What Causes Gum Recession?

Gum recession is the gradual pulling back of gum tissue from around a tooth, exposing more of the tooth’s root surface. It happens when the gumline loses its attachment to the tooth, whether from gum disease, physical wear from brushing, thin gum tissue, tobacco use, or excess force from a misaligned bite. Recession doesn’t reverse on its own, but its progression can be stopped.

If you’ve noticed a tooth looking a little longer than it used to, or a new sensitivity to cold water, you’re probably dealing with some degree of recession. You’re not alone. It’s one of the most common things we evaluate at Commonwealth Periodontics and Implant Center, and the causes are more varied than most people expect.

What Are the Most Common Causes of Gum Recession?

Gum recession usually comes down to one of a handful of factors, and most patients have more than one at play at once.

Periodontal disease is the leading cause. Bacterial infection in the gum tissue breaks down the attachment between the gum and the tooth, and over time, the bone underneath as well. According to the Cleveland Clinic, gum recession affects the large majority of adults over 65, with roughly 88 percent showing at least some recession on one or more teeth.

Aggressive brushing is a close second. Scrubbing hard, or brushing with a stiff-bristled toothbrush, wears away gum tissue the same way sanding wears down wood. It feels thorough. It’s actually doing damage.

Plaque and tartar buildup from inconsistent brushing and flossing lets bacteria sit against the gumline long enough to trigger inflammation, which is often the first domino in a chain that ends in recession.

Thin or genetically fragile gum tissue is something patients can’t control. Some people are simply born with a thinner gum biotype, which recedes more easily under the same amount of stress that a thicker biotype would tolerate fine.

Tobacco use, smoked or chewed, reduces blood flow to the gums. Less blood flow means slower healing and a gumline that’s more vulnerable to every other factor on this list.

Hormonal shifts during puberty, pregnancy, or menopause can make gum tissue more sensitive and more prone to recession, even with a hygiene routine that hasn’t changed.

Piercings and physical trauma, especially lip or tongue jewelry that rubs against the gumline day after day, wear tissue away in a very direct, mechanical sense.

Can Your Gums Recede Even If You Brush and Floss Well?

Yes. This is the question we hear most from patients who are frustrated and, frankly, confused. They’ve done everything right and their gums are still receding.

The answer usually comes down to how your teeth come together, not how clean they are. When a bite is misaligned, or when certain teeth take on more chewing force than they were built for, that excess pressure transfers directly into the gum and bone around those teeth. Over time, the tissue simply can’t hold its position.

Teeth grinding and clenching, often happening at night without the patient realizing it, is one of the most overlooked drivers of recession we see. It’s mechanical, not bacterial, so a spotless hygiene routine won’t touch it.

Crowded or rotated teeth create a similar problem. A tooth that sits outside the normal arch often has thinner bone and gum tissue covering it to begin with, which leaves it more exposed to recession even under normal forces.

Research published in JADA (the Journal of the American Dental Association) backs this up directly, noting that abnormal or irregular tooth position is one of the primary drivers of gingival recession, independent of gum disease. If this describes your situation, the fix usually isn’t a better toothbrush. It’s addressing the bite itself alongside any gum tissue that’s already been lost.

Is Gum Recession the Same Thing as Gum Disease?

Not exactly, though the two are closely linked. Gum disease is an infection. Gum recession is often, but not always, one of its symptoms.

Periodontal disease typically starts as gingivitis, an early stage where bacteria irritate the gums and cause redness, swelling, and bleeding when you brush. Left untreated, gingivitis can progress into periodontitis, where the infection moves deeper, the gum pulls away from the tooth, and pockets form that trap even more bacteria. In its most advanced form, the bone supporting the tooth breaks down, teeth loosen, and recession becomes severe. The American Academy of Periodontology outlines this same progression as the core of what periodontal disease actually is.

That said, plenty of recession happens outside of active disease entirely, from brushing habits, bite force, or genetics, as covered above. If you’re not sure which category you fall into, that’s exactly what a periodontal evaluation is for. If you’re wondering how the earliest stage of this progression actually resolves, our breakdown of gingivitis timelines walks through what to expect.

How Do You Know If Your Gums Are Receding?

Recession happens slowly, which is exactly why it’s easy to miss until it’s fairly advanced.

Can Gum Recession Be Reversed?

No, not on its own. Once gum tissue pulls back and the root is exposed, it doesn’t grow back the way skin heals over a cut. That’s the honest answer, and it’s worth hearing plainly rather than dressed up.

