Receding gums are often noticed when teeth begin to look longer or gaps appear along the gum line. While many people associate this with appearance alone, gum recession is rarely just a cosmetic issue. At Pure Periodontics in the City of London, receding gums are one of the most common reasons patients seek specialist periodontal care, and the underlying causes are often far more important than how the smile looks.
Understanding that gum recession represents a functional and structural problem rather than simply an aesthetic concern is crucial for protecting long term dental health. What appears in the mirror as a cosmetic change is often the visible manifestation of complex processes occurring beneath the gum line, processes that can have serious implications if left unaddressed.
What Causes Gum Recession
Gum recession occurs when the gum tissue pulls away from the tooth, exposing the root surface. This can happen for several reasons including untreated gum disease, aggressive brushing habits, clenching or grinding, thin gum tissue or previous orthodontic or restorative treatment. In many cases, recession is linked to periodontitis, where inflammation and bone loss weaken the support around the teeth.
Each cause of recession tells a different story about what has been happening in the mouth over time. Gum disease related recession typically occurs when chronic inflammation destroys the attachment between gum tissue and tooth structure. As periodontal pockets deepen and bone is lost, the gum tissue follows the declining bone level, pulling away from the tooth crown and exposing the root.
Mechanical factors also play a significant role. Brushing with excessive force, particularly with a hard bristled toothbrush, can gradually wear away delicate gum tissue. Many patients are surprised to learn that their diligent oral hygiene routine has actually been causing harm. The recession often appears on the prominent outer surfaces of teeth where the brush makes most contact, creating characteristic V-shaped notches at the gum line.
Clenching and grinding habits create forces that teeth and gums were not designed to withstand. These excessive forces can cause the thin bone on the outer surface of teeth to resorb, and as the bone disappears, the overlying gum tissue recedes as well. This type of recession is particularly common on the prominent canine teeth and premolars which bear significant force during grinding movements.
Some individuals are predisposed to recession due to anatomical factors. Thin gum tissue and thin underlying bone provide less resilience against the various stresses that gums face daily. In these patients, even minor trauma or inflammation can result in recession that would not occur in someone with thicker, more robust tissues.
Because gum recession often progresses slowly and without pain, it can go unnoticed until sensitivity or aesthetic concerns develop. Patients frequently report that they did not realise how much recession had occurred until they compared recent photographs with older images, or until someone else commented on the change in their smile.
Why Receding Gums Matter
Exposed tooth roots are more vulnerable to sensitivity, decay and wear. Unlike enamel, root surfaces are softer and less protected. As recession progresses, teeth may become increasingly sensitive to temperature and more difficult to keep clean. Over time, this can increase the risk of further gum disease and tooth instability.
The root surface lacks the hard enamel layer that protects the crown of the tooth. Instead, it is covered only by cementum, a much thinner and softer material that wears away more easily and is more susceptible to decay. Root surface cavities can develop quickly and are often more challenging to treat than cavities in enamel because the softer tooth structure does not hold fillings as reliably.
Sensitivity is one of the most immediate and bothersome consequences of gum recession. The exposed root surface contains tiny tubules that communicate directly with the nerve inside the tooth. When these tubules are exposed to temperature changes, sweet or acidic foods, or even air, they transmit these sensations directly to the nerve, causing sharp, shooting pain. This sensitivity can become so severe that it affects eating, drinking and even breathing comfortably through the mouth.
From a periodontal perspective, recession is also a sign that the supporting tissues around the teeth may be under stress. Dr Neesha Patel regularly sees cases where early recession was the first visible sign of more advanced periodontal problems beneath the surface. The recession serves as an early warning system, indicating that intervention is needed before more serious damage occurs.
As recession continues, the crown to root ratio of the tooth changes. More of the tooth structure becomes visible above the gum line while less remains anchored below it. This altered ratio can affect the stability of the tooth, particularly if bone loss accompanies the gum recession. In severe cases, teeth can become loose or shift position due to inadequate support.
The exposed root surfaces are also more difficult to clean effectively. Their position, often in areas that are already challenging to reach, combined with their rougher surface texture compared to enamel, makes them prone to plaque accumulation. This creates a vicious cycle where recession leads to increased plaque retention, which leads to more inflammation and potentially more recession.
More Than a Cosmetic Fix
Treating receding gums is not about making gums look better for photographs. It is about protecting the long term health of the teeth and supporting structures. Periodontal treatment focuses on controlling inflammation, stabilising gum levels and addressing the underlying causes of recession. In some cases, this may include advanced periodontal therapies or surgical procedures designed to improve gum health and reduce future damage.
The goal of treatment extends beyond simply covering exposed roots. It involves identifying and eliminating the factors that caused the recession in the first place. Without addressing these underlying causes, recession is likely to continue or recur even after surgical correction. This might involve treating active gum disease, modifying brushing technique, providing a night guard to protect against grinding forces or adjusting orthodontic or restorative treatment plans.
Specialist assessment is essential. Detailed gum measurements, evaluation of bone levels and analysis of bite forces all help determine the most appropriate treatment approach. Different patterns of recession require different treatment strategies, and what works well for recession caused by aggressive brushing may not be suitable for recession caused by periodontal disease.
Modern periodontal techniques offer various options for treating recession depending on its severity and cause. Some procedures focus on halting progression and protecting exposed roots, while others aim to regenerate lost tissue and restore more normal gum contours. The choice of technique depends on individual factors including the amount of recession present, the thickness of existing tissue and the patient’s overall periodontal health.
Patient Experience at Pure Periodontics
Patients often comment on the clarity and reassurance they receive throughout their treatment. One patient shared:
“Kirstie and team have taken such good care of me. Really excellent care and support and I couldn’t recommend the clinic more highly. The reception staff are also wonderful and welcoming, and the consultations with Neesha have been incredibly informative and put me at ease. My gum health has been transformed by this clinic and I couldn’t be more grateful.”
This reflects the practice’s focus on patient education and personalised care, ensuring patients fully understand their gum health and treatment options. Understanding the why behind treatment recommendations helps patients feel more invested in their care and more confident in the treatment plan.
Looking at the Bigger Picture
Receding gums should never be dismissed as a purely aesthetic concern. They are often a signal that the gums and supporting bone need attention. Early intervention can prevent further recession, reduce sensitivity and protect teeth for the long term.
With specialist periodontal care and a tailored treatment plan, it is often possible to stabilise gum health and prevent progression. Addressing gum recession early is one of the most effective ways to safeguard both oral health and confidence in a smile. The investment in treating recession properly pays dividends in preserved tooth structure, reduced sensitivity, improved long term stability and yes, a more attractive smile as well.