Gum recession, professionally termed gingival recession, is a condition in which the gum margin gradually shifts towards the tooth root. The consequence is exposure of the root surface, which can lead to aesthetic changes, sensitivity, and more serious oral health issues if the condition is not recognised and treated in time.
Although gingival recession often develops slowly and without pronounced symptoms in the early stages, it is a problem that should not be ignored. In practice, it is very often detected only when a patient notices that the teeth appear visually “longer”, that sensitivity to cold develops, or that the gums bleed during brushing.
At this point, it is important to immediately distinguish gum recession from other periodontal diseases, because although these conditions can overlap, the causes and the therapeutic approach are not always the same.
What is gingival recession and how does it develop
Gingival recession refers to the loss of gum tissue that would normally protect the tooth root and the surrounding bone. Unlike enamel, the tooth root has no natural protective layer, which makes it significantly more sensitive to external stimuli, bacteria, and mechanical trauma.
Gum recession can occur for several reasons, most commonly as a combination of factors that, over time, lead to gradual damage to the gingiva. In some people, recession appears locally, affecting one or a few teeth, while in others it can develop in a generalised way, affecting a larger portion of the dental arch.
It is important to emphasise that gingival recession is not exclusively a problem of older patients. It is increasingly seen in younger individuals as well, especially those with aggressive oral hygiene habits or with functional overloading.
The most common causes of gum recession
Gum recession most often does not occur due to a single isolated cause, but as a consequence of long-term exposure to various external and internal factors. Oral hygiene habits, the condition of the gums, and everyday behaviours all have a direct impact on gingival stability. Understanding the causes is essential for timely prevention and for stopping further progression of recession.
Incorrect or overly aggressive oral hygiene
One of the most common — and in practice most underestimated — causes of gum recession is incorrect or overly aggressive oral hygiene. This primarily refers to brushing too hard, using hard-bristled toothbrushes, and applying an aggressive horizontal brushing technique. In the long term, this approach does not remove plaque more effectively, but it does mechanically damage sensitive gum tissue and supporting structures.
With prolonged mechanical strain, the gingival margin gradually recedes, most often in the canine and premolar region, where the alveolar bone is naturally thinner and more vulnerable to trauma. In these areas, recession can develop very slowly and almost unnoticed until the tooth root becomes visibly exposed or sensitivity to cold, heat, or touch appears.
A particular issue is that many patients wrongly believe that brushing harder means better hygiene. In reality, excessive pressure not only fails to prevent problems, but directly contributes to gingival recession, enamel abrasion, and increased tooth sensitivity. An additional risk factor can be long-term use of unsuitable toothpastes with a pronounced abrasive effect.
In this context, correct brushing technique and overall oral hygiene play a key role in preventing gum recession and preserving periodontal health. A properly chosen toothbrush, controlled pressure, and an appropriate cleaning technique allow effective plaque removal without damaging the gums. In fact, correcting daily hygiene habits is often the first and most important step in stopping further progression of recession.
Inflammatory gum diseases
Inflammatory gum diseases, such as gingivitis and periodontitis, are a very common and often overlooked cause of gum recession. Long-standing inflammation leads to gradual damage of the tissues surrounding the tooth, including the gingiva, periodontal ligament, and alveolar bone. As supporting structures weaken, the gums recede and the tooth root becomes exposed, which further increases sensitivity and the risk of additional complications.
The problem is that inflammation in the early stages often does not cause pain, so many patients do not react in time. One of the earliest and most common signs of an inflammatory process developing in the mouth is gum bleeding during brushing or flossing. Although this is often attributed to “brushing too hard”, in many cases it is a clear signal that the gums are already inflamed.
If gingivitis is not treated, inflammation can spread deeper and progress into periodontitis, a condition that directly threatens tooth stability. At that stage, gum recession is no longer just an aesthetic issue, but part of a broader process that can lead to tooth looseness and tooth loss. This is why it is important to respond to early signs and not dismiss changes that seem “harmless”.
Bruxism and excessive tooth loading
Teeth grinding, known as bruxism, causes increased and prolonged mechanical loading of the teeth and the tissues around them. Unlike normal functional forces during chewing, bruxism forces are often stronger, longer-lasting, and act in unnatural directions. This type of loading can lead to micro-movement of teeth within the alveolar bone, placing additional strain on the gums and supporting structures.
