Gingival recession is more simply known as receding gums. It is characterized by exposure of the roots of the teeth and is caused by retraction of the gums away from the crown of the teeth, or by a loss of gum tissue. Gingival recession is most common in adults over 40, though it may occur earlier. It may or may not include recession of the alveolar bone. The most common cause of gingival recession is periodontal disease, though there are many other possible causes.
While periodontal disease is by far the most likely catalyst for gingival recession, overly aggressive brushing may also cause the gums to recede. Gingival recession may also be caused by brushing in a horizontal direction or using a toothbrush with bristles that are too hard. Flossing too aggressively may also cut into the gums and cause gingival recession. In some cases, the tissue of the gums is thin or fragile, simply due to heredity, which can predispose some people to gingival recession. The use of chewing tobacco has also been shown to adversely affect the mucous membranes in the mouth and cause the gums to recede. In some patients, trauma to the gingival tissue can occur with certain habits, like chewing the teeth or repeatedly probing the gum, though these causes are more often associated with psychiatric disorders. Piercings in the lip or tongue may also lead to trauma of the gum tissue, and certain oral habits children have may lead to gingival recession. Scurvy, which is a systemic disease caused by a lack of vitamin C, can also lead to gingival recession. Gingival recession may also appear as an effect of acute necrotizing ulcerative gingivitis or abnormal tooth position or crowding. In less common situations, the gum tissue may be intentionally retracted to expose an adult tooth that resists eruption.
Gingival recession is most often a progressive condition, which is part of the reason it appears more frequently in older people. The condition may happen so gradually as to go unnoticed until symptoms arise. Symptoms can include mobility of the teeth, or the illusion that the teeth are longer than they are, due to an increase in the area of the tooth that is exposed. The tooth may also appear to differ in color as the cementum becomes exposed, as the cementum is a different color from the tooth’s enamel. The roots may even become exposed, depending on the severity of the recession. The teeth may be hypersensitive, reacting with sharp pain when exposed to extremes in temperature or to excessively sweet, spicy, or acidic food or drink. If the cementum on the root surface of the tooth is no longer protected by the gingival tissue, it can be easily damaged, exposing the sensitive tubules that connect to the tooth’s pulp and increasing the sensitivity of the teeth. This exposure can also increase the likelihood of cavities forming below the gumline. When periodontal disease is also present, the gums may appear red or swollen, and gingival recession may be accompanied by bad breath. In some cases, treating the swelling caused by periodontal disease can reveal gingival recession that was previously undetected, due to swelling of the tissue creating the appearance of fuller gums.