Gingival recession, commonly known as receding gums, is a frequent dental condition where the gum tissue pulls back from the tooth surface. This process gradually exposes the tooth root, which is normally protected by the gum line. This exposure creates small spaces or pockets where bacteria can accumulate, potentially leading to further damage and increased tooth sensitivity.
The Biological Reality of Gum Tissue
The short answer to whether gums can grow back naturally is no, they cannot. Once the specialized soft tissue that forms the gingiva has been destroyed or lost, the human body does not possess the regenerative capacity to restore it to its original level. This limitation is due to the unique cellular structure of the gingiva.
Unlike the skin, which contains a robust population of stem cells that allow for continuous and significant self-repair following injury, gum tissue lacks this extensive regenerative capability. The gingiva’s primary function is to form a tight, protective seal around the tooth. Once the specialized attachment fibers that connect the gum to the tooth root are lost, the body cannot simply rebuild this complex biological attachment.
Furthermore, gum recession is often associated with the underlying loss of alveolar bone, a supporting structure that the soft tissue follows, making natural regrowth even more improbable. The chronic inflammation and destruction that cause recession create permanent changes in the tissue architecture that cannot be reversed by the body’s intrinsic healing mechanisms alone. This biological reality means that intervention is necessary to either halt the recession or surgically replace the lost tissue.
Primary Causes of Gum Recession
The most frequent cause of gum recession is untreated periodontal disease, an inflammatory condition triggered by the accumulation of bacterial plaque and tartar. The body’s immune response to these bacteria releases inflammatory mediators that destroy the connective tissue and the underlying bone structure supporting the teeth. As the bone level decreases, the gum tissue follows this loss, resulting in recession and the formation of deep pockets.
Aggressive or incorrect tooth brushing is another highly common mechanical cause of tissue loss. Using a hard-bristled toothbrush or employing a forceful horizontal scrubbing motion acts as a chronic, low-level trauma that physically wears away the delicate gingival margin over time. This mechanical abrasion is often localized to the areas where the person applies the most pressure, typically resulting in U-shaped defects. Switching to a soft-bristled brush and adopting a gentle, circular brushing technique is a simple preventative measure.
Certain anatomical factors also increase susceptibility to recession, particularly the genetic predisposition known as a thin gingival biotype. Individuals with a thin biotype have gum tissue that is less than 1.5 millimeters thick, making it inherently more fragile and vulnerable to breakdown from physical trauma or inflammation. Similarly, the misalignment of teeth or the presence of parafunctional habits like bruxism, which involves clenching or grinding, can contribute to the problem. The excessive force from bruxism places undue stress on the periodontal ligament and bone, causing the gum tissue to pull away from the tooth.
Professional Treatments for Receding Gums
The management of gum recession focuses on professional interventions aimed at halting the process and restoring the lost tissue. The initial step for recession caused by bacterial infection is often a deep cleaning procedure called scaling and root planing. This non-surgical treatment involves scaling to meticulously remove hardened plaque and tartar from above and below the gum line, followed by root planing to smooth the exposed root surface. The goal of this procedure is to eliminate the bacterial toxins and encourage the remaining healthy gum tissue to reattach to the clean root surface, thereby resolving the underlying infection.
Soft Tissue Grafting
When the recession is severe or root coverage is required for aesthetic reasons or to reduce sensitivity, surgical procedures are often recommended. The most common restorative method is the soft tissue graft, which aims to replace the lost gum volume. The connective tissue graft (CTG) is widely considered the gold standard for achieving predictable root coverage and optimal aesthetic results. In this procedure, a small piece of connective tissue is harvested from beneath the surface layer of the palate and transplanted to the site of recession.
A free gingival graft (FGG) is a similar technique where a thin layer of tissue containing both the outer and connective layers is taken from the palate and secured to the recipient site. This technique is typically favored when the primary goal is to increase the width and thickness of the attached gum tissue, creating a more robust band of protection against future recession. In cases where the patient prefers to avoid a second surgical site on the palate, allograft materials utilizing sterilized donor tissue can be used as an alternative to the patient’s own tissue.
Pinhole Surgical Technique (PST)
A newer, less invasive option for treating mild to moderate recession is the Pinhole Surgical Technique (PST). This method involves creating a tiny pinhole in the existing gum tissue, through which specialized instruments are used to gently loosen and reposition the gum over the exposed root surface. Biocompatible collagen membranes are then inserted through the pinhole to stabilize the tissue and promote healing, often resulting in quicker recovery and immediate cosmetic improvement without the need for extensive suturing.