Gum recession is far more common than most people expect. A review in the Journal of the American Dental Association (Kassab and Cohen, 2003) reported that about half of adults aged 18 to 64, and 88 per cent of people aged 65 and over, have at least one spot where the gum has pulled back from a tooth. For most of them it started quietly, with no pain at all.
Recession is rarely caused by one thing. Hard brushing, gum disease, a crowded bite, grinding and smoking can each play a part, and often two or three of them overlap. Working out which ones apply to you is what decides the treatment, so this article walks through the causes first and the fixes second.
The signs usually appear before any pain
Most people notice recession by accident. A tooth looks a little longer than its neighbour in a photo. A cold drink causes a sharp, short sting at one tooth near the gum. A yellowish band appears just above the enamel, which is the root surface showing through. Small dark gaps can also open between teeth near the gumline as the tissue that filled them shrinks.
Exposed root is softer than enamel and has no enamel layer to protect it. It wears more easily, it decays more easily, and it is a frequent reason for sudden tooth sensitivity, because the tiny channels in root dentine lead towards the nerve.
A few signs suggest something more active is going on and are worth booking in for sooner rather than later:
- recession on several teeth at the same time, rather than one or two
- a tooth that feels loose or has started to drift
- swelling, pus or a bad taste coming from the gum
- gums that still bleed after 3 to 4 days of careful brushing and flossing
- a gumline that is visibly changing over a few months
Ongoing bad breath can also point to gum disease underneath; our guide to bad breath covers the other common causes.
Brushing harder does not clean better
In people whose gums are otherwise healthy, brushing too hard is widely thought to contribute to recession, although a systematic review by Rajapakse and colleagues (Journal of Clinical Periodontology, 2007) found the evidence linking brushing and recession inconclusive. A firm or medium brush, a scrubbing side to side stroke and a very abrasive paste may slowly wear the gum and the root surface over years. It often shows up most on the canines and premolars, where the arch curves and people tend to press hardest.
Brushing habits are also the easiest factor to change at home. A soft or extra soft brush, angled towards the gumline and moved in small, gentle circles, removes plaque without the wear. Many electric brushes have a pressure sensor that lights up when you push too hard, which some people find the quickest way to break the habit. Replace your brush about every three months, or sooner if the bristles splay.
Gum disease takes the bone, and the gum follows
Periodontitis is a long-term inflammatory condition driven by bacterial plaque below the gumline. Over time it destroys the fibres and bone that hold a tooth in place. As the bone level drops, the gum usually drops with it, and recession tends to appear on several teeth rather than one.
Treatment starts without surgery. A dentist or OHT cleans the root surfaces below the gum to remove hardened deposits and bacteria, then reviews how the gums respond. Many people then need more frequent maintenance visits than the usual six-monthly check-up to keep things stable. Where the disease is advanced, referral to a registered periodontist may be recommended.
Other causes that are easy to overlook
Teeth sitting outside the bone
When a tooth is crowded or pushed towards the lip, the bone and gum covering its root are often very thin. Thin tissue recedes more readily and is harder to keep clean. Moving the tooth back into a better position with braces or clear aligners can sometimes improve the situation; in other cases the focus is gentle cleaning and closer monitoring.
Grinding and clenching
Heavy grinding is often seen alongside wedge-shaped notches at the gumline. Researchers still debate how much grinding itself causes these notches and how much is down to brushing and acid wear, so it is best thought of as a possible contributor rather than a proven cause. Signs of grinding include flattened tooth edges and a tired or sore jaw on waking. If grinding is present, a custom night guard helps protect the teeth from the forces involved.
Smoking and vaping
Smoking is a well-established risk factor for gum disease and makes the gums slower to heal. It can also hide the early warning signs, because smokers' gums often bleed less even when disease is present. Vaping is newer and the research is less settled, but it is not considered harmless for the gums. Stopping smoking is one of the most useful things a smoker can do for their gums.
Lip and tongue piercings
A stud or bar that repeatedly taps the gum behind the lower front teeth can wear away the tissue at that one spot. A 2024 systematic review by Difloe-Geisert and colleagues in the International Journal of Dental Hygiene found recession was more common in people with lip or tongue piercings. The recession is often very localised. Removing the piercing usually stops further damage; established recession may need a graft to cover the root again.
Thin gum tissue
Some people simply have thinner, more delicate gums and bone over their roots. Thin tissue is not a disease, but it gives way more easily to any of the other causes above. It is largely something you are born with, which makes the factors you can control more important.
Lost gum does not grow back on its own
Once the gum has receded, it does not return by itself, and no toothpaste, mouthwash, oil or supplement has been shown to regrow it. Leaving it alone is not always a stable option either. A 2016 systematic review in the Journal of Periodontology (Chambrone and Tatakis) followed untreated recession over the long term and found that most sites deepened over time, even in people with good oral hygiene.
When the root needs covering, for sensitivity, appearance or to protect a thin area, gum grafting is the main option. A Cochrane review (Chambrone and colleagues, 2018) found that several techniques can cover exposed roots, and that a connective tissue graft taken from the palate gave slightly better results where both root coverage and thicker gum were the goal. We look at that question in more detail in can receding gums grow back.
Not every receded area needs surgery. Small notches that are sensitive can sometimes be covered with tooth-coloured bonding, and desensitising toothpaste helps many people with mild sensitivity. The right choice depends on how deep the recession is, whether the cause is still active, and what is bothering you.
What a gum check involves
At an examination, your dentist or OHT measures the gum around each tooth with a fine probe, records any bleeding and recession, and checks for looseness. X-rays show whether the bone level has changed. Together these separate brushing wear on one or two teeth from gum disease affecting the whole mouth, which need quite different plans.
As a general guide, a check-up and clean in Sydney typically costs $200 to $400 (a typical market range, not a Lumi fee). Gum treatment beyond that varies widely with the number of teeth and the technique, so ask for a written treatment plan with fees and item numbers and check it with your health fund before booking.
If nerves have kept you away from the dentist, our article on dental anxiety explains what a gentle first visit can look like, including happy gas.
Questions we are often asked
Can I whiten my teeth if my gums have receded?
Exposed root surfaces tend to be more sensitive and do not lighten the same way enamel does. It is usually best to have the cause of the recession checked first. We cover this in whitening with receding gums and exposed roots.
Is recession always a sign of gum disease?
No. Hard brushing, a piercing or a tooth sitting outside the bone can all be linked with recession while the rest of the gums are healthy. Measuring the gums around every tooth is how a dentist tells these apart.
Will a water flosser fix receding gums?
A water flosser can help clean between teeth and reduce gum inflammation, which supports gum health, but it does not rebuild gum that has already gone. It works best alongside brushing and interdental cleaning.
Do health funds cover gum grafts?
Gum surgery generally falls under major dental cover. Waiting periods for major dental are commonly 12 months, but each fund sets its own limits and waiting periods, so check with yours using the item numbers on your treatment plan.
Book a gum check
If a tooth looks longer than it used to or the gumline has started to sting, an examination is the place to start. At Lumi Dental in Melrose Park, a new patient visit is a full 60 minutes, with time to measure your gums, explain what we find and talk through your options. You will usually receive a written treatment plan afterwards, often by email. You can book online or get in touch with any questions.
