Receding Gums: Causes and How to Stop the Progression
“My teeth look longer than they did a few years ago.” This is how many patients describe gum recession without knowing the name of what they are experiencing. The tooth has not grown. The gum has receded, exposing part of the root that should normally be covered.
It is a slow process, usually painless in its early stages and, unlike gum inflammation, it does not resolve on its own. However, its progression can be stopped, and the difference between taking action now and waiting another five years can be considerable.
What Is Gum Recession?
Gum recession occurs when the gum margin moves towards the root of the tooth, exposing a root surface that would normally be protected.
Unlike enamel, which covers the crown of the tooth, the root is covered by cementum, a thinner tissue that is considerably less resistant to wear and acid attack.
This is why gum recession is not simply an aesthetic concern. The exposed area is structurally more vulnerable than the part of the tooth that was previously visible.
How to Tell If You Have Receding Gums
The most common signs include teeth appearing longer, a yellowish area becoming visible near the gumline — the natural colour of the root, which is darker than enamel — sensitivity to cold, and the sensation of a small step when running your fingernail or tongue over the transition between the crown and the root.
In many cases, recession is asymmetrical. It may affect only one or two teeth, typically the canines and premolars, rather than the entire dental arch. This localised pattern can often provide useful information about the underlying cause.
Main Causes
Traumatic Brushing
This is one of the most common causes in people with good oral hygiene, which may sound contradictory but is not. Brushing with excessive force, using a hard-bristled toothbrush or repeatedly brushing backwards and forwards horizontally can gradually wear away the gum tissue over the years.
There is one pattern that often points towards this cause: recession may be more pronounced on the side opposite the dominant hand. In right-handed people, the teeth on the left side can sometimes be more affected because the toothbrush is applied with greater pressure and less control. When this pattern is present, brushing technique should be carefully assessed.
Periodontal Disease
Periodontitis destroys the bone and supporting tissues around the teeth, and the gum recedes as this support is lost. In these cases, recession is a consequence of the disease, and it makes little sense to treat the recession without first controlling the inflammation causing it.
We have dedicated another article on the blog to periodontitis, including the signs that may help identify it before significant tissue loss occurs.
Bruxism and Occlusal Overload
Excessive and repeated forces on a tooth, whether caused by grinding the teeth at night or by premature contact that concentrates pressure in a particular area, may contribute to gum recession.
These teeth may also show a wedge-shaped lesion near the neck of the tooth, associated with a combination of excessive loading and brushing. When temporomandibular joint involvement associated with bruxism is suspected, the diagnostic assessment should include cone beam computed tomography (CBCT), which allows the joint and surrounding bone structures to be evaluated accurately.
We have also written another article about teeth grinding, its causes and what can be done about it.
Position of the Tooth Within the Dental Arch
Teeth that sit too far outside the dental arch, particularly towards the lip or cheek, may have less bone covering their outer surface. In some cases, this layer of bone is very thin or absent altogether, leaving the overlying gum without adequate support.
This is why dental crowding and poorly positioned teeth can be risk factors: not because of the overlap itself, but because certain teeth may be positioned unfavourably in relation to the available bone.
Gingival Biotype and Anatomical Factors
Some people naturally have thinner, more translucent gums. This gingival biotype is more prone to recession when exposed to factors that might have little or no effect in someone with thicker gum tissue.
Labial frenula that attach very close to the gum margin may also create tension and contribute to recession.
Smoking and Oral Piercings
Smoking compromises blood supply and the healing capacity of gum tissues.
Lip and tongue piercings can cause repeated mechanical trauma in a very specific area, and the resulting recession may be particularly noticeable on the tooth that is in direct contact with the piercing.
Consequences
Tooth Sensitivity
This is the complaint that most often brings patients to the dental practice.
The exposed root contains dentinal tubules that communicate with the inside of the tooth. Stimuli such as cold, heat, sweet foods or even air may therefore trigger a brief, sharp pain.
Root Caries
The root surface demineralises at a higher pH than enamel, meaning that it is considerably more vulnerable to tooth decay. Root caries can progress quickly and may be technically more difficult to restore, particularly when it extends below the gum margin.
Aesthetic Impact
When recession affects the front teeth, it can alter the visible proportions of the teeth and expose dark triangular spaces between them. This is a legitimate reason for seeking treatment, even though it is rarely the most urgent concern from a clinical perspective.
Can Receding Gums Grow Back on Their Own?
No. Lost gum tissue does not regenerate spontaneously, and no topical product, toothpaste or gel can make it grow back. It is worth being clear about this because a great deal of misleading information circulates on the subject.
What can be done is to stop the recession from progressing, which in many cases is both a realistic and sufficient objective, and, in selected situations, surgically cover the exposed root.
How to Stop the Progression
Correct Your Brushing Technique
Always use a soft-bristled toothbrush.
Apply light pressure, just enough for the bristles to make contact with the gums without bending excessively. Use gentle circular movements or brush from the gum towards the tooth rather than scrubbing backwards and forwards horizontally.
People using an electric toothbrush should allow the brush to do the work without applying additional pressure, which is one of the most common mistakes when switching from a manual toothbrush. Many electric toothbrushes include a pressure sensor, and it is worth using this feature.
Treat Underlying Gum Disease
When inflammation is present, professional scaling and periodontal treatment may be required, followed by maintenance appointments at intervals determined during the dental assessment.
Without controlling the underlying inflammation, other measures will have only limited effect.
Control Bruxism
When tooth wear and excessive loading are present, a night guard can help reduce the impact of the forces generated during sleep. We have explained in another article on the blog what a dental night guard is and when it may be recommended.
Correct Tooth Position
Orthodontic treatment may reposition teeth that sit too far outside the dental arch, moving them into a position with better bone support. This approach addresses the underlying cause rather than only the consequence.
However, an important point should be made: poorly planned orthodontic treatment in patients with a thin gingival biotype can worsen recession rather than improve it.
For this reason, assessing bone support and gum thickness before moving the teeth is essential. This is one of the reasons why orthodontic planning in patients with gum recession requires a detailed assessment.
Desensitising Treatments for Symptoms
Toothpastes designed for sensitive teeth and varnishes applied in the dental practice can help control sensitivity. They act on the symptom rather than the underlying cause and should therefore be regarded as complementary measures.
When Is Surgery Recommended?
A gum graft may be recommended particularly when sensitivity does not respond to conservative measures, when recession continues to progress despite controlling the risk factors, when very little attached gum remains to protect the tooth, or when the aesthetic impact is significant for the patient.
The technique used depends on the individual case, the amount of tissue available and the number of teeth involved. The amount of root coverage that can be achieved varies according to the extent of the recession and the amount of remaining bone between the teeth. Results are generally more predictable when there is no loss of interproximal bone.
Before any surgical procedure of this kind, the underlying cause must be controlled.
Treating gum recession surgically without correcting traumatic brushing or treating the periodontitis that caused it means, in practice, allowing the same problem to develop again.
When to Seek an Assessment
If you have noticed that your teeth appear longer, experience sensitivity to cold in a specific area or can feel a small step near the gumline, it is worth arranging a dental assessment.
The earlier the cause is identified, the simpler the necessary intervention tends to be.
At an early stage, correcting brushing technique and controlling the relevant risk factors is often enough to stabilise the situation without any additional treatment.
