Receding Gums: What Causes It and What Can Actually Be Done

Gum recession does not reverse on its own, and no toothpaste, rinse or supplement regrows it. What can be done is identify the cause, stop it progressing, manage the sensitivity that comes with an exposed root, and in selected cases cover the root with a surgical graft. For most people the realistic goal is halting it where it is, and that is achievable.

If your gums have receded and you want to know why, an assessment will tell you.
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What is recession, exactly?

The gum margin has moved away from its original position, exposing part of the root surface that would normally be covered.

The root is not enamel. It is covered by a thin layer called cementum, which is softer, wears faster, and connects more directly to the nerve. That is why an exposed root is sensitive, why it decays more readily than a crown surface, and why recession is a functional problem as well as a cosmetic one.

The classic signs are a tooth that looks longer than its neighbours, a visible step or notch at the gumline, sharp sensitivity to cold air or cold water, and a dark line where a crown or filling margin has become exposed.

What causes it?

Almost always more than one thing at once, which is why identifying the mix matters.

Periodontal disease

Bone loss around a tooth takes the gum with it. This is the cause with the most at stake, because the recession is a visible symptom of something invisible — and gum disease is usually painless. Recession that comes with pockets, bleeding or teeth that have started to move needs the underlying disease addressed first, not the gum.

Toothbrush abrasion

Hard bristles, heavy pressure, and a horizontal scrubbing motion physically wear the gum margin away. It is most common on the outer surfaces, often worse on the side opposite the dominant hand, and it frequently comes with a wedge-shaped notch worn into the tooth at the gumline. Diligent brushers are disproportionately represented here, which is worth knowing.

Thin gum tissue

Some people simply have a thin biotype — less gum tissue and thinner bone over the roots, particularly where a tooth sits prominently in the arch. Thin tissue is more prone to recede under any of the other causes.

Grinding and clenching

Repeated heavy lateral force flexes the tooth at the gumline and contributes to both recession and the notching that accompanies it.

Orthodontic movement

Moving a tooth outside the envelope of bone that supports it can leave the root with very little covering. This is one reason gum health is assessed before orthodontic treatment starts.

Other contributors

Smoking, oral piercings rubbing against tissue, a high frenum pulling on the gum margin, and the margin of a poorly fitting restoration all appear regularly.

Recession has more than one cause, and the treatment follows the cause. Worth getting it identified.
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What can actually be done?

Stop it progressing

This is the primary aim and the one that applies to everybody.

• Treat any underlying gum disease. Where periodontal disease is driving it, nothing else works until that is addressed. See what each stage of gum disease actually needs.
• Change the brushing technique. Soft bristles only, light pressure, small circular or short strokes angled into the gumline rather than horizontal scrubbing. An electric brush with a pressure sensor helps people who habitually press too hard.
• Address grinding. An occlusal splint is $650 at Berala Dental, and it removes a significant load from the gumline.
• Adjust anything mechanically irritating the tissue, including piercings and restoration margins.
• Monitor with measurements. Recession is recorded in millimetres on a periodontal chart, so a comparison against the previous record answers the question of whether it is still moving. That is far more reliable than trying to judge it in a mirror.

Manage the sensitivity

• Desensitising toothpaste, used consistently rather than occasionally — it works by gradually occluding the tubules in the exposed surface, so it needs weeks
• Rub a small amount directly onto the sensitive area with a finger and do not rinse it off
• High-fluoride toothpaste or professionally applied fluoride varnish
• Reduce acidic drinks, which strip the surface layer as fast as it re-forms
• A bonded restoration over the exposed area where the notch is deep or the sensitivity is persistent

Cover the root

Where recession is localised, aesthetically significant or has left too little attached tissue, a gum graft can cover the exposed root. It is a surgical procedure — usually connective tissue taken from the palate, or a donor material — and it is generally carried out by a periodontist.

Berala Dental is a general dental practice. It provides periodontal treatment and does not have a specialist periodontist on site; where grafting is the appropriate option, a referral is arranged. Whether that applies to you is covered in do you need a periodontist.

Grafting is not automatically indicated. Stable recession that is not sensitive and not aesthetically troubling is frequently best left alone and monitored.

What does assessment involve?

A periodontal chart, which records recession in millimetres at six points around each tooth along with pocket depths, bleeding and mobility, plus X-rays to show bone levels. Together these separate the two situations that look similar from the outside: recession from mechanical wear on a healthy foundation, and recession that is a symptom of bone loss.

A check-up, X-rays and clean at Berala Dental is $250, and included in that fee are three intraoral X-rays, an OPG for new patients and thereafter every two to five years depending on bone loss and periodontal status, intraoral photos, the clean itself and a fluoride treatment, plus a periodontal chart where the clinician judges one is needed. Where periodontal treatment is indicated, the initial phase is $1,400 to $1,600 all-inclusive with three-monthly maintenance at $400. All figures assume no health fund contribution; yours may pay part of it depending on your policy, and a written quote is provided before treatment begins.

Quick answers

Can receding gums grow back?

Not on their own, and no toothpaste or rinse regrows them. Tissue can be replaced surgically with a gum graft in selected cases. For most people the aim is to stop the recession progressing and manage the sensitivity.

Does receding gums mean I have gum disease?

Not necessarily. Recession from heavy brushing, grinding or thin tissue can occur with entirely healthy bone. Distinguishing the two requires a periodontal chart and X-rays, because they can look identical from the outside.

How do I stop my gums receding further?

Identify the cause and remove it. That usually means treating any gum disease, switching to a soft brush with light pressure and a non-horizontal technique, addressing grinding, and having the measurements repeated over time to confirm it has stopped.

Is a gum graft worth it?

It depends on why it is being considered. Grafting has clear value where recession is progressing, where sensitivity is not manageable otherwise, or where the appearance genuinely matters to the person. Stable, comfortable recession is often better monitored than treated.

Finding out what is driving it

Recession has several possible causes, and they need different responses. Measuring it is the step that turns guesswork into a plan.

Berala Dental has cared for gums in Berala since 2002, and no question is a silly one.
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You can also read about deep cleaning and periodontal treatment, what sensitivity to cold means, gingivitis, the reversible stage of gum disease, or how our fees work. The Healthdirect Australia guide to gum disease is a useful general reference.

Written and reviewed by Humzah Aly, Oral Health Therapist. This article is general information only and is not a substitute for personalised dental advice. Please see a dental practitioner to discuss what is right for you.