Receding gums

and Sabine Schrör, medical journalist

Marian Grosser studied human medicine in Munich. In addition, the doctor, who was interested in many things, dared to make some exciting detours: studying philosophy and art history, working on the radio and, finally, also for a Netdoctor.

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Sabine Schrör is a freelance writer for the medical team. She studied business administration and public relations in Cologne. As a freelance editor, she has been at home in a wide variety of industries for more than 15 years. Health is one of her favorite subjects.

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When the gums recede, the gums become smaller and recede so that the sensitive tooth necks are exposed. In the long run, this can lead to teeth falling out. Poor oral hygiene often leads to receding gums. But the wrong technique when brushing your teeth and chronic teeth grinding are also possible triggers. Read more about the causes of receding gums and how they can be successfully treated and prevented!

Brief overview

Treatment and prevention: correct teeth brushing, regular self-inspection of the gums, regular visits to the dentist and oral hygiene, correction of ill-fitting dentures, healthy diet, bite guard (for nocturnal teeth grinding), possibly removing tongue / lip piercing, gum transplantation (in severe cases).
Causes: frequent inflammation of the gums, incorrect tooth brushing, hard toothbrushes, teeth grinding, lip and cheek fringes that are too close to the tooth (connective tissue folds between lip / cheek and gums), ill-fitting prostheses, lip and tongue piercings, orthodontic measures such as braces, predisposition.
Symptoms: loss of volume and retraction of the gums. Severity grades according to Miller range from class I (slight decrease, no damage to the dental bed and bone) to class IV (severe decrease with tissue and bone loss, severe tooth misalignment).
Consequences: exposed tooth necks, tooth neck caries, pain in the tooth necks from contact and temperature stimuli, inflammation of the tooth bed (periodontitis), breakdown of the jawbone, tooth loss.
When to the doctor Regular check-ups for prevention, but at the latest when the tooth necks are already exposed.

Recession of the gums: what to do?

The gums (gingiva) are a special part of the oral mucosa. When the gums recede (gum regression), it loses substance and increasingly withdraws from the teeth. As a result, more and more of the tooth sections below are exposed. Not only does it look unsightly, it can also damage your teeth. To prevent this from happening, you should do something as soon as the first signs of gum disease appear:

Make sure you brush your teeth regularly and use the right technique (e.g. don't press too hard).
Any existing tartar should be removed by the dentist.

If nocturnal teeth grinding (bruxism) is the reason for the receding gums, you should wear an individually adapted bite guard at night. This prevents tooth damage and is gentle on the gums.

Badly fitting dentures should be corrected so that the gums do not recede any further.
If piercings (e.g. on the lip or tongue) are the cause of the receding gums, you should definitely remove them.

If the regression has not progressed too far, the gums can rebuild once the cause has been corrected. At an advanced stage, however, the gingiva can no longer regenerate. Then, under certain circumstances, the only thing that can help is a gum transplant, in which tissue is transplanted from the palate to the affected areas.

Recession of the gums: prevention

In order to recognize impending gum recession at an early stage, you should regularly look at your gums in the mirror. Healthy gums look rosy, while an inflamed gingiva is typically red and swollen. Frequent bleeding gums can also indicate a disease of the gingiva. If you frequently suffer from inflammation of the gums, be sure to tell your dentist the next time you visit.

You can also effectively prevent receding gums with the right diet. It is important that the gingiva is supplied with all the necessary vitamins and other nutrients. Vitamins A and C in particular, as well as the trace element selenium, are essential for strong gums.

Vitamin A is found in liver sausage, eggs, leafy vegetables, carrots and apricots, for example. Classic sources of vitamin C are citrus fruits and kiwis. Selenium is found, for example, in mushrooms, cheese, legumes and nuts. If the body is adequately supplied with these substances and if oral hygiene is also good, then the gums are more resistant and therefore less prone to receding gums.

Recession of the gums: causes

In principle, receding gums can be due to inflammation of the gums (gingivitis) or other causes. There are usually several factors that play a role in receding gums.

