Gingival recession, commonly known as receding gums, is a prevalent condition where the margin of the gum tissue pulls back, exposing more of the tooth’s root surface. This process affects a significant portion of the adult population, particularly those over the age of 65. When soft tissue like skin is damaged, the body typically responds with cellular turnover to restore the area. However, once gum tissue is lost, the body cannot spontaneously regrow the lost gum line to its original position. This biological limitation means that the complex support structures around the teeth require professional intervention for repair.
The Biological Barrier to Gum Regeneration
Gums do not grow back because of the complex, multi-tissue structure that forms the attachment between the tooth and the jaw. True regeneration requires the simultaneous regrowth of three distinct tissues: new cementum on the tooth root, new periodontal ligament fibers, and new alveolar bone. The body’s natural healing response is programmed for a simpler, faster closure, resulting in repair rather than regeneration.
When tissue is damaged, the body’s cells race to close the wound. However, the fast-migrating epithelial cells of the gum line always outpace the slower-moving cells needed for true attachment. This rapid cell migration results in a “long junctional epithelium,” a soft tissue adhesion that seals the area but fails to restore the complex fiber attachment. The body prioritizes sealing the exposed tooth root with a fibrous, scar-like tissue that lacks the organized architecture of the original gum.
The specialized cells with regenerative potential, such as progenitor cells in the periodontal ligament, are typically lost or displaced during the recession process. Without a scaffold and the correct biological signals, these cells cannot rebuild the dentogingival junction. This biological environment is designed for stability and defense, not for large-scale reconstruction of the supporting apparatus. Consequently, the natural healing process repairs the defect with a less functional attachment, preventing the spontaneous restoration of the lost gum tissue.
Factors That Lead to Gum Recession
Gum recession results from mechanical and inflammatory forces acting against the gum tissue. Periodontal disease is one of the most frequent causes, beginning when bacterial plaque accumulation triggers chronic inflammation in the gums. This inflammation, called periodontitis, leads to the progressive destruction of the supporting alveolar bone that anchors the tooth. As the bone is lost, the overlying gum tissue follows, migrating toward the tooth root apex.
Aggressive mechanical trauma is another common factor, typically stemming from improper or overly vigorous brushing techniques. Using a hard-bristled toothbrush or applying excessive force during a side-to-side scrubbing motion can abrade the gum tissue over time. This chronic destruction wears away the gum margin, especially in individuals with thinner gum tissue. This abrasive action can also cause notching at the cementoenamel junction, accelerating tissue loss.
Anatomical and genetic predispositions also play a part in determining susceptibility to recession. Individuals with a thin gingival biotype (gum tissue less than 1.5 millimeters thick) are more vulnerable to breakdown from both trauma and inflammation. Misaligned teeth or teeth positioned too far toward the cheek or tongue often have very thin bone covering the root. This lack of underlying bone support makes the gum tissue covering those roots more susceptible to recession, even with normal brushing.
Tobacco use contributes to recession by impairing the body’s ability to maintain healthy gum tissue. The chemicals in tobacco products cause vasoconstriction, reducing blood flow to the gums. This decreased circulation limits the delivery of oxygen and nutrients and hinders the immune response, making the tissue more prone to bacterial infection and less able to repair itself.
Treatment Options for Receding Gums
Since the body cannot spontaneously restore lost gum tissue, treatment focuses on halting the progression of loss and surgically reconstructing the affected area. For recession caused by periodontal disease, the first step is non-surgical intervention: scaling and root planing. This deep cleaning procedure removes hardened plaque and bacterial toxins from the tooth and root surfaces below the gum line. The goal is to eliminate the source of inflammation, allowing the remaining gum tissue to stabilize and reattach to the cleaned root surface.
When recession is severe or aesthetically concerning, surgical repair is the only method to restore the lost tissue dimension. The most common procedure is a connective tissue graft, which involves transplanting a small piece of tissue, typically taken from the palate. This transplanted tissue is then placed over the exposed root and sutured into place. It serves as a biological scaffold to increase the thickness and height of the gum line, providing a durable, protective layer over the vulnerable root surface.
Preventing further tissue loss requires ongoing lifestyle adjustments and changes in oral hygiene habits. Switching to a soft-bristled toothbrush and adopting a gentler, circular brushing motion is necessary to avoid future mechanical abrasion. For individuals who clench or grind their teeth, a custom-made night guard can mitigate the excessive force placed on the teeth and supporting structures. Addressing underlying factors like quitting tobacco use and maintaining regular professional dental care ensures the long-term stability of the gum line.