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What Are Receding Gums?
Receding gums are a common dental condition involving the gradual pulling back of gum tissue from the tooth surface, exposing the tooth’s root. This can lead to increased sensitivity, tooth decay, and other oral health issues. In medical terms, receding gums are called “gingival recession”, where the roots of the teeth are exposed because of loss of gum tissue or a retraction of the gingival margin. When the tissue is pulled back and the root of the tooth is exposed, it can cause severe pain and sensitivity. Not only that, the exposed root is also more prone to plaque and damage than the enamel. 
How Do You Know If You Have Receding Gums?
The answer is simpler than you think. You might notice that your tooth looks longer (or is more sensitive) than usual. You might also notice a small notch at the base of your tooth, which means that your root might already be exposed (bad news). Because gum recession is such a gradual process, you might not even notice any of these signs and symptoms until they have already happened and the dentist gives you the dreaded news. However, it is a serious condition that needs to be addressed to prevent further damage to your teeth and gums and even loss of teeth – plus potential complications: The very last thing you want is to choke on a tooth that falls out in your sleep – and yes this can happen!
What Are The Causes Of Receding Gums?
Not everyone experiences gum recession; there are certain risk factors that predispose a person to this condition. The American Dental Association (ADA) identifies several causes of gum recession:
1) Periodontal disease: Bacterial infections can affect your gums and destroy tissue (as well as bone) which causes gum recession. A study reported by the CDC revealed that half of American adults were affected by periodontal disease in 2009 and 2010, with the numbers approximating 47.2 percent or 64.7 million American adults. Furthermore, the same study found that older adults aged 65 and older were more affected, approximately 70.1 percent! Among all the risk factors, this is the most common and the one that you should watch out for. 
2) Too-aggressive tooth brushing or use of a hard-bristled toothbrush
3) Gum injury
4) Ill-fitting partial dentures
5) Prominent tooth roots or attachment muscles
6) Smoking or tobacco use
7) Genetic predisposition: As with most health conditions, your genes also play a significant role. Researchers from the University of Pittsburgh School of Dental Medicine found that there are certain genetic markers or sequences that can predispose a person to tooth decay and periodontitis, both of which cause gum recession. 
Other risk factors include: Hormonal changes in women, such as those that occur during puberty, pregnancy, and menopause, can also cause increase gum sensitivity and predisposition to gum recession.
Lastly, one of the (if not the most) common risk factors is poor dental hygiene. Poor brushing, flossing, and rinsing can increase your risk for gum disease and gum recession.
3 11 Natural Remedies For Receding Gums
I have now expanded the lift of natural remedies to 11. Some are these are very simple – practical common sense – that can be implemented by virtually everyone.
Matcha or green tea, was found to suppression oxidative stress in the gums and reduce periodontal inflammation, both of which cause gum recession. Researchers Maruyama, et al. in 2011 concluded that after eight weeks of treatment with green tea supplementation, periodontal inflammation and recession was significantly reduced in their test subjects. Not only that, green tea is rich in antioxidants that can help detoxify your body. Try to have a cup of green tea in the morning or even use it as a warm mouthwash to help with your receding gums. 
2. Aloe Vera
Aloe vera is definitely a versatile natural remedy; from sunburn to dry skin, it can also help manage your receding gums. Topical application of aloe vera gel following standard dental treatments may significantly improve gum health. A study published in the Journal of Indian Society of Periodontology reported how aloe vera was able to soothe periodontal disease in people affected by receding gumlines. They included 15 subjects in their study and found that the soothing effects of aloe vera were clinically significant in healing gum disease and gum recession. You can apply aloe vera directly on your affected gums with a soft toothbrush or cotton bud, or as a mouthwash (aloe vera mixed in with warm water). 
3. Proper Oral Hygiene
Good oral hygiene is of course one of the finest ways to combat gum recession. Regular brushing with a soft-bristled brush and daily flossing can prevent plaque buildup, a key factor in gum recession. Remember to brush after every meal, use floss, and make sure you’re brushing correctly! Avoid aggressive brushing which can damage your gums and cause your gumline to recede – and make sure you reach every tooth. You can also get professionally cleaned by a dentist every six months (which is recommended) and get checked out as soon as you feel any unusual tooth and gum sensitivity.