Inflammatory causes of receding gums

If the gums become inflamed more often, sooner or later they will lose their substance. Most often, gingivitis is caused by bacteria, many of which live in the oral cavity. Some form a coating from proteins, carbohydrates and other food components, the so-called plaque, which is deposited on the teeth. If the plaque is not removed regularly, it can lead to gingivitis.

Daily brushing helps against soft plaque. Together with individual substances from the saliva, the plaque can harden into tartar, which can no longer be removed with a normal toothbrush. Since further bacteria can settle on the rough surface of the tartar and thus the risk of gingivitis further increases, the tartar should be removed by the dentist.

Risk factors for gingivitis

During pregnancy, certain hormones can loosen up the lining of the mouth and gums. This makes it easier for bacteria to invade the gums and cause inflammation there. One speaks here of pregnancy gingivitis.

Smokers and people with diabetes (diabetics) also suffer more frequently from inflammation of the gums, as the gingiva is usually poorly supplied with blood.

Non-inflammatory causes of receding gums

If the gums recede without inflammation, it is called gingival recession. It usually occurs when the gums are exposed to excessive pressure or tension. This is achieved, for example, by:

Incorrect toothbrushing: Excessive pressure when brushing can lead to receding gums in the long term. This is especially true if you are using a hard toothbrush.
Teeth grinding (bruxism): The pressure that acts on the teeth during nighttime teeth grinding can be transferred to the gums.
Lip and cheek frenas that are too close to the tooth: Lip and cheek frenas are folds of connective tissue between the lip or cheek and gums. If they are too close to the tooth, the heavy pull they apply can cause gums to recede.
Ill-fitting prostheses, lip or tongue piercings: Excessive pressure on the gingiva and bones can cause gum disease.
Orthodontic measures: If the teeth move forward, for example due to braces, this can lead to the breakdown of the outside jawbone and receding gums.
Predisposition: In some people, the gingiva is generally only very thin. Then even weak triggers are enough for the gums to recede.

Recession of the gums: symptoms

The teeth are firmly anchored in the jawbone via their roots. The part of the tooth that normally protrudes from the gum line is called the crown. The tooth neck is the short section between the root and the crown. With healthy teeth, the tooth necks are completely covered by the gingiva. This protects them from bacteria in the oral cavity and gives the teeth additional stability.

When the gums recede, the gums lose volume and withdraw from the tooth necks. Depending on how pronounced the symptoms are, a distinction is made between different degrees of severity.

Recession of the gums: degrees of severity

How pronounced the gum recession is can be indicated with the Miller graduation. Accordingly, there are four classes:

Class I: The receding gums do not yet reach the mucogingival line (border area between the movable oral mucosa and the gums). The tooth bed and bones are intact.
Class II: The gums go back to the mucogingival line. The tooth bed and bones are intact.
Class III: The gum recession extends to the mucogingival line. There has already been a loss of tissue and bone, resulting in slight misalignment of teeth.
Class IV: Like class III, but severe tooth misalignments are already evident.

Recession of the gums: consequences

If the gums recede more and more, the tooth necks will eventually be exposed. These only have a very thin layer of enamel. Therefore, without the protective gums, they are hardly safe from invading bacteria - cervical caries is therefore one of the most common consequences of receding gums.

Exposed tooth necks are also very sensitive to pain: Touching and temperature stimuli, for example when consuming ice cream or hot drinks, cause unpleasant pulling on the unprotected tooth necks.

In addition, bacteria get into the tooth bed more easily due to the receding gums. There they can cause inflammation, periodontitis. Long-lasting inflammation of the dental bed can in turn attack the jawbone, which then gradually dissolves. The teeth then lose their anchorage, loosen up and, in extreme cases, fall out.

Recession of the gums: when do you need to see a doctor?

If it is discovered early enough, gum recession can be stopped. The most important thing is to identify the triggers and eliminate them. The trained eye of a dentist not only recognizes the receding gums faster than a layperson, but also its cause. Regular routine examinations at the dentist are therefore very important.

But at the latest when the teeth are "getting longer", i.e. the tooth necks become visible and possibly hurt, you should visit a dentist. Because then the receding gums are already advanced and must be treated as soon as possible.

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