Brushing too hard - Dr. Akriti Dogra

Relationship Between Brushing Too Hard And Noticeable Gum Recession And Other Factors To Consider.

There is a reason soft-bristled toothbrushes are the brushing tools of choice for dentists all over the world; hard bristles and rough brushing technique can hurt your delicate gums. But while a heavy hand during brushing can contribute to gum recession, it’s not the only culprit, several other problems could be leading to your diminishing gumline. In today’s blog we will cover “What” and “Why” behind receding gums. 

A Quick Anatomy Lesson

In a healthy mouth, teeth are supported by both hard and soft tissues: the jaw bone, which supports tooth roots, and pink gum tissues which surround and protect teeth. Several types of gum tissue play different roles in how they support the teeth. “Free gingiva” is that tissue which most closely surrounds the crown of the tooth and isn’t directly connected to the tooth. You probably notice this when flossing: floss can usually move up underneath this part of the gums. The “attached gingiva” is above the free gingiva, and is important in protecting the underlying bone from bacteria and infection. It is vitally important to maintain a certain level of attached gingiva for this reason.

Just above and below on the lower teeth the attached gingiva, is a darker reddish tissue that is not firmly connected. It is called “mucogingival tissue.” It is thinner and softer than the attached gingiva. It does not provide the same type of protection.

What is gum recession?

When the firm attached gingiva pulls away from the tooth and bone, it exposes the root surface of the tooth. This is called recession. Exposed tooth roots can create a host of issues. This is because the surface of tooth roots is softer than the outer enamel layers of a tooth crown, making them more prone to decay and toothbrush abrasion. Ultimately, this can result in abfractions or v-shaped notching along the root surface. The root surface is also an area that transmits temperature sensitivity and can cause discomfort and pain for patients when eating or drinking. The more the tissue and bone recede, the higher the chance of sensitivity, decay and less stability of the tooth itself.

What causes recession?

I see many patients with gum recession; it’s a common oral health issue caused by several potential problems. While I mentioned that abrasive brushing technique could cause gum recession, these other causes are other common culprits for damage to the attached gingiva:

Trauma: your mouth is designed to fit together in perfect alignment. However, a bad bite (or the dental term “malocclusion”) can create unnecessary friction and damage to teeth. When teeth repeatedly hit against each other, it can cause the teeth or tooth to move in such a way that gum tissues begin to pull away. Ill-fitting dentures or partials can also lead to friction that destroys gum tissue. Often, aligner therapy such as Invisalign can solve malocclusion problems to prevent this trauma.

Clenching/grinding: stress or anxiety from the day can sometimes spill over into the quality of your sleep. Some people have a tendency to clench or grind their teeth a condition called “bruxism” which puts undue stress on the teeth. This can lead to the tissues that attach to the tooth and bone loosening, eventually resulting in permanent recession.

Tobacco/smokeless tobacco use: Smokeless tobacco or “dip” can cause a recession in the area it’s placed in the mouth. Cigarette or cigar use causes vasoconstriction of the blood vessels that nourish the tissues and, over time, can lead to thinning, weak gum tissues.

Genetics: Genetics defines so many facets of our body; if your mom or dad had a tendency towards certain areas of gum recession, then it may be passed along to you, too.

Periodontal disease: The signs of periodontal disease are red, swollen, or tender gums that bleed, and an unpleasant taste in the mouth, can eventually destroy gum tissue and expose vulnerable tooth roots.