Prevalence of Gum Recession in Premolars
Gum recession in premolars is relatively uncommon compared to other tooth positions, with first premolar sites demonstrating approximately 28% prevalence of thick bone wall phenotype, which is protective against recession. 1
Context-Specific Prevalence Data
The available evidence primarily addresses gum recession in the context of dental implant placement rather than natural teeth, but provides important anatomical insights:
Anatomical Considerations for Premolars
First premolar sites show significantly more favorable anatomy compared to anterior teeth, with approximately 27.5% having a thick facial bone wall phenotype (>1 mm), compared to only 4.6% in central incisor sites. 1
The thick wall phenotype in premolars is protective against mucosal recession, as thin or damaged facial bone walls are identified risk factors for recession development. 1
General Population Prevalence
Overall gum recession affects 88% of people aged 65 years and older and 50% of people aged 18-64 years at one or more sites, though these figures represent all tooth positions combined. 2
More than 50% of the population has one or more sites with gingival recession of 1 mm or more, with recession being more frequently found on buccal (facial) surfaces than other tooth aspects. 2
In young adults specifically, gingival recession was found in 14.6% of subjects and affected 1.6% of all examined teeth, though this study did not isolate premolar-specific data. 3
Key Risk Factors Affecting Premolars
Orthodontic treatment shows positive correlation with recession prevalence and severity, making this particularly relevant for premolar areas often involved in orthodontic mechanics. 3
Oral piercing demonstrates significant association with recession, which can affect premolar regions depending on piercing location. 3
Thin tissue biotype, facial malposition, and thin or damaged facial bone walls are primary anatomical risk factors, though premolars generally have more favorable anatomy than anterior teeth. 1
Clinical Implications
The relatively lower prevalence of recession in premolars compared to anterior teeth is explained by their more favorable anatomical characteristics, including thicker facial bone walls and generally better soft tissue support. 1 However, when recession does occur in premolars, it follows the same multifactorial etiology involving trauma, inflammation, anatomical factors, and patient-specific risk factors. 2, 4
Recession prevalence and extent increase with age across all tooth positions, making long-term monitoring essential even in anatomically favorable sites like premolars. 2, 5