4. Skip The Sugar
Too few people are aware of the fact that you really do not need added sugar. It has no “benefits” other than for the taste buds… and is literally responsible for the deaths of millions of people. Sorry for the harsh truth – but it really is true. However, quitting sugar is not as hard as you think. If you for example just start taking your coffee without sugar, your taste buds will “adapt” to it pretty fast and you will start enjoying it that way. It only takes a little self discipline to go sugar free.
5. The Water Swish
It’s really obvious, but too few people do it: A further very simple practice is rinsing / swishing out the mouth with plain water after eating – especially after sweet foods or drinks! While arguably not as good as flossing / brushing, it is a lot better than nothing. A good vigorous swish-n-spit does remove many food particles and reduce remaining sugars in the mouth – and is super-easy! So in addition to your regular brushing / flossing routine, get into the habit of thoroughly swishing out your mouth with water after every time you eat – you will improve your dental and gum health, your breath and your smile! 🙂
6. Probiotics aka. “Good Bacteria”
Everyone knows that sugar feeds bad bacteria in the mouth and makes them multiply like crazy – which leads to dental decay and gum disease.
So why not employ your very own army of ‘good bacteria’ to fight the invaders? 🙂
People are beginning to learn that the microbiome (bacterial “ecosystem” in the body) is extremely important not only for the gut (which influences not only physical but mental health), but also oral health too!
It makes perfect sense if you think about it: Just as the “good bacteria” of probiotics fight the bad guys in your stomach, they do the same in your mouth and it is of course the bad bacteria which are responsible for tooth decay, gum disease and bad breath.
It gets even more serious! Bad bacteria in the mouth have also been implicated in heart disease as they work their way around the system.
According to a Harvard scientist, swallowing these newly discovered bacteria could be the “superweapon” you need to do to fix all your dental issues, from gum bleeding and teeth rotting to bad breath and cavities.
One interesting thing I learned about probiotics is that long term use is actually advised. They are one of the supplements that ought to be part of a healthy daily regimen for most people.
7. Oil Pulling
Swishing oil (like coconut, sesame, or sunflower oil) in the mouth for 5–20 minutes can reduce bacteria levels, a contributing factor to gum disease.
8. Herbal Extracts
Mouthwashes containing clove, basil, and tea tree oil have shown anti-plaque and anti-gingivitis properties. Essential oils like peppermint, thyme, and tea tree also have antiseptic properties against oral bacteria.
Supplements containing antioxidants like lycopene and green tea extract can improve gum health. Green tea, in particular, has been shown to reduce plaque formation, gum bleeding, and inflammation markers.
This multi-herbal supplement is reported to be able to reduce gum bleeding and pocket depth when used alongside standard treatments.
11. Omega-3 Fatty Acids
Supplements containing omega-3 fatty acids can reduce gum inflammation and improve attachment between teeth and gums.
Professional Treatments For Receding Gums
For more advanced cases of receding gums, professional treatments may be necessary. Here is an detailed rundown of 3 of the prominent treatments available:
Scaling and Root Planing (SRP):
Scaling and Root Planing, commonly referred to as SRP, is a deep cleaning dental procedure aimed at treating periodontal disease (commonly known as gum disease). It involves the thorough cleaning of the tooth root surfaces to remove plaque, tartar (calculus), and bacterial toxins from the teeth and below the gumline.
The Process of SRP:
1. Assessment Initially, a dental professional assesses the depth of the periodontal pockets (the space between the tooth and gum) using a periodontal probe. This assessment helps in determining the severity of the gum disease.
2. Scaling This step involves the removal of plaque and tartar from the tooth surface and the area below the gumline. Dental hygienists use specialized instruments, such as ultrasonic scalers and hand scalers, to meticulously remove these substances. Ultrasonic scalers use vibrations to break up tartar and plaque, while hand scalers scrape off these deposits from the teeth.
3. Root Planing After scaling, root planing is performed. This procedure smoothens the root surfaces of the teeth, which helps in removing any remaining bacteria and provides a clean surface for the gums to reattach to the teeth. Smoothing the root surfaces also makes it more difficult for plaque, bacteria, and tartar to accumulate again.
