Dental Recession is a common treatable condition often seen at St. Lawrence Dentistry.
In health the gum (gingival) margin normally extends about 1mm above the ‘cementoenamel junction’ or ‘CEJ’. This is a slightly visible anatomical border identified on a tooth. The CEJ is the location where the enamel, which covers the anatomical crown of a tooth, and the cementum, which covers the anatomical root of a tooth, meet.
Gum recession is the shift of the gum below the CEJ toward the root of the tooth. By definition, recession results in the exposure of cementum portion of the tooth. Cementum is a specialized calcified substance covering the root of a tooth. The cementum is the part a tooth which attaches to the surrounding bone by a ligament called the ‘periodontal ligament’.
Recession usually occurs in people older than the age of 30 on the front aspect of teeth; it occurs less frequently on the back of teeth, and rarely in between teeth. Recession may be localized or generalized and often occurs during periods of inflammation that are combined with bad habits (improper tooth brushing technique, fingernail injuries). It appears more on teeth which are prominently located and on teeth which have very thin gum tissue.
Localized causes include excessive grinding pressure, poorly fitting dental crowns, plaque, and calculus. Plaque is bacteria and its matrix that adheres to the outer tooth surface. Calculus consists of primarily of mineralized, dead bacteria, with a small amount of mineralized salivary proteins.
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Gum recession can lead to molar teeth having furcation bone loss. To learn more about this important topic please visit us at:
Gum recession begins as a small oval defect but may progress to expose the entire root. St. Lawrence Dentistry offers grafting procedures to treat dental recession can recover the root of the tooth with new gum tissue. These are offered if the recession is very progressive in nature, the patient is experiencing sensitivity from the root surfaces, or if esthetics are a concern.
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The most widely accepted classification of dental recession is the Miller system. Dr. Hawryluk will diagnose what recession category your teeth fall into. The key to understanding the classification system us to familiar with the term ‘mucogingival junction’. This is is an anatomical feature found on the intraoral mucosa. The mucosa of the cheeks and floor of the mouth are freely moveable and fragile, whereas the mucosa around the teeth and on the palate are firm and keratinized. Where the two tissue types meet is known as a mucogingival junction. The Miller classes are as follows:
- Class 1: Recession that does not extend to the mucogingival junction with no bone loss. This class is best treated with proper brushing/flossing technique and visits with the dental hygienist.
- Class 2: Recession that extends to or beyond the mucovingival junction, with no interdental bone loss. Dental grafting can many times regain all or almost all of the original gum present.
- Class 3: Recession that extends to or beyond the mucogingival junction, with some periodontal bone loss. Dental grafting can usually regain some of the lost gum but it is sometimes not as successful as treating as in a class II situation.
- Class 4: Recession that extends to or beyond the mucogingival junction, with severe bone and/or soft-tissue loss in the interdental area and/or severe malpositioning of the teeth. Grafting will be able to thicken the remaining gum but regaining lost gum is not expected in this class.
If you have dental recession and would like to investigate treatment options further please call St. Lawrence Dentistry.