In people with a thin gingival biotype, this chronic load significantly increases the risk of gingival recession. In such cases, the gums tolerate constant pressure less well, so over time they begin to recede, most commonly around the teeth that are most exposed to the load. In addition to recession, bruxism is often associated with tooth abrasion, sensitivity, and pain in the jaw joints.
It is important to emphasise that bruxism is very often an unconscious problem. Many patients are not aware that they grind their teeth, especially if it happens during sleep. Early signs can include morning jaw tension, headaches, facial muscle pain, or increased tooth sensitivity.
In many cases, teeth grinding (bruxism) is linked to psychological factors, primarily stress, anxiety, and emotional tension. Long-term stress does not affect only overall health; it very often reflects on oral health as well through unconscious parafunctional habits that further burden the teeth and gums.
If bruxism is not recognised and controlled in time, it can accelerate the development of gingival recession and worsen existing gum problems. This is why timely identification of the cause and the introduction of appropriate measures are crucial for preserving periodontal health.
Anatomical and genetic factors
In some individuals, the gums are naturally thinner and more sensitive, which increases the risk of recession even with proper oral hygiene. Malpositioned teeth, a shallow vestibule, or pronounced bony dehiscences can also be predisposing factors.
How to recognise gum recession – symptoms you should not ignore
Gum recession often begins quietly and without pronounced discomfort, which is why many patients do not notice the problem until it has already progressed. That is why it is important to recognise early signs of gingival recession so that you can react in time.
One of the earliest and most common symptoms is tooth sensitivity, especially to cold, hot, or sweet stimuli. As the tooth root gradually becomes exposed, external triggers reach the nerve endings more easily, causing discomfort or pain.
Visual changes are also a common indicator. Teeth may look longer than before, and the gum line may appear unevenly receded. In some people, a visible difference in gum height between neighbouring teeth can be noticed.
Bleeding gums during brushing or flossing can indicate an inflammatory process that contributes to gingival recession.
In advanced cases, gum tenderness, a stinging sensation, and the appearance of indentations near the neck of the tooth may develop, where deposits and bacteria can accumulate more easily.
Gingival recession or periodontitis – what is the difference?
Although they are often mentioned together in everyday speech, gum recession and periodontitis are not the same condition and do not always arise for the same reasons. Gingival recession can develop even in people without active inflammatory gum disease, especially when it is caused by mechanical factors such as incorrect oral hygiene, brushing too hard, or anatomical characteristics of the teeth and gingiva.
Periodontitis, on the other hand, is a chronic inflammatory periodontal disease that affects the supporting apparatus of the teeth, including the gums, periodontal ligament, and alveolar bone. In this condition, gradual destruction of supporting structures occurs, which can ultimately lead to tooth looseness and tooth loss.
It is important to emphasise that gingival recession can exist without significant bone loss, whereas in periodontitis bone loss is one of the key diagnostic criteria. However, untreated periodontitis very often leads to gum recession over time, further worsening the clinical picture and increasing the risk of sensitivity, aesthetic issues, and additional complications.
Precisely because symptoms can overlap, it is important to recognise early which symptoms point to parodontoze, as early detection plays a decisive role in timely treatment and in preventing permanent damage.
For all these reasons, accurate diagnosis by a dentist is essential to distinguish these conditions and choose appropriate therapy, because the treatment approach for gingival recession and periodontitis is not the same and requires an individual assessment of each patient.
How gum recession is diagnosed
A diagnosis of gingival recession is made through a clinical examination, during which the dentist assesses the position of the gums, the depth of periodontal pockets, the presence of inflammation, and the sensitivity of the exposed tooth root. If needed, radiographic diagnostics are used to assess the condition of the alveolar bone and determine whether there is loss of supporting tissue.
An important part of the examination is also a detailed analysis of the patient’s habits, including brushing technique, toothbrush choice, frequency of floss use, and the presence of parafunctions such as bruxism. Particular attention is paid to orthodontic history, as tooth movement can affect the stability of the gingiva and bone tissue.
In people who have been, or are currently, involved in therapy described in the article Ortodontska terapija kod odraslih, recession can occur as a consequence of moving teeth outside the bony envelope, especially in those with a thin gingival biotype.
Can receded gums grow back?
One of the most common questions patients ask is whether gum tissue that has receded can “grow back”. In most cases, spontaneous regrowth of gum tissue is not possible, but that does not mean the condition cannot be halted or significantly improved.
