Receding Gums: Why It Happens and What Can Be Done

Most people notice recession in the mirror before they notice anything else. A tooth looks a little longer than it used to. There is a small notch near the gumline that your fingernail catches on. Or cold water hits one tooth and you feel a quick zing that you did not used to feel. By the time any of that is noticeable, it has usually been happening slowly for years. Here is what is actually going on, and what can and cannot be done about it.

What recession actually is

Your gum normally sits like a collar around each tooth, covering the spot where the crown meets the root. Recession means that collar has pulled back, and some of the root is now out in the open.

That matters because the root is not built like the part of the tooth you usually see. The crown is covered in enamel, which is hard and does not feel much. The root has no enamel on it. It is softer, the nerve pathways sit closer to the surface, and it picks up decay more easily.

Why it happens

There is rarely one single cause, but these are the ones I see most often:

• Gum disease. Bacteria and tartar below the gumline cause inflammation that breaks down the attachment and the bone holding the gum in position.

• Brushing too hard, or with a hard-bristled brush. Scrubbing sideways wears away both gum tissue and tooth surface right at the gumline.

• Thin gum tissue, which tends to run in families. Some people simply start with less tissue to work with.

• Tooth position. A tooth that sits outside the arch or is crowded forward has thinner bone and gum covering it.

• Grinding and clenching, which load teeth in directions they were not designed to handle.

• Tobacco, particularly chewing tobacco held in the same spot each time.

• A lip or tongue piercing that rubs one specific area day after day.

Sorting out which of these is driving it matters, because the treatment is different for each one.

Why a receded tooth gets sensitive

Exposed root is the usual reason cold air or a cold drink produces a sharp, short zing on one particular tooth. That kind of sensitivity comes and goes quickly. If instead you have an ache that lingers for minutes, or pain that wakes you up, that is a different problem and worth having looked at rather than filed under sensitive teeth.

The other consequence is decay. Root surfaces give way to cavities more readily than enamel does, so recession tends to bring cavities right at the gumline. Those are also harder to fill well, because they sit at the edge of the gum where it is difficult to keep dry and see clearly.

Does gum tissue grow back?

The honest answer is no. Gum that has receded does not grow back on its own, and no toothpaste or rinse will regrow it, whatever the package says. What we can do is stop it from getting worse, treat the sensitivity, and in some cases cover the exposed root surgically.

That is why I spend most of the appointment looking for the cause rather than the fix. Covering a root without changing what wore it down in the first place only buys time.

What we can do about it

• Measure it and track it. I record how much recession there is on each tooth so that at your next visit we can tell whether it is stable or still moving. That single piece of information changes what is worth doing.

• Treat active gum disease. Cleaning below the gumline, sometimes a deep cleaning, then rechecking how the tissue responds.

• Change what is causing the wear. A softer brush and a different technique. On its own, this often stops mechanically driven recession from progressing.

• Treat the sensitivity directly. Fluoride varnish in the office, a desensitizing toothpaste used consistently over several weeks, or bonding a thin layer of filling material over the exposed area.

• A night guard, if grinding is part of the picture.

• A gum graft, where tissue is moved or added to cover the exposed root. Whether you are a good candidate depends on which teeth are involved, how much tissue is available nearby, and what caused the recession. This is often done by a periodontist.

• Orthodontic treatment, when a tooth sitting in the wrong position is the real driver.

What helps at home

• Use a soft-bristled brush. Not medium. An electric brush with a pressure sensor is useful mostly because it tells you when you are pushing too hard.

• Think of brushing as guiding the bristles along the gumline rather than scrubbing. The brush does the work.

• Clean between your teeth every day. A good share of recession starts as gum disease, and gum disease starts between the teeth.

• If cold bothers you, give a sensitivity toothpaste a fair trial. It generally takes a few weeks of consistent use, not a few days.

• Keep your checkups on schedule. Comparing one visit to the next is how we catch recession that is still moving while there are still easy options.

When to have it looked at

Sooner is better, and it does not need to be urgent to be worth a visit. If you notice a tooth looking longer, a notch you can feel at the gumline, sensitivity that has settled on one tooth, gums that bleed or stay puffy, or a tooth that feels like it moves, bring it up. Recession caught early is mostly a monitoring and prevention problem. Caught late, after bone has been lost around the tooth, the options get narrower.

If you are not sure whether what you are seeing is recession or just the way your teeth have always looked, that is a perfectly good reason to ask. It takes a minute to check, and knowing where you stand is worth more than guessing at it in the mirror.

This post is general information, not a diagnosis. Gums recede for different reasons in different people, and what is right for your situation depends on an exam.

Hashimi Dental, 3701 Market St. Suite E, Riverside, CA 92501.