Receding gums are more than a cosmetic matter

There are also conditions in which the gum and the bone beneath it recede without any preceding inflammation. The causes are varied: poor oral hygiene or the wrong brushing technique, brushing too hard (brushing trauma), injuries, misaligned teeth or grinding can all be behind it. Receding gums are not only a cosmetic matter; exposed tooth necks and hypersensitivity can also cause pain. Exposed roots react sharply to contact with cold or hot food and drink. Lengthened teeth and long tooth necks are at first purely a cosmetic problem. The risk of decay, however, rises markedly, because the dentine exposed in the root area is far more susceptible to caries than enamel. If the recession is left untreated, health problems can follow as the gum withdraws further around the exposed neck and the bone breaks down. Because oral hygiene becomes more difficult, gum inflammation and root caries are often the result.

Gum correction / recession coverage

If the periodontal disease is left untreated, the inflammatory process advances and reaches deeper regions of the tooth root. Bony defects form, usually funnel-shaped and found between the teeth. The largely inflammation-free withdrawal of the gum and the bone beneath it is called a recession defect. In a recession, the gum surrounding the tooth withdraws and the alveolar bone beneath it breaks down. The tooth can look longer, because part of its root surface becomes visible. Patients with gingival recession may suffer from root hypersensitivity, develop caries on the root surface and find the appearance impaired.

The ideal situation shows a harmonious gum line with pleasing red-and-white aesthetics – white from healthy teeth, red from healthy gums. Where there are asymmetries, surgical gum correction can create a more attractive and clinically more satisfactory situation. In what is known as a gummy smile, seemingly too much gum makes the teeth look short.

Gingival recessions are divided into four classes according to a classification laid down by P. D. Miller in 1985. The degree of recession determines the prognosis for covering it.

Miller class I

Very good prognosis: the recession does not extend to the mucogingival junction, the border between attached and movable oral mucosa. No interdental tissue has been lost. Complete coverage can be expected.

Miller class II

Extensive coverage can be achieved: the recession crosses the mucogingival junction. The interdental tissue is not affected.

Miller class III

Partial coverage is possible: the recession reaches into the mucosa. A loss of interdental tissue rules out complete coverage of the root surface.

Miller class IV

Coverage of the root surface is not to be expected: the recession extends beyond the mucogingival junction and there has been a loss of both soft and hard tissue.