What this article is about:
- What is gum recession?
- What causes gum recession?
- What are the consequences of gum recession?
- What helps with gum recession?
- Further tips for healthy gums.
1. What is gum recession?
Gum recession, also known as gingival recession, occurs when the gums pull back from the border between the shiny, light tooth enamel and the dull, usually somewhat darker tooth neck. Different degrees of gum recession are distinguished depending on its extent. In the mildest cases, the transitional zone between the enamel and the tooth neck becomes visible, while in the most severe cases, a large part of the tooth neck is exposed, and the tooth loosens due to accompanying inflammation and damage to the jawbone (cf. Kwon et al.).
Gum recession can usually be detected by yourself, as it almost always occurs on the cheek-side surface of the teeth. One, several, or many teeth can be affected.
Gum recession is very common: half of all people between 18 and 64 years of age are affected, and from the age of 65, nine out of ten people already experience this change. In general, more men than women suffer from gum recession (cf. Kassab et al.).
2. What causes gum recession?
While factors such as tooth position and anatomical peculiarities of the jawbones are often present in gum recession, gum inflammation – medically termed "gingivitis" – is a primary cause.
Gum inflammation usually arises from the invasion of germs that develop in dental plaque. Dental plaque constantly forms on tooth surfaces, both in visible areas outside the gums and in "gum pockets" below the gumline where teeth and gums meet.
On average, every person hosts 50 to 200 different microbes (bacteria, viruses, fungi) in their saliva, known as the oral microbiome. Dental plaque consists of a mixture of the microbiome, protein bodies from saliva, and food residues, forming a "biofilm" that adheres surprisingly firmly to surfaces (cf. Valm; cf. Kassab et al.).
In its initial stage, the plaque is still soft and feels "fuzzy" with the tongue. If it is not removed, or removed inadequately, minerals from the saliva eventually accumulate, and the plaque becomes hard, so-called tartar. On its rough surface, plaque forms even more easily, and germs migrate into its porous structure, making them almost impossible to remove. While soft plaque can be removed by various measures yourself, tartar can only be combated by professional measures.
If germs from plaque or tartar penetrate the gums, gum inflammation occurs. The gums swell as inflammatory cells from the blood migrate in to fight the pathogens. Sometimes, redness and pain also occur. A typical and reliable sign of gum inflammation is bleeding when brushing teeth or biting into, for example, crisp fruit or vegetables. Mild inflammations often go unnoticed by those affected, but the dentist can detect them, among other things, by pressing a small probe, which causes bleeding in case of inflammation (cf. Heitz-Maifield et al.).
Once the inflammation has subsided, a minimal, imperceptible shrinkage of the gums is the result. However, if inflammatory events occur repeatedly, the repeated shrinkage events ultimately lead to visible gum recession.
Further risk factors that can promote gum recession include malocclusion, diabetes, and cigarette smoke (cf. Kwon et al.).
3. What are the consequences of gum recession?
Quite a few people have pronounced gum recession without initially even noticing it. Sooner or later, however, gum recession has serious consequences:
While healthy gums tightly enclose the teeth, preventing the penetration of germs, gum recession exposes the tooth necks to a greater or lesser extent. This allows germs to easily penetrate the tooth via the unprotected periodontium, leading to tooth decay (caries). Exposed tooth necks can also be sensitive to pain (cf. Kassab et al.).
Each tooth is anchored to the jawbone by connective tissue, known as the periodontium. If germs penetrate this periodontium, periodontitis occurs. Although it can arise as a fundamental consequence of poor oral hygiene, it becomes more common with increasing gum recession because the tight, protective connection between the gum and the tooth is lost. If the inflammation persists, it gradually destroys the periodontium, causing the teeth to loosen. Ultimately, the jawbone can also be affected, leading to tooth loss (cf. Heitz-Maifield et al.).
4. What helps with gum recession?
The most important measure to stop gum recession is consistent and effective oral hygiene. Dental plaque, as the main cause of gum recession, constantly reforms. To remove plaque, it is therefore necessary to brush your teeth thoroughly for about 2 to 3 minutes in the morning and evening. However, with a toothbrush alone, on average only about 70% of the tooth surfaces can be reached. Residues remain mainly in the interdental spaces and at the gum line. Therefore, cleaning the interdental spaces is an indispensable part of daily oral hygiene to effectively prevent gum inflammation and thus gum recession.
This is precisely where modern methods like photodynamic cleaning with manadental come in: here, bacterial residues are first stained with the special manadental liquid – then activated with light and specifically eliminated. Studies show that this method is 99.9% more effective than conventional mouthwashes and can lead to an improvement in gum health by almost 50% after just four weeks. Due to these successes, manadental is already recommended by many dental practices.
While gum inflammation is treatable, once gum tissue has receded, it unfortunately does not spontaneously grow back. In cases of gum recession, the primary goal is to prevent further progression of gum loss (cf. Kwon et al.). Here too, reliable daily cleaning forms the foundation for improvement.
5. Further tips for healthy gums:
Even with oral hygiene, the dosage matters: too frequent, too long, and too intense brushing with incorrect technique (too much pressure, too hard or cracked bristles) can even promote the occurrence of gum recession: constantly recurring, tiny injuries to the gums during brushing lead to inflammation, which in turn causes gum recession and shrinkage (cf. Van der Weijden, Timmerman et al.).
Since the bristles of even the best toothbrush quickly wear out and become cracked, causing gum injuries, the brush should be replaced every 2 months.
Smoking promotes the development of gum inflammation and thus also gum recession. Therefore, cigarette consumption should be stopped (cf. Valm).
Diet also plays a role: Since bacteria thrive particularly well in a sugary environment, sugary foods should be consumed sparingly and preferably with main meals, but not constantly as "snacks in between" (cf. Valm).
Professional teeth cleaning by a dentist should be done once a year as part of dental preventive care, even with careful oral hygiene. This also removes even the smallest deposits of tartar (cf. Wei et al.).
References:
Kwon, T., Lamster, I. B. & Levin, L. (2021). Current Concepts in the Management of Periodontitis. International Dental Journal, 71(462−476).
KASSAB, M. M. & COHEN, R. E. (2003). The etiology and prevalence of gingival recession. American Dental Association, 134.
Valm AM. The Structure of Dental Plaque Microbial Communities in the Transition from Health to Dental Caries and Periodontal Disease. J Mol Biol. 2019 Jul 26;431(16):2957-2969.
Heitz-Mayfield LJA. Conventional diagnostic criteria for periodontal diseases (plaque-induced gingivitis and periodontitis). Periodontol 2000. 2024 Jun;95(1):10-19.
Van der Weijden F, Slot DE. Oral hygiene in the prevention of periodontal diseases: the evidence. Periodontol 2000. 2011 Feb;55(1):104-23.
Wei, Y., Dang, G., Ren, Z., Wan, M., Wang, C., Li, H., Zhang, T., Tay, F. R. & Niu, L. (2024). Recent advances in the pathogenesis and prevention strategies of dental calculus. Npj Biofilms And Microbiomes. https://doi.org/10.1038/s41522-024-00529-1
