What is gum recession?
Gum recession is when the edge of the gum moves down towards the root, leaving part of the root visible. It is treated first by removing the cause and then, where useful, with a gum graft that covers the root or thickens the gum. Not every recession needs surgery, but every recession deserves a diagnosis.
Signs include:
- a tooth that looks longer than its neighbours;
- a yellowish or darker area near the gum, which is the root;
- sensitivity to cold or to brushing in that spot;
- sometimes a small notch at the neck of the tooth.
Recession is common in adults and can affect people who brush very conscientiously. That is one of its paradoxes: overly vigorous brushing is a classic cause.
Why gums recede
Recession almost always results from a predisposition combined with a trigger.
The predisposition is mainly a thin gingival phenotype: in some people, the gum and bone covering the root are naturally very thin, especially over the canines and lower front teeth. A tooth positioned forward in the arch, outside its bony envelope, is also more exposed.
The most common triggers:
- traumatic brushing: a hard brush, horizontal scrubbing, too much pressure;
- periodontal disease, which destroys bone and attachment and lets the gum drop;
- orthodontic movement of teeth outwards where the bone is thin;
- a frenum (small fold of tissue) attached too close to the gum margin, pulling on it with each lip movement;
- a piercing of the lip or tongue that rubs against the gum;
- smoking, which weakens the tissues;
- a crown or filling with a poorly fitting edge at the gumline.
Clenching is often mentioned. Its direct role in recession is still debated, but it may contribute to notches at the neck of the teeth.
Consequences and diagnosis
An exposed root is less protected than the crown of the tooth. It has no enamel covering, which explains sensitivity to cold, a topic covered in our article on tooth sensitivity. It is also more vulnerable to decay and wear. On front teeth, appearance is often what prompts the visit.
Diagnosis relies on a periodontal examination: measuring the depth of the recession, the thickness and width of the remaining keratinised gum and, above all, the state of the attachment between the teeth. Since the 2017 EFP and AAP classification, recessions are described using the Cairo classification:
- RT1: no attachment loss between the teeth, the papilla is intact;
- RT2: attachment loss between the teeth, but less than on the visible surface;
- RT3: attachment loss between the teeth equal to or greater than on the visible surface.
This distinction is key: the better the attachment between teeth is preserved, the more realistic full root coverage becomes.
Non-surgical options
Not every recession needs an operation. A shallow, stable recession without troublesome sensitivity or cosmetic concern can simply be monitored, provided its cause has been dealt with.
The first step is always the same:
- correct your brushing: soft brush, gentle movement from gum to tooth, no horizontal scrubbing, as described in our article on brushing technique;
- treat any inflammation or gum disease;
- remove a problem piercing and stop smoking;
- revise an ill-fitting restoration.
For sensitivity, desensitising toothpastes, fluoride varnishes applied in the practice or a small bonded composite at the neck of the tooth can bring relief. The composite also restores a wear notch. These measures do not move the gum back up, but they stabilise the situation and improve comfort.
Gum grafting: the main techniques
When recession is progressing, bothers you aesthetically, causes significant sensitivity or comes with gum that is too thin, mucogingival surgery may be proposed as part of gum treatment. The most widely used techniques:
- subepithelial connective tissue graft: a thin graft is taken from beneath the surface of the palate, placed over the root and covered by the patient's own gum, moved upwards (coronally advanced flap). This is the reference technique for root coverage, particularly in the aesthetic zone;
- the tunnel technique: instead of cutting through the papilla, the dentist creates a "tunnel" under the gum through small incisions, slides the graft in and draws the gum towards the crown. It preserves blood supply well and suits several adjacent recessions;
- free gingival graft: mainly used to create a band of thick, resilient gum where it is missing rather than to cover a visible root, as its colour blends in less naturally;
- substitutes: collagen matrices of animal origin or other biomaterials can, in some cases, replace tissue taken from the palate. Enamel matrix derivatives are sometimes added.
The choice depends on the recession class, the number of teeth, gum thickness and your expectations.
The procedure, recovery and results
Grafting is carried out under local anaesthetic in the practice. Discomfort afterwards often concerns the palate, when tissue is taken from there, more than the grafted area. A palatal plate or dressing may protect the donor site.
Usual instructions:
- soft, lukewarm food for the first few days, chewing on the other side;
- do not brush the grafted area for the period indicated, and use the prescribed mouthwash;
- do not pull your lip to look at the graft;
- avoid smoking, which compromises the graft's blood supply;
- come back for stitch removal and check-ups.
The result is judged over several months, as the gum matures and its colour blends in. Full coverage is a realistic aim for RT1 recessions and is often partial for RT2. For RT3, coverage is unpredictable, and the goal is rather to thicken and stabilise the gum. Your dentist should give you honest expectations before the procedure.
Preventing recession and getting assessed in Rabat
The best graft is the one you never need. A few habits protect your gums: a soft brush with light pressure, suitable interdental brushes, regular scaling, stopping smoking and a check before any orthodontic treatment when the gum is thin. In children and teenagers, a frenum pulling on the gum can be spotted early.
At German Dental Clinic in Agdal, assessing a recession includes measuring the gum and attachment, identifying the cause and explaining the options, from simple monitoring to grafting. If you live in Rabat and a tooth looks longer or feels more sensitive, you can book an appointment for an assessment.
Frequently asked questions
Can receding gums grow back on their own?
No, gum that has receded does not grow back by itself. Removing the cause, such as aggressive brushing or inflammation, stops it progressing. When the gum is merely swollen from inflammation, its shape may change after treatment, but an exposed root can only be covered again with surgery.
Is a gum graft painful?
The procedure is done under local anaesthetic and is not usually painful. In the following days, discomfort mainly affects the palate when a graft has been taken from there. It is generally well controlled with the prescribed painkillers, a soft diet and protection of the donor site.
Does a gum graft last?
A well-integrated graft generally gives thicker, more stable gum than the original. How well it lasts, however, depends on removing the cause: if traumatic brushing, smoking or inflammation continue, a new recession can appear. Regular check-ups are part of the result.
Can recession make you lose a tooth?
An isolated recession caused by brushing, without gum disease, rarely leads to tooth loss. The risk increases when recession is part of periodontitis with bone loss between the teeth. That is why the assessment distinguishes a localised recession from more widespread gum disease.
Can a graft be done before or after orthodontic treatment?
Yes, depending on the situation. When the gum is very thin and teeth need to move outwards, thickening it beforehand may be discussed. In other cases, it is better to wait until treatment ends to judge the recession with the teeth in their final position. The periodontist and orthodontist coordinate this decision.
The information on this page is general. Only a consultation allows a diagnosis and a suitable treatment plan.