What can be done is stopping it from getting worse and, in many cases, surgically restoring the tissue that was lost. The path forward depends heavily on the cause. Recession from active gum disease responds to treating the infection. Recession from brushing habits or bite force responds to changing the mechanical stress that’s causing it. Either way, the earlier it’s addressed, the less tissue and bone you’re likely to lose in the meantime. Ongoing periodontal maintenance visits are a big part of keeping recession from progressing once it’s been identified and treated.

What Treatments Fix Gum Recession?

Treatment depends on what’s driving the recession and how much tissue has already been lost.

For recession tied to active gum disease, scaling and root planing is usually the first step. It’s a non-surgical deep cleaning that removes plaque and tartar from below the gumline and smooths the tooth root, which helps the gum reattach and halts the disease process that’s driving the recession.

For recession that’s already exposed the root, gum and tissue graft procedures rebuild the missing tissue directly. We typically use one of three techniques depending on the site: a connective tissue graft, where tissue is taken from beneath the surface of the palate; a free gingival graft, often used when the area needs thicker tissue; or a pedicle graft, which uses tissue adjacent to the recession site rather than taking it from elsewhere in the mouth. Grafting has a strong track record when aftercare instructions are followed closely. If you want to understand what can go wrong and how it’s corrected, our post on what to watch for during graft healing covers the signs of a graft that isn’t taking as it should.

For cases where the gumline itself is uneven, whether from recession or from excess tissue in other spots, reshaping an uneven gumline can restore symmetry once the underlying health issue has been addressed.

If bite force or grinding is the root cause, treatment often includes a night guard or bite adjustment alongside any surgical work, since fixing the tissue without addressing the force behind it tends to invite the same problem right back.

Wondering which of these applies to you? A quick evaluation can tell you whether grafting, deep cleaning, or something else fits your case.

See which option fits your gums

When Should You See a Periodontist About Receding Gums?

As soon as you notice it. Recession is progressive, meaning it tends to get worse, not better, without intervention, so an early evaluation gives you more options and usually a simpler treatment path.

A general dentist can spot recession during a routine exam, but a specialist trained specifically in gum and bone health is who determines the actual cause and the right way to treat it, whether that’s a hygiene-based approach, a bite adjustment, or a grafting procedure. At Commonwealth Periodontics and Implant Center, our periodontists, including Dr. Susan Ballou Gibson, who has practiced periodontics in the region since 1991, and Dr. Lucy Belcher, a Board-Certified Diplomate of the American Academy of Periodontology, evaluate the tissue, the bone, and the bite together rather than treating recession as an isolated cosmetic issue.

TL;DR: What Causes Gum Recession

Gum recession happens when gum tissue pulls back from a tooth and exposes the root underneath. The most common causes are periodontal disease, aggressive brushing, plaque and tartar buildup, thin or genetically fragile gum tissue, tobacco use, hormonal changes, and physical trauma from piercings. A less obvious but significant cause is bite force: teeth grinding, clenching, and misaligned teeth can drive recession even in patients with excellent oral hygiene. Recession can’t reverse on its own, but treatments like scaling and root planing, gum grafting, and bite correction can stop it from progressing and, in many cases, restore lost tissue. The sooner it’s evaluated, the more options are on the table.

If you’ve noticed any of these signs, it’s worth getting a professional opinion before it progresses further.

Schedule a gum health evaluation

Frequently Asked Questions

What is the most common cause of gum recession?

Periodontal disease is the most common cause. Bacterial infection breaks down the gum’s attachment to the tooth and, over time, the supporting bone as well, causing the gumline to pull back.

Can gum recession happen without gum disease?

Yes. Aggressive brushing, thin gum tissue, teeth grinding, misaligned teeth, tobacco use, and physical trauma can all cause recession independent of active gum disease.

Does gum recession get worse over time if untreated?

Typically, yes. Recession is progressive, and the underlying cause, whether bacterial or mechanical, usually continues unless it’s addressed directly.

Is gum recession painful?

Not usually on its own, though the exposed root surface often brings noticeable sensitivity to cold, heat, or sweets. Pain is more commonly tied to an underlying infection than to the recession itself.

Can a soft-bristled toothbrush stop gum recession from progressing?

Switching to a soft-bristled brush and a gentler technique can stop recession caused by brushing trauma from getting worse, but it won’t address recession caused by gum disease or bite force, which need their own treatment.

How much does it cost to treat gum recession?

Cost depends on the cause and the treatment needed, ranging from a deep cleaning to a surgical graft. During a consultation, our team can walk you through pricing and insurance coverage specific to your case.