4. Antibacterial Agents In some cases, the dentist may apply antibacterial agents, such as antibiotic gels or fibers, in the periodontal pockets to help reduce bacterial growth and aid in healing.
The Purpose of SRP:
Treating Gum Disease SRP is primarily used to treat gum disease. By removing plaque and tartar, it helps in reducing gum inflammation (gingivitis) and preventing the progression to more severe forms of periodontal disease (periodontitis).
Preventing Tooth Loss By addressing periodontal disease, SRP plays a crucial role in preventing tooth loss, which is a common consequence of untreated gum disease.
Improving Oral Health SRP improves overall oral health and hygiene. It can also reduce bad breath (halitosis) caused by the bacteria in periodontal pockets.
Post-Procedure Care and Maintenance:
Follow-Up After SRP, patients may need to return for a follow-up visit to check the healing of gums and the depth of periodontal pockets.
Oral Hygiene Maintaining good oral hygiene post-procedure is vital. This includes regular brushing, flossing, and possibly the use of a mouthwash as recommended by the dentist.
Regular Dental Visits Regular check-ups and cleanings are important to monitor oral health and prevent the recurrence of periodontal disease.
Potential Discomfort and Management:
Mild Discomfort Patients may experience mild discomfort, sensitivity, and slight bleeding during and after the procedure. This is usually temporary.
Pain Management Dentists may use local anesthesia during the procedure to minimize discomfort. Over-the-counter pain relievers can be used post-procedure if necessary.
Pinhole Surgical Technique:
The Pinhole Surgical Technique (PST), also known as Pinhole Gum Rejuvenation, is a very interesting, minimally invasive procedure developed for the treatment of gingival recession. This innovative technique offers a less painful and more aesthetically pleasing alternative to traditional gum grafting methods.
The Pinhole Surgical Technique represents a significant advancement in the treatment of gingival recession. It offers a less invasive, more comfortable option with quick recovery and immediate aesthetic improvements. However, patient selection and the skill of the dentist are key factors in its success. As with any dental procedure, patients should discuss their options with their dentist to determine the best course of treatment for their specific needs.
The Procedure of Pinhole Surgical Technique
1. Preparation The procedure begins with the administration of a local anesthetic to numb the treatment area, ensuring the patient’s comfort throughout the process.
2. Creating the Pinhole The dentist makes a small pinhole in the gum tissue, typically above the area of recession. This pinhole serves as the access point for the rest of the procedure and is significantly smaller than incisions made in traditional gum grafting.
3. Loosening Gum Tissue Special instruments are inserted through the pinhole to gently loosen and stretch the gum tissue. This step is crucial as it allows the gum tissue to be moved over the areas of recession without the need for grafts or sutures.
4. Repositioning the Gums Once the gum tissue is loosened, the dentist carefully repositions it to cover the exposed roots of the teeth. This step not only improves the aesthetics of the smile but also protects the roots from sensitivity and decay.
5. Stabilizing the Gums Collagen strips or other stabilizing materials are then inserted through the pinhole to hold the gums in their new position and to encourage natural healing and regeneration of the gum tissue.
6. Healing The pinhole created in the gum typically heals within a day or two, with minimal discomfort or swelling. The collagen helps in the rapid recovery and regeneration of gum tissue.
Advantages of the Pinhole Surgical Technique:
• Minimally Invasive Unlike traditional grafting techniques, PST does not involve cutting or sutures, making it less invasive.
• Reduced Pain and Discomfort Patients generally experience minimal pain and discomfort during and after the procedure.
• Faster Recovery The recovery time is significantly shorter compared to traditional grafting methods.
• Immediate Cosmetic Improvement The aesthetic results are immediate and can be quite dramatic, improving the patient’s smile and confidence.
• No Need for Donor Tissue PST eliminates the need for grafts from the patient’s palate or the use of donor tissue, which is often required in traditional procedures.
Considerations and Suitability:
• Patient Selection Not all patients with gingival recession are suitable candidates for PST. The dentist will assess the severity of recession, the health of the gums, and other factors to determine suitability.
