What Are Receding Gums?

Medically reviewed by Edmund Khoo, DDS

Receding gums, also known as gingival recession, are when the gum tissue pulls away from the tooth, exposing the root surface of the tooth underneath. Receding gums make it easier for bacteria to grow, which can eventually lead to inflammation and tooth decay that could lead to chronic tooth diseases.

Receding gums are a common occurrence in older adults, but they can also occur in younger age groups, including among young adults.

There are several causes of receding gums as well as treatment options and preventative measures to help manage the condition and prevent it from getting worse.

Types of Receding Gums

There are four classes of receding gums, which fall under the Miller Classification of Marginal Tissue Recession, a system that rates the severity of gingival recession.

Class 1

Class 1 gum recession is mild, with no loss of soft tissue or interdental bone (the bone in between teeth). If gingiva (gums) are still attached to the facial (the surface of the tooth facing the cheeks and lips), it is classified as Class 1 recession. Complete root coverage can be restored.

Class 2

As with Class 1 recession, there is no loss of soft tissue or the bone in between teeth in Class 2 recession. The main difference is the gingiva is unattached from the facial. It is also possible to restore complete root coverage with treatment.

Class 3

Class 3 recession is where there is a loss of bone in between the teeth and a loss of soft tissue. It may also involve displacement of the tooth. If this stage becomes more severe, only partial coverage of the root can be achieved with treatment. However, in milder cases of Class 3, it is possible to restore complete root coverage during treatment.

Class 4

Class 4 recession is the most advanced form of recession where there is a lack of papilla (the gum tissue in between the spaces of your teeth). There is also a loss of bone between the teeth. At this stage, regardless of the severity of the Class 4 recession, root coverage cannot be achieved.

Symptoms of Receding Gums

There are a few symptoms that may indicate receding gums. Some of these symptoms are also present in other oral health conditions, so if you think you have receding gums, you'll need to visit a board-certified dentist for an accurate diagnosis.

Symptoms of receding gums include:

• Increased tooth sensitivity to foods, liquids, and temperatures
  

• Tooth decay

• Non-carious cervical lesions (NCCLs), or the loss of hard tissue from the teeth that appear as round-shaped depressions

• Visible exposure of the tooth's root; the tooth may appear longer

• Increase in dental plaque
  

What Causes Receding Gums?

Receding gums happen when the gum tissue starts to pull away from the tooth, exposing the root surface of the tooth underneath. As the recession becomes more severe, bone and soft tissue loss can occur around the teeth.

Several factors can cause receding gums. Long-term habits of improper brushing—brushing too hard or not frequently enough—or smoking can contribute to gum recession. Plaque buildup that leads to inflammation in the gums can also be a factor.

The most common cause of receding gums is periodontal disease, or gum disease. Poor oral hygiene—avoiding daily brushing and flossing and regular dentist appointments—can often lead to gum disease, such as gingivitis. Tobacco use, dry mouth, diabetes, and having a weakened immune system can also put you at risk for gum disease.

Risk Factors

There are a few conditions or factors that can make someone more likely to have receding gums. These include:

• Diabetes

• Thin gum tissue

• A history of progressive gum recession or inflammatory periodontal disease (an inflammatory condition of the gums and the periodontium, the supporting structures for the teeth)

• Brushing too hard, especially with a stiff-bristled toothbrush

• Smoking

• Aging

How Are Receding Gums Diagnosed?

If you think you have symptoms or risk factors for receding gums, visit your dentist for a check-up. Seeing your dentist for regular dental appointments is an important part of maintaining good oral hygiene and health.

