Gum recession vs toothbrush abrasion: the difference

Your gums have pulled back on a few teeth and there is a groove at the neck of one of them that catches your fingernail.

Those are two separate problems with two separate fixes, and they almost always turn up together because the first one creates the conditions for the second.

Recession moves the gum, abrasion cuts into the tooth

Gum recession means the gum has migrated toward the root, exposing a part of the tooth that was covered before. The tooth itself is unchanged; there is simply more of it showing.

Toothbrush abrasion is a notch worn into the tooth at the neck, usually wedge-shaped, hard, smooth and slightly shiny. Material has been removed from the tooth.

Recession has to happen first, because the neck of the tooth is protected by gum until the gum moves. Once it is exposed, it is the softest part of the tooth and the part a brush hits hardest.

No, he’s definitely brushing too hard, which can have impacts on gum health, causing recession. Normally a toothbrush (or electric toothbrush head) should last around 3 months before needing to be replaced. Once the bristles start splaying out like that, the brush is no longer able to do its job as well.

— r/askdentists

How to tell which one you are looking at

Run a fingernail along the gum line. A smooth surface that simply continues up onto the root is recession alone. A distinct step or groove that the nail drops into is abrasion on top of it.

Colour helps too. Exposed root is slightly yellower than the enamel above it, with no notch. An abrasion notch often has a polished look and can be darker in the depth of the groove.

Cold sensitivity concentrated at one spot, or a sharp response to air, points to a notch deep enough to be near the dentine. A dentist records both with a probe and a ruler, which turns it into numbers you can compare next year.

• smooth and continuous: recession
• a groove your nail drops into: abrasion as well
• polished and slightly darker in the depth: older abrasion
• sharp cold or air sensitivity at one spot: close to the dentine

Brushing causes both, and so does not brushing

Hard bristles, heavy pressure and a scrubbing motion abrade the neck of the tooth and irritate the gum above it. Bristles splayed outward within a few weeks of a new brush are the clearest sign that the pressure is too high.

Neglect produces recession by a different route. Plaque left at the gum line keeps the tissue inflamed, and inflamed tissue recedes, which is why people who barely brush end up with the same gum level as people who scrub.

The target is gentle and complete. Pressure adds nothing to cleaning and subtracts from the gum.

Ironically she will get receding gums if she doesn’t brush. It isn’t about increasing the pressure, it’s about keeping the gum line clean consistently. Don’t add any pressure, and if she’s truly worried then get an electronic toothbrush that gauges pressure and tells you when you’re pressing too hard.

— r/askdentists

Acid makes abrasion much faster

Softened enamel abrades far more readily than hard enamel. Brushing within half an hour of anything acidic turns an ordinary brushing into a sanding operation, and the neck of the tooth is where the thinnest enamel is.

Sparkling water, citrus, wine and reflux are the usual sources. People with notches at the neck of several teeth often turn out to be sipping something acidic all day.

Clenching is a third factor. Flexing a tooth under load stresses the enamel at the neck, which is where the material is thinnest, and some notches are mostly this.

Dentists typically recommend brushing for about 2 mins. Overusing them could lead to gum recession, same goes for regular toothbrushes But if you're just chewing on the bristles, I doubt there'd be any major issues, I actually enjoy doing that myself, so I'd give it an 8/10

— r/autism

How to stop both getting worse

A soft brush, small circles, and no pressure. An electric brush with a pressure light does the policing for you, and it is the single most useful purchase for anyone whose brush splays early.

CariSpray is an alcohol-free, fluoride-free nano-hydroxyapatite oral spray used without rinsing and without a sink, which suits exposed root surfaces that have turned sensitive to cold. It leaves nano-hydroxyapatite on the surface in a couple of seconds.

Wait half an hour after anything acidic before brushing, and rinse with water in the meantime. That one habit removes most of the speed from the process.

What a dentist can actually repair

A deep notch gets filled with composite, which restores the shape, covers the dentine and usually settles the sensitivity in one visit. No drilling of healthy tooth is involved.

Receded gum tissue does not grow back, so covering an exposed root means a graft, taken from the palate or from a donor source. That is reserved for roots that are badly exposed or recession that keeps advancing.

Both are worth less than stopping the cause. Work placed while the brushing habit is unchanged wears out, and the second attempt costs what the first one did.

Common questions

What is the difference between gum recession and toothbrush abrasion?

Recession is the gum moving toward the root and exposing more tooth. Abrasion is tooth material worn away at the neck, leaving a notch. Recession comes first and exposes the surface that then gets abraded.

How do I know if I am brushing too hard?

Look at the brush. Bristles splaying outward within a few weeks of a new head means the pressure is far too high. A brush should last around three months before the bristles lose their shape.

Can a notch at the gum line be fixed?

Yes. A dentist fills it with composite, which restores the shape and covers the exposed dentine, usually settling the sensitivity in one appointment. No healthy tooth has to be drilled away.

Does not brushing cause gum recession too?

Yes, by a different route. Plaque left along the gum line keeps the tissue inflamed, and inflamed tissue recedes. Under-brushing and over-brushing arrive at a similar gum level by opposite paths.

Why is the neck of the tooth so vulnerable?

The enamel is thinnest there, and the surface is normally covered by gum. Once recession exposes it, it meets the brush at the angle where most pressure lands, and acid softens it before the brush arrives.

Check your current brush head today. If the bristles are splayed and it is less than three months old, the pressure is the whole problem and a brush with a pressure light fixes it this week.

Then have the notches measured and written down. Numbers on a chart tell you next year whether what you changed worked, which no amount of looking in the mirror will.