“If your gums are receding, stop brushing so hard.”
“Use a softer toothbrush to prevent gum recession.”
This advice is commonly doled out to gum-recession sufferers, and their recession continues to worsen. Gum-tissue recession happens slowly, over time, so even when patients follow this advice, they will likely continue to witness the slow disappearance of precious gum tissue. With continued tissue loss, sensitivity is bound to ensue as the root structure is exposed. The teeth are also at higher risk of mobility and loss.
So, what exactly is gum recession? It’s what happens when gum tissue is no longer able to adhere to one or more teeth. When the tissue recedes, we know that the bone to which teeth are connected has to be in some degree resorbed. In other words, the bone recedes first, and the tissue follows suit. Recession can occur in a single tooth, and sometimes it is everywhere.
Over-zealous brushing is actually one of the least common causes of gum recession, and patients are always surprised to learn that the likely cause of their recession is related to tooth position and their bite. Habits such as clenching and grinding contribute greatly as well.
In an ideal world inside your mouth, the upper and lower teeth come together in a manner that ideally serves chewing, speaking, and other joint functions when the jaw closes. Teeth should be positioned straight up and down, not tipping in or out, and the arches should reflect one another so the surfaces of the teeth are in proper occlusion when they come together. That means the cusps touch in very specific places. Without proper occlusion, biting forces are directed incorrectly, placing undue stress on the bone and setting wheels of recession in motion.
Think of it like a hammer, a wide nail, and a piece of wood just wide enough to drive the nail straight down the center. The teeth are like nails, and the driving force of biting, chewing and even clenching are the hammer. If you stand a nail up perfectly straight in the piece of wood and then bring down the hammer with equally straight force, the nail will drive snugly and cleanly into the wood and the wood maintains its integrity. If you set the nail sideways, then bring the hammer straight down into it, the wood splinters and cracks and the nail will lack stability. Over time, this is very much the same as teeth that are tipped and/or not in ideal alignment with the opposing teeth. The stress of less-than-ideal forces encourages bone loss, and gum tissue adheres to bone.
Can you correct this type of recession?
If your teeth are crooked, crowded, tipped in or out, or you clench or grind (common behaviors for those with maligned teeth), you cannot bring back lost gum tissue. The good news is that you can definitely prevent it from progressing further. For some people it’s as simple as wearing a clear plastic retainer to maintain the teeth’s position and prevent them from continuing to tip and move. For others, a night guard is appropriate to prevent grinding and clenching during sleep. For people with more prominent recession or a concern that the recession will worsen, the best thing to do is change the position of the teeth with simple orthodontic treatment. At Incredible Smiles, we favor Invisalign braces over other orthodontic methods for the ease, comfort, and convenience of the treatment. Many patients can be treated in as little as five months using clear aligners that gently move the teeth.
How do you know if your recession is alignment-oriented? Look at your teeth! But also, ask yourself what you tend to do with your teeth and jaw during both day and at night. I have a little bit of recession on one lower front tooth. After learning about potential causes, I started noticing that I have a “busy” habit of tapping that tooth on the back of my upper front tooth. I have been doing this for years, and now that I’m aware of it, I’m working to stop the tapping. When you look at your teeth–all of them—in a mirror, what do you notice? Open your mouth, then close up, biting down all the way. If you’re occluding properly, your upper arch will appear larger than your lower arch and both the upper and lower teeth will stand up straight like soldiers. Also, the back teeth will close comfortably.
A good bite feels good. Your upper front teeth should close in front of your lowers and hide the lowers by only halfway at most. There are many ways a bite can go wrong, and if any parts of a good bite are missing, (most importantly, your own comfort), you should see a good dentist or orthodontist! If you bite down and the teeth are not touching in the back, if teeth appear to slant in or out, or if there is general inconsistency in the shapes of your arches (healthy, high functioning arches are shaped like a wide horseshoe), you may want to have your bite and your alignment assessed.
Whatever the cause of your recession, brushing your gum tissue too vigorously is likely not the culprit (though in some cases it may be). With proper consultation, you may be able to fix what, for many, seems like a lost cause.