Exposed roots on your teeth can sometimes be painful or unsightly, but how concerning is it? Do you need to see your dentist? Do you need to have gum grafting? It depends on several factors. Here’s what you need to know about exposed tooth roots, also known as receding gums or gingival recession.
What is an exposed tooth root?
The portion of your tooth that is naturally above the gumline is the crown, which is covered by a hard white substance enamel. The part of your tooth that should be anchored in the bone and covered with gum tissue is called the root. Generally, 1/3rd of the tooth is visible and 2/3rds of the tooth is under the gum and bone.
If you can see or feel where the whitish enamel ends and the yellowish dentin begins, or if the gum line seems significantly different than the surrounding teeth, you probably have an exposed root. If the exposed root is dark brown or black, you likely have a cavity and need to see your dentist as soon as possible. Checking for these things is something that regularly happens at a teeth cleaning appointment.
What are the symptoms of an exposed tooth root?
Sometimes even very tiny amounts of root exposure can cause sensitivity with tooth brushing, or when eating and drinking cold, acidic, sour, or sweet foods and drinks. Occasionally the gum will be tender or swollen. Some people have no symptoms at all.
Why are exposed roots and gum recession concerning?
If you can see the root of your tooth, there is less bone holding your tooth in place. Also, the crowns of your teeth are protected by dental enamel, while the roots of your teeth are not. That inner layer of the tooth is known as dentin, which is more much more prone to cavities and sensitivity.
What causes an exposed root?
Teeth can have exposed roots for many reasons including gum disease, grinding, trauma, tobacco use, tooth position, orthodontics, and genetics.
- Advanced gum disease, known as periodontitis, causes inflammation and bone loss around the teeth, which can lead to root exposure, and eventually tooth loss if left untreated.
- Grinding puts excessive forces on the teeth and supporting bone, which can lead to bone loss and gum recession over time.
- Traumatic injuries can cause damage to the teeth and bone, which can cause the root to become exposed.
- Tobacco use can contribute to exposed roots in several ways. Chewing tobacco is a chronic irritant on the tissue which can cause the gums to recede, while smoking reduces blood flow to the gum tissues and contributes to periodontal disease.
- Tooth position (misaligned teeth) can make some teeth more likely to have exposed roots. If a tooth is tipped, rotated, or crowded out of the dental arch, the bone may not cover the root.
- Orthodontics (braces) can sometimes contribute to gum recession, although in other cases it can help reduce the progression of bone loss. When teeth are moved with orthodontics, they can be pushed out of the available bone or moved into a more ideal position.
- Genetics is a major factor for recession. Just like some people have thinner or thicker hair, certain people have more fragile gum tissue, which is known as “thin bio-type”, and may be more prone to recession.
Does brushing too hard cause gum recession?
Overly aggressive tooth brushing can worsen gum recession, but it is usually not the primary cause. If exposed roots were caused by brushing too hard, the gum recession would be mostly even throughout the entire mouth, which is rarely the case. However, soft-bristled toothbrushes are strongly recommended.
Are exposed roots normal with aging?
Exposed roots and gum recession are not a normal, inevitable consequence of aging, although it is more common to see gum recession in older people. This is because all the damage to your teeth and gums is cumulative over your lifetime, so anything that happened when you were younger will be visible as you age unless you have had it repaired.
How do you treat an exposed root?
Once the gum is gone, the only way to get it back is to have it surgically covered back up with a gingival graft. Donor tissue (either from the roof of the mouth, or from an alternative source like cadaver tissue) is used to cover the exposed root. Although it may sound like a terrible, invasive procedure, most patients find recovery to be quick, with minimal postoperative discomfort.
The other way roots can be covered is with a filling or crown. However, unless the tooth has a cavity or needs a crown for another reason, this is not as ideal as grafting.
When do exposed roots need to be treated?
First off, if you sustained a traumatic injury to your teeth and you have an exposed root, reach out to your dentist immediately.
If your gum recession is caused by periodontal disease, grinding, or misaligned teeth, those issues need to be addressed to prevent the root exposure from getting worse.
If you are having moderate or severe sensitivity in areas where the tooth roots are exposed, or are avoiding brushing the area due to sensitivity, you should consider having your recession treated.
Many periodontists (gum specialists), recommend treating exposed roots with more than 3 millimeters (⅛ inch) of gum recession.
In addition to looking at how much of the root is exposed, another important factor that is considered is how much gum tissue is still remaining. Genetics determine the width of the attached gingiva, which is the pink fibrotic tissue that holds your gums to the bone that supports your teeth. If you have a small zone of attached gingiva, even small areas of recession may be concerning.
Treating exposed roots sooner rather than later increases the chances that surgery will be successful in fully covering the root.
At home pain relief options
Sensitivity toothpastes are a great option for dealing with small amounts of painful recession. In addition to fluoride, sensitivity toothpastes often have an ingredient called potassium nitrate that helps treat sensitivity. Besides just brushing with the toothpaste, you can also rub it directly on the exposed roots, especially before bed, to get extra benefits.
Fluoride mouth rinses can be beneficial in reducing sensitivity and preventing cavities on exposed roots, but if you want an alternative to fluoride products, look for arginine rinses and toothpastes.
And, always talk to your dentist if you have concerns!
