Overview

Gum recession occurs when gum tissue pulls back, exposing the root surface. It often develops slowly and goes unnoticed until sensitivity or aesthetic concern arises. Exposed root has no enamel protection, making it vulnerable to decay and sensitivity. Gum recession cannot repair itself — once lost, tissue does not grow back without intervention.

Symptoms

• Teeth that appear longer than normal
• Visible tooth root surface — darker yellow or brown compared to the crown
• Tooth sensitivity to cold, sweet, or acidic foods
• A notch or groove at the gum line; gums that bleed when brushing
• Loose teeth in advanced cases with bone loss

Causes & Risk Factors

• Aggressive brushing with a hard-bristled toothbrush — one of the most common causes
• Periodontitis: bone and gum tissue destroyed by infection
• Thin gum tissue biotype (genetic — common in people of Arab descent)
• Teeth positioned outside the dental arch with thin or absent supporting bone
• Oral piercings; tobacco use; grinding and clenching
• Orthodontic treatment: tooth movement can thin overlying bone

Complications

• Root caries on exposed surfaces — harder to treat than enamel decay
• Progressive bone loss and eventual tooth loss
• Increasing sensitivity making eating painful
• Aesthetic concerns: longer teeth and visible roots

Diagnosis

Clinical examination measures recession depth around each tooth with a periodontal probe. Miller's classification grades severity (Class I-IV) and guides surgical planning. X-rays assess remaining bone support.

Treatment

• Treat the underlying cause: gum disease treatment, correct brushing technique
• Switch to electric toothbrush with pressure sensor or soft-bristled brush
• Connective tissue graft (CTG): gold standard — palatal tissue covers the exposed root
• Free gingival graft to increase gum tissue thickness
• Desensitising agents for symptomatic relief

Prevention

• Use a soft-bristled toothbrush and gentle circular technique
• Treat gum disease early and maintain periodontal health
• Quit smoking and tobacco; remove oral piercings traumatising the gum
• Wear a night guard if grinding; attend regular dental check-ups

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