater height in the oral cavity and a shorter length in the jaw. Over time, this causes the tooth to become unstable and begin to have mobility.
• The greater height in the oral cavity is given by the exposure of the root. The root has no enamel on its surface, and thus is directly exposed to stimuli from the oral cavity: cold, sweet, pressure on the exposed surface. These will cause pain in the tooth.
• Gingival retraction makes it possible for the tooth to be more visible in the oral cavity than in the jaw. Thus, a tension of forces accumulates at the level of the surface where the transition from the tooth to the root is made. There, the size of the enamel layer is minimal and this leads to the appearance of cervical lesions. These are areas where layers of the tooth have been lost. These areas will be sensitive to thermal and chemical stimuli. In addition, if the cause is not eliminated, these lesions will deepen until they reach the pulp chamber where the nerve of the tooth is found. Thus, the need for root canal treatment arises. If the lesion advances, the chances of tooth fracture increase.

 

Gingival retraction treatment

 

Depending on the cause that led to gingival retraction, the treatment is different:

• If the problem is an imbalance of forces transmitted to the tooth axis, then a dental brace will be installed to straighten the teeth and correct the bite so that the forces are directly proportional to the tooth's ability to withstand pressure.
• If there are one or more missing teeth, the remaining teeth will also bear the forces of the missing ones. Thus, they will be subjected to great pressures. To remedy this situation, prosthetic works will be performed to replace the missing teeth. Depending on the treatment indication, implants or supported works can be inserted on the neighboring teeth so as to restore a balance of forces.

 

Treatment in case of periodontitis

 

Periodontal disease affects the supporting tissues of the teeth. The first step is to affect the gums, during which gingival retraction occurs, then the supporting bone of the tooth. The treatment of periodontal disease is represented by subgingival curettage, which can be performed in two ways:

• • manually using classic instruments;
  • through a complex protocol that includes the laser - this will eliminate bacteria and tissue infected by bacteria, allowing the gums to recover, stop bleeding when brushing, regain their color and texture, and decrease tooth mobility.

 

After eliminating the cause that led to gingival retraction, there are several solutions to cover the exposed tooth surface:

• covering it with composite material to protect the tooth from thermal and chemical stimuli in the oral cavity;
• covering the tooth with a prosthetic piece – this is indicated in the event that the tooth in question has other problems that require a prosthetic solution;
• covering the exposed tooth area with a gum graft. This option has low addressability.

 

If you also suffer from gingival retraction, do not hesitate to schedule an appointment online or by calling +40.318.282.274 , in any of the 11 clinics in the country.