Gingivitis is the mildest form of gum disease, an inflammation of the gums caused by plaque accumulation along the gumline. Symptoms include redness, swelling, and bleeding when brushing or flossing. Whether gums can grow back depends entirely on the severity of the disease. Taking action at the first sign of gum irritation can prevent permanent damage to the supporting structures of the teeth.
Understanding the Stages of Gum Disease
Gum disease starts with gingivitis, which is a fully reversible condition. At this stage, the bacterial infection has only irritated the soft gum tissue, without causing destruction to the underlying bone or connective tissue. Professional cleaning combined with improved home care can eliminate the inflammation, allowing the gum tissue to return to its healthy state.
If gingivitis is not addressed, it advances into periodontitis. In periodontitis, chronic inflammation causes the gums to pull away from the tooth, creating deep pockets where bacteria thrive. This infection destroys the periodontal ligament and the alveolar bone that anchors the teeth. This loss of supporting structure leads to gum recession, making the teeth appear longer and exposing sensitive root surfaces. The physical damage caused by periodontitis is permanent.
The Biological Reality of Gum Tissue Loss
Once gum recession occurs due to periodontitis, the lost tissue does not possess the capacity for spontaneous regeneration. The specialized gingival tissue, which forms a tight seal around the tooth, is destroyed along with the periodontal ligament and supporting bone. Adult human biology does not contain the necessary stem cell populations or cellular signals to naturally rebuild these specialized structures once compromised by disease.
The body’s wound-healing response focuses on repair, resulting in scar tissue, rather than true regeneration of the original tissue. Therefore, when the gumline recedes, the gum tissue will not grow back to cover the exposed root surfaces on its own. While the disease can be halted and inflammation reduced, the lost gum and bone remains a permanent deficit without intervention.
Restoring Gum Health When Tissue Is Lost
Since natural regrowth is not possible, professional dental interventions are necessary to halt the disease and restore lost tissue. The first treatment for established periodontitis is scaling and root planing (SRP), or deep cleaning. This non-surgical procedure involves meticulously removing hardened plaque and tartar from above and below the gumline. Root planing smooths the tooth root surfaces, which discourages bacteria from reattaching and helps the remaining gum tissue reattach to the cleaned roots, reducing periodontal pocket depth.
If significant gum recession has occurred, surgical interventions like gum grafting may be recommended by a periodontist, a specialist in gum health. Gum grafting procedures are restorative, physically covering exposed root surfaces to reduce sensitivity and protect the tooth from further damage.
Connective Tissue Graft
This is the most common technique, where a small piece of tissue is harvested from beneath a flap on the palate and stitched over the area of recession.
Free Gingival Graft
This graft uses tissue taken directly from the surface of the palate to increase the thickness and volume of thin gum tissue.
Pedicle Graft
This graft is used when there is enough healthy gum tissue adjacent to the recession site. A flap of nearby gum tissue is partially cut, leaving one edge attached to maintain its blood supply, and then stretched laterally to cover the exposed root before being sutured.
These grafting techniques do not regenerate the original structures but successfully restore the protective barrier around the tooth, improving both function and appearance.
Maintaining Long-Term Gum Health
After professional treatment, maintaining long-term gum health depends on consistent and effective home care. Following periodontitis, dental professionals recommend a strict schedule of periodontal maintenance visits, often every three to four months. These frequent appointments allow for monitoring pocket depths and removing bacteria that can repopulate below the gumline.
Daily oral hygiene must include gentle brushing with a soft-bristled toothbrush to avoid irritating the gums or causing new recession. Brushing at a 45-degree angle to the gumline helps clean the area where plaque accumulates. Flossing or using interdental brushes once a day is necessary to clean the tight spaces between teeth. Avoiding tobacco products is a significant factor, as smoking is a major risk factor for recurrence and hinders healing.