What are the different stages a gum recession can go through?

gum recession stages
Gum recession is a common condition. More than 50% of the population has at least one area of gum recession. If left untreated, it gradually progresses and can be associated with other signs such as loosening and tooth loss.
Find out in this article how recession occurs and its different stages.

What is gum recession?

Gum recession is a condition where you notice a gradual movement or decrease in the height of your gums. It gives you the impression that your teeth are longer, but it is just a consequence of the change in the position of your gums that now expose part of your roots.

In addition to impacting your smile, the exposure of the roots to the oral environment will result in dental sensitivity.

the structure of the tooth

Unlike the crown, the root is not protected by enamel. When the gums recede, they expose the dentin, which contains small canals called tubules. The tubules go through the entire dentin thickness and end at the tooth nerves. Therefore, you may feel pain when you eat hot or cold foods.

Gum recession can also lead to more serious complications such as mobility or tooth loss.

The stages of gum recession:

Gingival recession is a condition that progresses over time.

In the presence of an inflammation or injury, in addition to other predisposing factors, the gum tissue retracts from the top of the gum (marginal gum) to the roots.

The way recession evolves depends on the factors involved.

1. In trauma-induced gum recession:

Gum recession following an injury, such as due to vigorous brushing or piercing, is usually limited to one tooth or a small group of teeth. They involve only the gum area in front of the teeth without damaging the interdental gum. The interdental gum is the triangular-shaped tissue that fills the spaces between the teeth.

You may also not notice any signs of inflammation (your gums may look normal as they recede). However, in the early stages, you may spot a red or white fissure called Stillman's cleft.

Stillman's cleft, the first stage of gum recession caused by trauma

An image showing a Stillman's cleft or fissure on the gum

In this type of recession, complete root coverage can be achieved with a gingival graft technique. The image below shows the stages of trauma-induced recession without treatment.

gum recession stages following a trauma

2. In periodontal disease:

Periodontal disease involves the infiltration of bacteria into the gums, causing inflammation. The resulting reactions will destroy the tissues surrounding the teeth, including the bone, gums, and ligaments that hold the teeth in place.

Recession due to gum disease usually progresses slowly over many years and often affects several teeth. It involves all the gum tissue surrounding the tooth, including the interdental gum, which causes black triangles to appear between the teeth when you smile.

receding gums due to untreated periodontitis

Receding gums due to untreated periodontitis

The bone and ligaments that support the teeth also deteriorate, making the teeth appear looser. If left untreated, you may end up losing your teeth.

Once the gum between the teeth is affected, complete root coverage cannot be achieved as the bone that would support the graft has been lost.
The picture below shows the stages of gum recession due to periodontitis. gum recession stages following gum disease

What can speed up the progression of gum recession?

Many factors can contribute to the appearance of gum recession. However, gum disease (also referred to as periodontitis) and trauma are the two main factors that trigger this problem.

Trauma involves all factors that can injure the gums, such as aggressive tooth brushing, ill-fitting dentures, and piercing.

Gum recession due to inflammatory gum disease does not happen overnight. It usually progresses slowly over many years. This is why it is common in adults, usually around their forties, and less common in young people.

Other causes are known to increase the risk of recession, among them:

  • Poor oral hygiene.
  • Dental malposition.
  • Thin gums.
  • Bone loss around teeth.
  • Smoking.
  • Incorrect bite.

Poor oral hygiene involves inadequate brushing or lack of interdental cleaning, which promotes plaque build-up and the infiltration of bacteria into the gums. This can lead to inflammation and destruction of the tissues that support the teeth, especially the bone and gums.

Using a hard bristle toothbrush or aggressive brushing will injure the gums through repeated rubbing. It can also cause tooth wear resulting in sensitivities.

Similarly, piercings on the tongue or lips, with their repeated rubbing on the mouth tissues, can also cause gum irritation.

The risk of recession is even greater if you have crowded teeth. Poorly positioned teeth will hold more plaque and food debris and be harder to clean, promoting inflammation. In addition, they affect the contour and shape of the gums around the teeth, making them thinner and less resistant in some areas.

Smoking reduces blood flow to the gums and weakens the immune system, which promotes bad bacteria and further tissue damage.