Receding gums happen gradually. You might notice a tooth looks longer than it used to, a notch near the gumline, or new sensitivity to cold. Gum recession exposes the root surface of the tooth, which is not covered by enamel. This guide explains common causes, how recession is evaluated, when a gum graft is recommended and what the procedure involves.
What gum recession is
Gum recession is when the gum tissue around a tooth pulls back and exposes more of the tooth, including part of the root. NIDCR lists gums pulling away from the teeth, making teeth appear longer, among the symptoms of gum disease (NIDCR: Gum disease). MedlinePlus lists receded gums among the symptoms of periodontitis (MedlinePlus: Periodontitis). The American Academy of Periodontology (AAP) says gum recession from periodontal disease can expose roots and make teeth look long (AAP: Cosmetic procedures).
Why it matters
- Sensitivity. MouthHealthy explains that exposed roots lack enamel, so heat, cold and acidic foods can reach the nerve more easily (MouthHealthy: Sensitive teeth). See our sensitive teeth guide.
- Decay risk on roots. The AAP says root coverage procedures help protect vulnerable roots from decay.
- Further recession and bone loss. According to the AAP, gum graft surgery helps prevent additional recession and bone loss.
- Appearance. Longer-looking teeth or an uneven gumline can affect your smile.
Common causes
Gum disease
Periodontal disease is a leading cause. NIDCR explains that plaque and tartar trigger inflammation that damages the gums and supporting tissues. Smoking or tobacco use is the most significant risk factor, and other risk factors include older age, diabetes and genetics. Our guide to signs of gum disease and our article on diabetes and oral health go further.
Other contributors
Dentists also commonly look at brushing too hard or with a hard-bristled brush, teeth grinding, tooth position, and naturally thin gum tissue. Your dentist or periodontist can tell you which factors apply in your case.
How recession is evaluated
NIDCR describes a gum exam in which the dentist checks for inflammation, bleeding and receding gums and uses a small ruler called a probe to measure the pockets around teeth. In a healthy mouth, these pockets are usually 1 to 3 millimeters. X-rays can show bone loss. Our dental X-rays guide explains the imaging.
If gum disease is present, it usually needs to be treated first. NIDCR describes scaling and root planing (a deep cleaning) and, in advanced cases, surgery. See our guide to deep cleaning.
Gum graft surgery
The AAP describes gum graft surgery this way: the periodontist takes gum tissue from your palate or another donor source and uses it to cover the exposed root. It can be done on one tooth or several. The AAP says it will cover the exposed root, help prevent additional recession and bone loss, and may reduce tooth sensitivity and improve the appearance of your smile (AAP: Surgical procedures).
Who performs it
Gum grafts are usually done by a periodontist. The AAP says periodontists receive three years of specialized training after dental school and are trained in comfort measures such as sedation or anesthesia. Our overview of dental specialists explains the role, and our guide to dental sedation options covers comfort choices.
What recovery is generally like
Your periodontist will give specific instructions, which commonly include eating soft foods, avoiding brushing or flossing the treated area until told otherwise, using any prescribed rinse, and returning for follow-up visits. If tissue was taken from the palate, that area also needs time to heal. Follow your own surgeon’s instructions closely, and call them if you have heavy bleeding, increasing pain or swelling, or fever.
Other options
- Watching mild recession. Some mild, stable recession may simply be monitored.
- Desensitizing treatments. MouthHealthy lists desensitizing toothpaste and fluoride gel for sensitivity.
- Bonding. Tooth-colored material can cover some exposed root areas; see our dental bonding guide.
Preventing further recession
- Brush twice a day with a fluoride toothpaste and a soft brush, using gentle pressure.
- Clean between your teeth daily. NIDCR mentions floss, interdental brushes, picks or a water flosser recommended by a dental professional.
- Quit tobacco. NIDCR calls it the most significant risk factor for gum disease.
- Keep regular checkups and cleanings.
- Ask about a night guard if you grind; see our teeth grinding guide.
Questions to ask before a graft
- What is causing my recession, and is it still active?
- Does gum disease need to be treated first?
- Which teeth would be treated, and where would the graft tissue come from?
- What anesthesia or sedation options do you offer?
- What should I expect during healing, and what can I eat?
- How many follow-up visits will there be?
- What will it cost, and how much will my insurance pay? Ask for a written, itemized estimate.
- What can I do to keep recession from returning?
Key takeaways
- Gum recession exposes root surfaces, which can cause sensitivity and raise the risk of root decay.
- Gum disease is a major cause; tobacco is its most significant risk factor, according to NIDCR.
- Gum graft surgery covers exposed roots with tissue from your palate or another donor source, and the AAP says it helps prevent further recession and bone loss.
- Gentle brushing, daily cleaning between teeth, quitting tobacco and regular checkups help prevent more recession.
Living with mild recession
Not every case of recession needs surgery. If your dentist decides to monitor an area, they will usually record measurements at each visit so changes can be spotted early. Your role is to keep plaque under control with gentle, thorough brushing and daily cleaning between teeth, to avoid tobacco, and to report any new sensitivity or changes in how your gums look. If you grind or clench, protecting your teeth at night may also help. Using a desensitizing toothpaste can make cold drinks more comfortable while you and your dentist watch the area. If measurements show the recession is getting worse, the conversation may then turn to a graft or other root coverage procedure.
Frequently asked questions
Can receded gums grow back?
Gum tissue that has receded does not typically grow back on its own. Treatments such as gum grafts are designed to cover exposed roots.
Does a gum graft hurt?
The procedure is done with anesthesia, and the AAP notes periodontists are trained in sedation and other comfort measures. Some soreness during healing is common; ask your periodontist what to expect.
Does a gum graft reduce sensitivity?
The AAP says it may reduce tooth sensitivity by covering exposed roots.
Is gum recession always caused by gum disease?
No. Gum disease is a major cause, but other factors can contribute. A dental exam can identify the cause.
Will insurance cover a gum graft?
It depends on your plan and whether the graft is considered medically necessary. Ask for a written estimate with procedure codes; our guide to reading a treatment plan explains how.
Sources
- American Academy of Periodontology: Surgical Procedures
- American Academy of Periodontology: Cosmetic Procedures
- NIDCR: Periodontal (Gum) Disease
- MedlinePlus: Periodontitis
- ADA MouthHealthy: Sensitive Teeth
By the Dentist Review Editorial Team.
This article is for general information only and is not medical advice. Talk to a licensed dentist about your own situation. See our disclaimer.
Featured image: “Dental floss open” by Tiia Monto, via Wikimedia Commons, licensed CC BY-SA 4.0. Resized and compressed for the web.
Our guides are written and reviewed by the Dentist Review editorial team. We research each topic using public, authoritative sources such as the CDC, the National Institutes of Health (NIH/NIDCR), the American Dental Association (ADA) and CMS, and we update guides when guidance changes. Guides are for general information only and are not dental or medical advice; please read our disclaimer and learn more about us.