Causes of gingival recession

Lack of time or stress are often the reason why people get used to a poor oral hygiene technique. With scrubbing movements of the toothbrush, the bristle tips sweep past the same spot on the gum margin again and again. The force injures the gums, and as they heal, the gum margin recedes.

To avoid gingival recession, the oral hygiene technique must be optimised and, if necessary, corrected. Regular check-ups in the dental practice can also help to detect any signs of gingival recession early.

Using toothbrushes with hard bristles also increases the risk of developing gingival recession. For this reason, a toothbrush with medium or soft bristles may be recommended.

People with a thinner gum type are generally more susceptible to gingival recession than people with a thicker gum type. The gum type is mainly determined by genetics. People with a thin gum type should therefore pay particular attention to optimising their oral hygiene at home.

The thickness of the gums can be assessed at the dental check-up. In particular, the risk of developing gingival recession should be assessed before starting orthodontic treatment.

Orthodontic treatment can be carried out with removable appliances (braces) or fixed appliances (brackets). The risk of developing gingival recession is particularly increased with fixed appliances.

Gingival recession occurs in around 20 percent of adults who undergo orthodontic treatment. In adolescents under 16, gingival recession is found far less often once they have completed the correction of their tooth position.

Gingival recession can occur both during and several years after the completion of orthodontic treatment.

Smoking cigarettes has a wide range of harmful effects throughout the human body. Besides reducing overall life expectancy, smokers also suffer changes to the oral mucosa considerably more often, up to and including oral cancer.

Smokers of more than 20 cigarettes a day show significantly more gingival recession than non-smokers. Because of their reduced resistance, the gum margin in smokers is also more vulnerable, for example to the mechanical action of toothbrush bristles.

Because the blood supply to the gums is generally lower in smokers, no surgical treatment should be carried out there. Surgical coverage of the exposed root surfaces, where appropriate, can only be considered after the patient has successfully stopped smoking.

Alongside snuff, chewing tobacco is the most common form of smokeless tobacco use. Chewing tobacco is placed loose or in pouches under the upper lip, where it comes into contact with the oral mucosa. Besides nicotine, the tobacco releases toxic substances, some of which can cause cancer.

Nicotine is what makes chewing tobacco addictive. Users thus become dependent on it.

Chewing tobacco irritates the oral mucosa and causes gingival recession. The irritation can regress after stopping chewing tobacco. The gingival recession, however, remains even after the user has stopped and may therefore need to be treated surgically.

Frequently playing with piercings is a habit that can harm the teeth and gums. Around 80 percent of those who wear them show a loss of actual tooth hard substance at the points of contact, and gingival recession also occurs in 25% of cases.

After the piercing is removed, the gingival recession remains and may therefore need to be treated surgically.

After the treatment of periodontitis, receding gums are usually observed. In periodontal treatment, however, this is desirable, because the shrinking of the gum margin allows the unwanted gum pockets to heal.

Unlike gingival recession in people without periodontitis, the shrinkage that results from the healing of the gums cannot be reversed.