Causes of gingival recessions
The most common cause of gingival recessions is an incorrect tooth brushing technique, when frequent scrubbing injures the gum line. In addition, known risk factors such as smoking, smokeless tobacco (snus) or piercings have an influence on the formation of gingival recessions.
Incorrect tooth brushing technique
Gingival recessions can occur due to incorrect tooth brushing technique. Frequent scrubbing with high pressure on the gumline is the most common cause.
Lack of time or stress are often the reason for getting used to poor oral hygiene techniques. During scrubbing movements of the toothbrush, the bristle ends always sweep past the same spot on the gum line. In the process, the gums are injured by the application of force. As it heals, the gum line retracts.
To avoid gingival recession, the oral hygiene technique must be optimised and corrected if necessary. Similarly, regular check-ups at the dentist’s office can help to detect any signs of gingival recession early.
The use of hard-bristled toothbrushes also increases the risk of developing gingival recession. For this reason, a toothbrush with medium-hard or soft bristles may be recommended.
The thickness of the gums can vary from person to person. Thin gums are less resistant and therefore more prone to gingival recession.
People with a thinner gum type are basically more prone to gingival recession than people with a thicker gum type. The formation of the gum type is mainly genetically predetermined. Therefore, people with a thin gum type should pay special attention to optimising their oral hygiene at home.
The thickness of the gum type can be determined during the dental check-up. In particular, the risk of developing gingival recession should be clarified before starting orthodontic treatment.
During orthodontic treatments, the teeth are often shifted outwards. This causes the outer tooth anchorage to dissolve, which can lead to gingival recession.
Orthodontic treatment can be performed with removable (braces) or fixed appliances (brackets). In particular, the risk of gingival recession is increased when fixed appliances are used.
Ginggival recession occurs in about 20 per cent of adults who have orthodontic treatment. Ginggival recession is much less common in adolescents under the age of 16 who have completed their teeth straightening.
Ginggival recession can occur both during and for several years after the completion of orthodontic treatment.
Smoking causes the gums to have less blood supply. This reduces its resistance, which can increase susceptibility to gingival recession.
Cigarette smoking reveals a variety of negative effects throughout the human body. In addition to reducing general life expectancy, smokers also suffer significantly more mucosal changes, including oral cavity carcinoma.
Smokers who smoke more than 20 cigarettes a day reveal significantly more gingival recession than non-smokers. Due to the reduced resistance, smokers are also more susceptible to the gum line, for example to the mechanical impact of the bristles of a toothbrush.
Due to the reduced blood supply to the gums in smokers in general, surgical treatments should not be carried out there. Only after a successful smoking cessation can the surgical coverage of the denuded root surfaces be tackled.
Smokeless tobacco (snus)
The consumption of smokeless tobacco products, such as snus, leads to changes in the mucous membrane (leukoplakia, facultative precancerous lesions) at the deposit site in the oral cavity and often to gingival recession.
Besides snuff, chewing tobacco is the most common form of smokeless tobacco consumption. Chewing tobacco is placed in loose form or packaged in sachets under the upper lips and thus brought into contact with the oral mucosa. In the process, the tobacco releases toxins in addition to its nicotine, which can also be carcinogenic.
The addictive effect of chewing tobacco is unfolded through exposure to nicotine. The users become addicted to it.
Chewing tobacco causes irritation of the oral mucosa and gingival recession. The irritations may disappear after the user stops using chewing tobacco. However, the gingival recessions remain even after consumption has been stopped and may therefore have to be treated surgically.
Piercings cause repeated mechanical irritation to the gum margins when speaking or playing with them, which can cause them to retract.
Frequent playing with piercings is a habit that can be harmful to teeth and gums. Around 80 percent of the wearers also reveal a loss of the actual hard tooth substance at the corresponding contact points and in 25 percent of the cases, gingival recession also occurs.
After the piercings have been removed, the respective gingival recession remains and must therefore be treated surgically in given circumstances.
After therapy has been carried out for periodontitis, the gum line will also recede. Compared to the recession of the gums, this reduction of the gum line is desirable.
After the treatment of periodontitis, gingival recession is usually observed. However, this is desirable during periodontal treatment, as the shrinkage of the gum line allows the unwanted gum pockets to heal.
In contrast to gingival recession in sufferers without periodontitis, the shrinkage that occurs when the gums heal cannot be reversed.
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