Guides · Gums
Why do gums recede, and do they grow back? Treatment options
The causes of gum recession (hard brushing, gum disease, clenching, thin gums, orthodontics), its signs, ways to stop it progressing and treatments such as gum grafts.
Receded gum does not grow back on its own; but its progression can be halted and, in suitable cases, the root can be covered with a gum graft. The commonest causes are hard/horizontal brushing, untreated gum disease, clenching and a congenitally thin gum type. Sensitivity, teeth that look longer and notches on the root surface are the main signs.
What is gum recession?
The gum retreating from the neck of the tooth towards the root, leaving the root surface exposed. The root has no enamel, so sensitivity, decay and wear risk increase in the receded area. The tooth looks "longer" and black triangular gaps can appear between the gums.
Causes
- Hard, horizontal brushing: Wears the gum mechanically; usually on the canines and premolars, and more marked on the left side in right-handed people.
- Gum disease (periodontitis): Inflammation from plaque and calculus destroys bone; when the bone recedes, so does the gum. The commonest and most important cause.
- Clenching and occlusal loads: Excessive force causes notches at the tooth neck (abfraction) and recession.
- A thin gum biotype: A congenitally thin, narrow band of gum recedes more easily.
- Malpositioned teeth and orthodontics: Recession on teeth pushed outside the bone; considered in the treatment plan.
- High muscle attachments (frenulum): Pull on the gum with lip movement.
- Smoking, piercings, overhanging filling/crown margins.
Signs
Hot-cold sensitivity, a yellow root surface and notch at the tooth neck, redness and bleeding of the gum (if disease-related), teeth looking longer, gaps between the teeth, food packing.
Does it grow back?
Lost gum does not regenerate on its own. However, (1) if the cause is removed the progression stops, and (2) in mild-to-moderate recession the root surface can be covered again with a gum graft. Early intervention decides the outcome; gaps between teeth where bone support is completely lost may not be fully closed by surgery.
Treatment
- Correcting the cause: Brushing technique (soft brush, 45°, circular), a night guard for clenching, cleaning and root planing for gum disease, correcting overhanging restorations, stopping smoking.
- Controlling sensitivity: Desensitising toothpaste, fluoride varnish, a bonding agent on the exposed root.
- Composite restoration: Marked notches at the tooth neck are filled with composite; sensitivity and decay risk fall.
- Gum graft (root coverage): Connective tissue from the palate or a graft material is placed under gum moved over the receded area. 45–90 minutes under local anaesthesia; sutures for 2 weeks; the gum thickens and the root is covered. Success depends on the depth of recession and the level of neighbouring bone and gum.
- Frenectomy: Correcting the muscle attachment pulling on the gum.
Preventing recession
- A soft brush, light pressure; a pressure sensor on an electric brush
- Take bleeding gums seriously; a check every 6 months
- A splint for signs of clenching
- Assessment of gum thickness in orthodontic planning
For the stages and treatment of gum disease see Gum treatment; for the causes of bleeding, Why do gums bleed?
This article is for general information only; diagnosis and treatment tailored to you require a dental examination.
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