In the early stages of recession, it is possible to stabilise the condition with proper oral hygiene, removal of the underlying causes, and professional cleaning. This prevents further recession and reduces sensitivity symptoms.
In cases of more pronounced recession, especially when it is aesthetically or functionally problematic, surgical methods for root coverage exist, such as gingival grafting or connective tissue grafting. The decision about surgery is made individually, depending on the clinical picture and the patient’s expectations.
Treatment of gingival recession – an individual approach is essential
Treatment of gum recession is always tailored to the cause and the degree of recession. In milder cases, the focus is on patient education, correcting brushing technique, changing the toothbrush, and controlling inflammation. Regular professional tooth cleaning is particularly important, because removing plaque and tartar reduces inflammation and prevents further gum damage.
In patients with bruxism, therapy also includes reducing excessive loading of the teeth and gums. In these situations, an individual protective splint is often recommended as part of a broader approach to liječenju bruksizma – terapije, which reduces the long-term risk of recession progression.
How to prevent gum recession – what you can do every day
Although gum recession cannot always be prevented completely, good habits can significantly reduce risk and slow its progression. Prevention is largely based on understanding the causes and maintaining consistent, properly performed oral hygiene.
Correct brushing technique is one of the most important steps. Excessive pressure and horizontal brush movements can mechanically damage the gums over time. Using a soft-bristled toothbrush is recommended, along with gentle circular motions directed from the gums towards the teeth, with controlled pressure and enough time devoted to each area of the mouth.
Toothpaste choice also plays a role. Highly abrasive toothpastes can further irritate already sensitive gums and exposed tooth necks. In cases of recession, toothpastes designed for sensitive teeth and gum health are preferred, with formulas that strengthen enamel and reduce sensitivity without additional mechanical irritation.
Regular use of dental floss or interdental brushes is important for removing plaque from spaces a toothbrush cannot reach. Neglecting these areas promotes inflammation, which over time can accelerate gingival recession and further compromise gum stability. Consistent and correctly performed hygiene remains the foundation for preserving periodontal health and preventing further complications.
The role of professional cleanings and regular check-ups
Home care, no matter how good, cannot fully replace professional dental care. Regular examinations allow early detection of recession and timely intervention before the problem becomes more pronounced and harder to manage.
Professional tooth cleaning removes tartar and plaque that cannot be completely removed at home. This reduces gum inflammation, stabilises the periodontium, and prevents further gingival recession.
During check-ups, the dentist also assesses other risk factors, such as malocclusion, bruxism, or unfavourable tooth position, and, if necessary, proposes additional therapeutic measures to preserve long-term gum stability and the supporting structures of the teeth.
When gum recession becomes an aesthetic concern
In addition to health consequences, gingival recession often has a pronounced aesthetic impact, especially when it affects the front teeth. Exposed roots can change the appearance of the smile, make teeth look visually longer, and disrupt facial harmony.
For patients for whom smile aesthetics are an important aspect of quality of life, gum recession is often addressed as part of a broader aesthetic rehabilitation.
In certain cases, periodontal therapy is combined with aesthetic procedures to achieve a functionally stable and visually natural result, while preserving the health of supporting structures and ensuring long-term tooth stability.
Gum recession and the long-term consequences if it is not treated
Untreated gingival recession can lead to a range of complications. The exposed tooth root is more susceptible to decay because it does not have the protective enamel layer. The risk of inflammation and further loss of supporting tissue also increases.
Over time, tooth looseness can develop as well, especially if recession is associated with periodontal disease.
For that reason, gum recession should not be viewed only as an aesthetic issue, but as a condition that requires professional monitoring and, where needed, treatment.
When to see a dentist
It is recommended to see a dentist as soon as the first signs of gum recession are noticed, such as sensitivity, changes in the appearance of the teeth, or bleeding gums. Early intervention often enables a simpler and more effective solution.
If symptoms are ignored, treatment options can become more complex and may require surgical procedures. A timely examination is crucial for preserving gum health and long-term tooth stability.
Why early recognition of gingival recession is crucial
Gum recession is not rare, but it is often underestimated. Although it may seem harmless at first, in the long term it can have serious consequences for the health of the teeth and gums.
Understanding the causes, recognising early symptoms, and consistent oral hygiene form the basis of prevention and successful treatment. With regular dental check-ups and an individually tailored approach, it is possible to stop recession progression and maintain a healthy, stable smile.