Gingival recession, commonly known as receding gums, occurs when the margin of the gum tissue wears away or pulls back, exposing more of the tooth structure or the root underneath. This exposure often leads to increased tooth sensitivity and can make teeth appear noticeably longer. Once this soft tissue is lost, it cannot spontaneously return to its original position or regenerate naturally. While the lost tissue will not grow back on its own, various professional interventions are available to stop the progression of recession and restore the coverage, health, and appearance of the gum line.
The Biological Reality: Why Gum Tissue Does Not Regenerate Naturally
The reason gum tissue does not regenerate is rooted in the complex, specialized nature of the tissue that anchors the tooth. While the mouth is known for rapid healing of the outer epithelial layer, recession involves the loss of the underlying connective tissue and the periodontal ligament fibers that form the attachment to the tooth root. Once these specialized attachment fibers are destroyed, the body lacks the specific cellular components needed to rebuild this complex attachment spontaneously. Rapid-healing epithelial cells migrate downward along the root surface faster than the slower-moving cells required to rebuild the bone and ligament. This results in a permanent loss of the attachment apparatus, which requires surgical intervention to reverse.
Key Factors That Cause Gum Recession
The most common driver of gum recession is periodontal disease, a bacterial infection beginning with plaque and tartar buildup. Bacteria release toxins that trigger chronic inflammation, slowly destroying the gum tissue and underlying bone. As supporting bone is lost, the gum tissue pulls away from the tooth, creating pockets that harbor more bacteria.
Mechanical trauma from aggressive oral hygiene is another significant factor, often seen in individuals who brush too hard or use a hard-bristled toothbrush. This abrasive action physically wears away the delicate gingival tissue over time. Switching to a soft-bristled brush and adopting a gentle, circular brushing technique is a simple, effective preventative measure.
A person’s genetic makeup also plays a role, as some individuals are predisposed to having a thin gingival biotype, meaning naturally thin and fragile gum tissue. This thin tissue is more susceptible to recession from minor trauma or inflammation. Furthermore, using tobacco products significantly increases the risk of recession because it impairs blood flow, making the tissue more vulnerable to infection and less able to heal.
Misaligned teeth or orthodontic forces can also contribute to recession, especially when teeth are positioned too far outside the jawbone, resulting in insufficient bone and gum coverage. Excessive clenching or grinding of the teeth (bruxism) places excessive force on the surrounding tissues, accelerating the breakdown of the gum attachment. Addressing these underlying issues, such as using a nightguard for bruxism or seeking orthodontic correction, is necessary to halt the progression.
Professional Treatments for Restoring Gum Coverage
Because lost gum tissue is permanent, professional treatment focuses on halting the progression of the recession and physically restoring the lost coverage. For cases driven by chronic inflammation or infection, the initial non-surgical intervention is scaling and root planing, often called a deep cleaning. This procedure involves meticulously removing hardened plaque and tartar from above and below the gum line, then smoothing the exposed tooth root surfaces. This process eliminates the source of inflammation and allows the remaining gum tissue to reattach more firmly to the cleaned root surface, stabilizing the condition.
For aesthetic concerns or minor recession where surgery is not desired, non-invasive cosmetic options can mask the exposed root surface. Composite bonding involves applying a tooth-colored or gum-colored resin material directly to the exposed root to cover it and reduce sensitivity. Gingival veneers, or gingival masks, are thin, removable, custom-made prostheses made from a flexible material that snaps over the affected area to conceal the recession and restore the appearance of a full gum line.
When biological restoration of the lost tissue is needed, surgical procedures are often performed by a periodontist. Gum grafting is the most common approach, involving transplanting tissue from one area of the mouth to the recessed site. These surgical solutions physically re-establish the protective barrier, covering the sensitive root surface and stabilizing the gum structure.
Connective Tissue Graft
A connective tissue graft, considered the gold standard, harvests tissue from under the surface of the palate and places it over the exposed root to encourage new blood vessel formation and tissue integration. This technique is highly effective for root coverage and provides excellent aesthetic results.
Free Gingival Graft
The free gingival graft involves taking a small piece of tissue directly from the surface of the palate to create a wider band of firm, resilient gum tissue. This procedure is often used when the primary goal is to thicken very thin gum tissue to prevent future recession.
Pinhole Surgical Technique (PST)
An alternative, less invasive surgical option is the Pinhole Surgical Technique (PST), which uses a small hole in the gum tissue to gently loosen and reposition the existing gum down over the exposed root.