• Long-Term Care Post-procedure, maintaining good oral hygiene and regular dental check-ups are crucial for the long-term success of the treatment.
• Skill of the Dentist The success of PST largely depends on the skill and experience of the dentist performing the procedure.
Gum Graft Surgery Technique for Gingival Recession:
Gum graft surgery, also known as gingival graft or periodontal plastic surgery, is a reliable and effective treatment for gingival recession. Gum graft surgery aims to cover the exposed root, protect the tooth, and improve the appearance of the gum line. It not only addresses functional issues like sensitivity and root protection but also improves the aesthetic appearance of the gums. The success of the surgery depends on the technique used, the patient’s oral health, and adherence to postoperative care instructions. As with any surgical procedure, patients should consult with their dentist or periodontist to understand the best approach for their specific condition.
Types of Gum Grafts:
1. Connective Tissue Grafts: The most common type, where a flap of skin is cut at the roof of the mouth (palate) and tissue from under the flap, known as subepithelial connective tissue, is removed and then stitched to the gum tissue surrounding the exposed root.
2. Free Gingival Grafts: Similar to connective tissue grafts, but instead of subepithelial tissue, a small amount of tissue is taken directly from the roof of the mouth and then attached to the gum area being treated. This method is often used for people with thin gums who need extra tissue to enlarge the gums.
3. Pedicle Grafts: In this method, instead of taking tissue from the palate, it is grafted from gum around or near the tooth needing treatment. A flap (pedicle) is partially cut away so that one edge remains attached. This flap is then pulled over or down to cover the exposed root and sewn into place. This technique is preferred for patients who have plenty of gum tissue near the tooth.
The Procedure of Gum Graft Surgery:
1. Preparation: The area is numbed with a local anesthetic to ensure patient comfort.
2. Tissue Harvesting: Depending on the type of graft, tissue is harvested either from the patient’s palate or adjacent gum.
3. Graft Placement: The harvested tissue is then carefully placed over the area of gum recession, ensuring that it adequately covers the exposed root.
4. Suturing: The graft is secured in place with stitches, either at the donor site (palate) or around the grafted area.
5. Healing: The graft will gradually integrate with the surrounding tissue, promoting new tissue growth and resulting in a more stable, healthy gum line.
Postoperative Care and Recovery
• Healing Time: Complete healing usually takes a few weeks. During this time, patients may need to eat soft foods and follow specific oral hygiene instructions to ensure successful healing.
• Pain Management: Patients may experience some discomfort and swelling, which can be managed with pain relievers and ice packs.
• Follow-Up Visits: Postoperative visits are necessary to monitor the healing process and remove sutures if they are not self-dissolving.
Advantages of Gum Graft Surgery:
• Reduced Sensitivity: By covering exposed roots, gum grafts can significantly reduce tooth sensitivity.
• Improved Gum Health: Grafts protect the roots from decay and prevent further recession and bone loss.
• Aesthetic Benefits: Gum grafts can improve the appearance of the teeth and smile, especially in cases where recession has led to an uneven gum line.
Considerations and Suitability:
• Individual Needs: The choice of grafting technique depends on the specific needs and condition of the patient’s gums.
• Oral Health: Patients must have good overall oral health to undergo the procedure.
• Long-Term Care: Maintaining good oral hygiene and regular dental check-ups are essential for the longevity of the graft.
 California Dental Association. Receding gums. https://www.cda.org/Portals/0/pdfs/fact_sheets/receding_gums_english.pdf
 American Academy of Periodontology. CDC: Half of American Adults Have Periodontal Disease. https://www.perio.org/consumer/cdc-study.htm
 American Dental Association. Genes May Be Linked to Tooth Decay, Gum Disease. https://www.colgate.com/en-us/oral-health/conditions/gum-disease/ada-04-genes-may-be-linked-to-tooth-decay-gum-disease
 Maruyama, T, et al. (2011). Supplementation of green tea catechins in dentifrices suppresses gingival oxidative stress and periodontal inflammation. https://www.ncbi.nlm.nih.gov/pubmed/20869695
 Bhat, G, Kudva, P, & Dodwad, V. (2011). Aloe vera: Nature’s soothing healer to periodontal disease. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3200013/
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