How Does Teeth Grinding Cause Gum Recession

Gum recession, when the gums shrink back exposing tooth roots, is found unaesthetic by many and causes sensitivity. There are several causes of receding gums including tooth grinding or to give it its formal name bruxism.

If you’ve just been told that your gum recession is most likely caused by bruxism it might come as a shock. You may be wondering – how does tooth grinding cause gum recession? 

Grinding and clenching the teeth during the day or night puts pressure on the gums. It also causes tooth mobility and subsequently small pockets which puts the gums at risk of gum disease, bone loss and later gum recession.  

In this post, Gum Disease Guide takes a closer look at the causes of bruxism and how tooth grinding causes gum recession and several treatment options.  

What Is Tooth Grinding

Tooth grinding sometimes referred to as bruxism can happen during the day (awake bruxism) or the night (sleep bruxism) and is quite common. Research has shown that 20% of adults grind their teeth during the day and 8-16% of adults grind or clench whilst asleep (1). 

Tooth grinding is prevalent in all sexes, age groups, social classes, and cultures. Research has shown that awake bruxism occurs more in females, but sleep bruxism is prevalent in both men and women (2). 

If you grind your teeth during the night you may also snore or have sleep apnea (small pauses in your breathing).

Signs and Symptoms of Tooth Grinding

How does the dentist know that tooth grinding is a cause of your gum recession? Your dentist may spot the following telltale signs:

• Indentations on the tongue, some dentists refer to this as a scalloped tongue,
• Broken teeth or fillings
• Abnormal tooth wear
• Large jaw muscles
• Reduced salivary flow
• Oral lacerations
• Limited mouth opening

You may report that you suffer with:

• Headaches
• Ear ache
• Disturbed sleep

Why Does Teeth Grinding Cause Gum Recession? 

Grinding the teeth puts a lot of pressure on the teeth and the structures that support them including the gums, alveolar bone and periodontal ligaments. This has several results. 

Loss of Supporting Structures

When excessive pressure is applied it can lead to the loss of structures which support the gum tissue.  For example, excessive pressure can cause 

• The periodontal ligaments (the fibres that attach the tooth to the jaw bone) to become irritated, inflamed, loose and break. 
• Chemical messengers that control bone metabolism in the jaw cause the jaw bone to be reabsorbed. Bone density decreases (3).

 When there is nothing to support the gum tissue they shrink or recede.

Periodontal Pockets and Gum Disease

Loose periodontal ligaments and a decrease in bone density can also lead to mobile and wobbly teeth. This can create space between the teeth and the gums, known as gingival pockets. Bacteria can collect in these pockets. The bacteria can irritate the gums and initiate an immune response. The gums become red and inflamed (this is called gingivitis, it is a mild form of gum disease).

When left untreated this can result in chronic inflammation which can lead to bone loss and further gum recession. The disease at this stage is called periodontitis. 

What Causes of Tooth Grinding

Bruxism may be caused by a combination of physical, psychological and genetic factors but it isn’t fully understood what causes it. 

Sleep Bruxism was classified in 2005 by the American Academy of Sleep Medicine as a sleep-related movement disorder. It may be a sleep-related chewing activity associated with arousal during sleep (4). 

Both Awake and Sleep Bruxism may also be linked with  

• Genetics
• Abnormal stress levels
• Sleep disorders
• Smoking
• Consuming lots of alcohol and caffeine
• Taking drugs like ecstasy and cocaine
• Sleep apnea syndrome
• Certain medicines, including a type of antidepressant known as selective serotonin reuptake inhibitors (SSRIs)
• Anxiety disorders (5, 6)

How to Stop Teeth Grinding and Reverse Gum Recession

Several procedures are available to reverse gum recession. But before you can restore the aesthetics of your smile you may need to treat the bruxism first. 

Treatment for Bruxism 

Firstly, reducing your intake of known stimulants such as caffeine, alcohol and smoking may help reduce or eliminate how much you grind your teeth and will have a positive effect on your oral and general health. 

These steps can also be taken to prevent tooth grinding from causing further damage to your gums and teeth. These include  

Splint therapy – Mouthguards or dental splints are frequently recommended for patients to wear overnight. They protect the teeth, gums and any artificial teeth, fillings or composite bonding from the pressure caused by teeth grinding and clenching overnight. 

Self-awareness – If you grind your teeth during the day, it has been proposed that you can make yourself aware of tooth clenching or grinding throughout the day.  To do this, place coloured stickers in places that will catch your eye during the day. For example, place orange dots on the kettle, bathroom mirror, steering wheel or telephone. When you catch sight of one of these dots ask yourself if you are clenching or grinding your teeth.

Muscle relaxation – Tooth grinding can cause pain in the jaw and headaches. To prevent these symptoms take part in some jaw relaxation techniques (here’s one example: https://www.youtube.com/watch?v=d45gvkFCKz8).

For those that grind in the night jaw botox, muscle relaxants and medication for anxiety or stress may be suggested by your dentist depending on the severity of your bruxism. 

Treatment for Gum Recession

The aesthetics of your smile can be restored with the following procedures: 

Composite bonding – Composite resins similar to those used for white fillings can be used to cover the exposed tooth root. White or gum-coloured polymers can be used depending on the location and severity of your gum recession. 

Gum Grafting – Donor tissue can be harvested and used to cover the exposed root. Tissue can be sourced from the root of your mouth, healthy gum tissue, a cadaver or it can be artificial tissue. You can find out more about gum grafting here. 

Pinhole Surgery – Pinhole surgery involves making a small incision in the gum tissue just below your recession and lifting healthy gum tissue over the exposed root. Special tools and collagen strips are used to secure the tissue in place. 

Treat Gum Disease – If tooth mobility has resulted in gingival pockets and gum disease this will need to be treated before gum recession can be treated.  

Final Thoughts

Teeth grinding can cause gum recession, exposed roots and gum disease. Developing and maintaining oral hygiene that is first class can help prevent gum recession from worsening as well as treating and preventing gum disease. 

First-class oral hygiene is achieved by brushing the teeth twice a day, cleaning the gum pockets with a Gum Pocket Brush and the interdental spaces daily using the correct techniques.

Sources for How Does Teeth Grinding Cause Gum Recession

1. Glaros AG. Incidence of diurnal and nocturnal bruxism. J Prosthet Dent. 1981 May;45(5):545-9. doi: 10.1016/0022-3913(81)90044-5. PMID: 6938686. Available here 
2. Shetty, S., Pitti, V., Satish Babu, C. L., Surendra Kumar, G. P., & Deepthi, B. C. (2010). Bruxism: A Literature Review. Journal of Indian Prosthodontic Society, 10(3), 141-148. https://doi.org/10.1007/s13191-011-0041-5. Available here
3. Jati, A. S., Furquim, L. Z., & Consolaro, A. (2016). Gingival recession: its causes and types, and the importance of orthodontic treatment. Dental Press Journal of Orthodontics, 21(3), 18-29. Available at https://doi.org/10.1590/2177-6709.21.3.018-029.oin
4. Thorpy, M. J. (2012). Classification of Sleep Disorders. Neurotherapeutics, 9(4), 687-701. Available here https://doi.org/10.1007/s13311-012-0145-6
5. Kuhn M, Türp JC. Risk factors for bruxism. Swiss Dent J. 2018 Feb 12;128(2):118-124. PMID: 29533049. Available here.
6. NHS. Accessed 4/10/22