Your dentist will look for physical signs of receding gums or may run some imaging tests to make a diagnosis and classify whether you have Class 1, 2, 3, or 4 gum recession. These tests may include:

• 3D imaging: A highly accurate digital test that uses superimposed (layered) three-dimensional (3D) images to diagnose gum margin changes

• High-resolution ultrasonography: An imaging test that uses high-frequency sound waves to produce detailed images of the gums, teeth, and bones

• Radiography: An X-ray beam that passes through soft tissues to produce images of your teeth and bones

• Periodontal probe: A handheld dental instrument used by dentists to measure pocket depths and the level of gum recession
  

Treatments for Receding Gums

If you have receding gums, treatment is necessary to protect your oral health, reduce harmful bacteria in the mouth, and prevent the recession from progressing to a more severe stage. Gums do not grow back after receding so they need to be treated by your dentist or managed with preventative care.

Preventative Treatment

To treat receding gums, your dentist may first recommend preventative treatment options. Depending on the case, they may also suggest options for procedures and surgeries that can help restore root coverage completely.

Preventative treatment options for mild cases of gum recession include learning proper tooth-brushing techniques to control plaque and reduce erosion of enamel (the hard outer layer of teeth) and using toothpaste designed for sensitive teeth.

Surgery

There are several surgical options for single or multiple recessed gums, which include connective tissue grafts (CTGs), coronally advanced flap (CAF) treatments, and tunneling procedures.

• Connective tissue graft (CTG): Also known as a gum graft, this involves your dentist removing tissue from the roof of your mouth and then placing it in the area that needs grafting and sewing it into place.

• Coronary advanced flap (CAF): For single recessed gums, CAF uses two vertical-releasing incisions to create a trapezoid-shaped flap over the areas of gum recession. A modified CAF procedure for multiple recessed gums does not use vertical incisions.

• Tunneling procedures: These work by undercutting and lifting the papilla (the gum tissue found between the spaces of the teeth).

Complementary Treatments

Complementary treatments include the use of orthodontics (devices that correct irregular tooth alignment and bite, such as mouthguards), which can also prevent gum recession from getting worse.

How To Prevent Receding Gums

You can incorporate some strategies into your daily routine to prevent receding gums. Try the following tips to improve your oral health and reduce your chances of developing receding gums:

• Brush your teeth twice a day

• Floss your teeth once per day

• Visit your dentist regularly for an examination and professional cleaning

• Use a soft or ultra-soft toothbrush, along with a toothpaste with a low Relative Dentin Abrasivity (RDA) value, which is less damaging to the tooth enamel

• Avoid smoking, as tobacco increases your risk of gum disease

• Avoid sweets and beverages containing added sugars
  

Related Conditions

Receding gums are often caused by or associated with other dental conditions.

Chronic inflammatory periodontal disease is a long-lasting inflammatory condition that destroys gum tissues and periodontium (the supporting structures for the teeth). It also causes a gradual bone loss that can lead to root exposure and gum migration.

Another related condition is occlusal trauma, which is an injury to the teeth that occurs due to excessive force. This causes the teeth to not align properly and can speed up bone and soft tissue loss.

A Quick Review

Receding gums, or gingival recession, is when the gums pull back from the teeth to reveal the surface of the root underneath. There are four classifications of receding gums, which range in severity and symptoms.

Your dentist can perform tests to diagnose receding gums and determine a treatment plan for you. Receding gums are common and can be successfully managed and treated with a combination of preventative measures and surgical treatments.

Frequently Asked Questions

Can gums grow back after receding?

Gums can't grow back after receding. Once gums have receded, they will require preventative care or treatment by a dentist.

At what age do gums start to recede?

Gum recession has been found to occur in children as young as 10 years old. However, gum recession is most common among older adults, as the frequency of gum recession increases with age.

How do I stop my receding gums from getting worse?

To prevent receding gums from getting worse, it is important to maintain a healthy oral health routine by brushing your teeth twice a day and flossing your teeth once a day. It's also recommended to visit your dentist regularly for a professional cleaning and examination. It's best to avoid or limit smoking.

What toothpaste is best for receding gums?

A toothpaste with a low Relative Dentin Abrasivity (RDA) value, which is less damaging to the tooth enamel, is best for receding gums. There are also toothpastes that are specially formulated for sensitive teeth and for gum health.

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