Gum recession can be slowed, stopped, or reversed depending on how far it has progressed. Mild cases often respond to non-surgical treatments like deep cleaning and better oral hygiene, while moderate to severe recession typically requires a surgical procedure to restore lost tissue. The right approach depends on how much gum tissue you’ve lost, whether bone loss is involved, and whether the roots of your teeth are already exposed.
How Dentists Assess the Severity
Before recommending treatment, a periodontist will evaluate your recession using a classification system that predicts how much root coverage is possible. The key factor is whether the bone and soft tissue between your teeth (the papilla) is still intact.
In the earliest stages, the bone and surrounding tissue are preserved, and complete root coverage is achievable with treatment. As recession advances and that tissue between teeth shrinks or disappears, only partial coverage becomes realistic. In the most severe cases, where the papilla is essentially gone, full root coverage isn’t possible regardless of technique. The width of the remaining tissue matters too: papillae that are 3 mm or wider at the base provide better blood supply for a graft to survive, while narrower tissue reduces the predictability of a good outcome.
This assessment is what separates a case where your dentist might say “let’s watch it” from one where they recommend surgery soon. Getting evaluated early, before bone loss begins, gives you the most treatment options and the best chance of full correction.
Non-Surgical Treatment: Scaling and Root Planing
For mild recession caused by gum disease, the first-line treatment is scaling and root planing, commonly called a deep cleaning. Scaling removes tartar and bacteria that have built up below the gumline and around the roots of your teeth. Root planing then smooths the root surfaces so plaque and tartar can’t easily reattach.
This procedure won’t regrow lost gum tissue, but it can stop the progression of recession by eliminating the bacterial infection driving it. When gum disease is caught early, deep cleaning can prevent both further recession and tooth loss. Your dentist may use local anesthesia during the procedure, and it’s typically done in one or two visits depending on how many areas of your mouth need treatment.
Gum Graft Surgery
When recession has exposed tooth roots or progressed beyond what deep cleaning can address, gum grafting is the standard surgical treatment. There are three main types, and the one your periodontist recommends depends on your specific situation.
Connective Tissue Graft
This is the most common type for exposed roots. The surgeon opens a small flap in the roof of your mouth, removes a piece of connective tissue from underneath, then stitches that tissue over the exposed root area. The flap on your palate is closed back up. This approach is used specifically to cover exposed roots, reduce tooth sensitivity, and protect against decay in the newly vulnerable area.
Free Gingival Graft
Instead of taking tissue from under a flap, this technique removes a thin piece directly from the surface of the roof of your mouth. Because it uses a smaller amount of tissue, the surgeon can make more precise modifications to your gumline. It’s often chosen when the goal is to thicken existing gum tissue rather than cover a large area of exposed root.
Pedicle Graft
This option uses gum tissue from right next to the recession site rather than from your palate. The surgeon creates a flap from healthy neighboring gum tissue and repositions it over the area that needs coverage. You need to have enough healthy tissue adjacent to the problem area for this to work, but the advantage is that the graft keeps its own blood supply since it’s never fully detached.
The national average cost for gum graft surgery in the United States is around $2,742, with prices ranging from roughly $2,120 to $4,980 depending on the extent of treatment and your location.
The Pinhole Surgical Technique
A newer alternative to traditional grafting, the Pinhole Surgical Technique (PST) skips the palate altogether. Instead of transplanting tissue, the periodontist makes a tiny hole in your existing gum tissue, loosens it with specialized instruments, and repositions it to cover the exposed roots. Collagen strips are placed through the pinhole to stabilize the tissue in its new position.
PST has a success rate above 90%, comparable to traditional gum grafting. The major advantage is recovery time. Most patients return to normal activities immediately after the procedure. You’ll need to avoid brushing and flossing for the first 24 hours and stick to soft foods during that window, but after that you can start reintroducing firmer foods. There’s no palate wound to heal, which eliminates the most uncomfortable part of traditional graft recovery. Patient satisfaction with PST tends to be high for this reason.
Not everyone is a candidate. PST works best for certain recession patterns, and your periodontist can tell you whether it’s appropriate for your case.
Regenerative Treatments
In some cases, particularly when bone loss accompanies the recession, your periodontist may apply a protein-based material during surgery to encourage your body to rebuild the structures that anchor your teeth. One well-studied option uses proteins naturally produced during tooth development, primarily a protein called amelogenin. When applied to a damaged area, these proteins stimulate the cells in your periodontal ligament to migrate, multiply, and differentiate into the types of cells needed to regenerate bone, root-covering tissue (cementum), and the ligament fibers that connect teeth to bone.
This isn’t a standalone treatment. It’s used as an addition to surgical procedures like gum grafting, applied directly to the root surface before the graft is placed. The goal is to achieve true regeneration of the supporting structures rather than simply covering the root with soft tissue.
Recovery After Gum Surgery
If you have traditional gum graft surgery, plan for about two weeks of modified eating and careful oral hygiene. During the first one to two weeks, stick to soft, cool, non-acidic foods and avoid chewing on the graft site. Skip hot coffee for at least the first 48 to 72 hours. Carbonated beverages can irritate the surgical site and even cause the graft to fail, so avoid those as well. Don’t drink through a straw, as the suction can dislodge healing tissue. Alcohol should be avoided for at least the first week.
For oral hygiene, do not brush anywhere near the graft site until your periodontist clears you. When you do resume brushing that area, use an extra-soft toothbrush and follow their specific instructions. Avoid alcohol-based mouthwashes, which can burn and dry out the healing tissue. Sleep with your head slightly elevated to help manage swelling. If you smoke, stop for at least the first week. Smoking delays healing and significantly raises the risk of complications.
Managing Sensitivity at Home
Whether you’re waiting for a procedure or managing mild recession that doesn’t yet need surgery, exposed roots can cause significant sensitivity to hot, cold, and sweet foods. Desensitizing toothpaste is the most accessible way to manage this. Look for products containing potassium nitrate, stannous fluoride, arginine, or strontium chloride. These ingredients work by calming the nerve signals inside your teeth.
One thing to know: desensitizing toothpaste isn’t instant. It works best with consistent, long-term use and can take several weeks before you notice a meaningful difference. Use it as your regular toothpaste rather than applying it occasionally.
Beyond toothpaste, the basics matter. Brush with a soft-bristled toothbrush using gentle pressure, since aggressive brushing is one of the most common causes of recession in people who don’t have gum disease. If you clench or grind your teeth at night, a custom mouthguard can reduce the mechanical stress on your gums. And if gum disease is the underlying cause, staying on top of professional cleanings (your dentist may recommend every three to four months rather than every six) helps keep bacteria levels low enough to prevent further tissue loss.