Gum recession is when the gum margin pulls back toward the root of the tooth, exposing the root surface. Teeth that look longer than they really are, sensitivity to cold drinks, and cosmetic changes noticed when smiling are the most common reasons people seek care. In this article, we cover the signs and causes of gum recession and current treatment options.
What is gum recession?
Gum recession (gingival recession) is the shift of the gum margin below the cementoenamel junction, exposing the root surface to the oral environment. It can affect a single tooth or several teeth. Normally the gum covers the root; because the root surface is not covered by enamel, it is more vulnerable to external factors once exposed.
Gum recession becomes more common with age, but it is not simply a natural result of aging. In most cases there is an underlying cause that can be brought under control.
What are the signs of gum recession?
The most obvious sign is a tooth that looks longer than before. Other signs may include:
- Sensitivity: A brief, sharp twinge with cold, hot, sweet or sour foods and drinks, or when brushing,
- Visible root surface: A more yellow, matte surface near the gumline compared with the enamel,
- Notches at the neck of the tooth: V- or U-shaped wear at the level of the gumline,
- Gaps between teeth: Dark triangles that form when the gum papilla between the teeth is lost,
- Susceptibility to root decay: An increased likelihood of cavities developing on the exposed root surface.
Gum recession usually progresses slowly and often causes no pain. As a result, many people do not notice it until it becomes obvious.
What causes gum recession?
There is no single cause of gum recession; usually several factors play a role together:
- Periodontitis: Gum disease leads to loss of the connective tissue and bone that support the tooth, and the gum recedes as it follows the lost bone.
- Thin gum tissue (phenotype): In people who are born with thin, narrow gums, the underlying bone is usually thin as well, and recession develops more easily.
- Traumatic brushing: A hard-bristled brush, excessive force and horizontal scrubbing can gradually wear away the gum margin.
- Orthodontic movement: Moving a tooth outside the boundaries of the bone can increase the likelihood of recession, particularly with thin gum tissue.
- Lip and cheek attachments: Attachments (frenula) that insert close to the gum margin can pull on the gums.
- Fillings and crowns that extend past the gum margin: These can make plaque buildup and inflammation more likely.
- Lip and tongue piercings, smoking and teeth clenching: These can have adverse mechanical or biological effects on the tissues.
To better understand the link between gum disease and gum recession, see our article on periodontitis stages and grades.
Can receded gums grow back on their own?
No. Receded gums do not return to their original level on their own. Once the cause is under control, progression can be slowed or stopped; covering the root surface again is possible with surgical techniques in suitable cases.
The likelihood of root coverage depends largely on the condition of the supporting tissue between the teeth. According to the Cairo classification, which was also adopted in the 2017 classification, gum recession is divided into three types:
- RT1: There is no attachment loss between the teeth; root coverage is more predictable in this type.
- RT2: There is also loss between the teeth, but it is no greater than the loss on the lip or cheek side of the tooth. In suitable cases, part or all of the root may be covered.
- RT3: The loss between the teeth is greater than the loss on the lip or cheek side; complete root coverage is generally not expected.
A brief twinge with cold may come from an exposed root surface. However, similar complaints can also be related to decay, a crack or gum disease. Desensitizing toothpastes can ease the discomfort, but an examination is still needed to find the cause.
What are the treatment options for gum recession?
Treatment is planned according to the cause and extent of the recession, the thickness of the gum tissue and the person's concerns. Not every case of gum recession requires surgery.
Cause-related and non-surgical approaches
The first step is to control the factor causing the recession. If there is gum inflammation, gum disease treatment is carried out; brushing technique is corrected and a suitable brush is chosen. Fluoride applications and desensitizing products can be used for sensitivity, and in suitable cases, fillings can be placed for wear at the neck of the tooth.
Surgical treatment options
When the root surface needs to be covered or gum thickness needs to be increased, periodontal plastic surgery techniques are considered. These include the coronally advanced flap or tunnel techniques, usually combined with a connective tissue graft taken from the palate, as well as free gingival grafts. These procedures are performed under local anesthesia, with the aim that you do not feel pain during the procedure.
Which technique is suitable and the result that can be achieved vary from person to person. For more detailed information, see our gum recession treatment page. Options for adjusting gum levels in the smile are described on the gum aesthetics page.
How can gum recession be prevented?
The foundation of preventing gum recession is effective plaque control without damaging the gums:
- Use a soft-bristled brush and do not press down hard,
- Instead of scrubbing horizontally, use gentle strokes from the gumline toward the tooth,
- Clean between your teeth every day without skipping,
- See your dentist if you clench or grind your teeth,
- Quit smoking,
- Ask for your gum tissue to be evaluated before orthodontic treatment,
- Catch gum disease early with regular check-ups.
Our article on proper brushing and interdental cleaning can guide you on the right technique.
When should you see a dentist?
If you notice that your teeth look longer, your gumline has become uneven or you have sensitivity to cold, you should see a dentist or a periodontist. Do not delay an examination if the recession is accompanied by bleeding gums, loose teeth, bad breath or inflammation at the gumline.
The examination assesses the extent of the recession, gum thickness, the supporting tissue between the teeth and possible causes. Following this assessment, periodontist Dr. Nadin Gemrekoğlu, DDS, PhD, plans the treatment options together with the patient. You can use the contact page to make an appointment.