You see in the mirror that your teeth look "longer" than they used to. The root surfaces are exposed, they react to cold and heat, and sometimes unaesthetic notches appear at the gum line. This is gum recession — and it will not resolve on its own.
What exactly is gum recession?
Gum recession is a permanent shift of the gum margin towards the root apex. As a result, the root surface — normally covered by gum and bone — becomes exposed. This leads to sensitivity, aesthetic problems and, in advanced cases, tooth mobility.
At Modern Dental & Orthodontics, when a patient presents with recession, we always start by answering three questions. First: how far has the recession progressed? Second: what caused it? Third: is it still progressing?
The answers to these questions determine whether the patient needs treatment at all, and if so — what kind.
The Cairo classification — why it matters
For many years periodontology used the Miller classification (1985), which divided recessions into four classes based on the depth of recession and the condition of the interdental tissues. In 2018, Cairo proposed a simplified and clinically more practical system with three types:
| Cairo type | Clinical description | Prognosis for recession coverage |
|---|---|---|
| RT1 | No attachment loss in the interdental spaces | Very good — frequently 100% coverage |
| RT2 | Partial interdental attachment loss, less than the buccal loss | Moderate — partial coverage possible |
| RT3 | Interdental attachment loss equal to or greater than the buccal loss | Limited — complete coverage usually not possible |
The practical consequence is simple: RT1 has a very good prognosis. If the patient has an RT1 recession, surgical treatment (e.g. a connective tissue graft) gives a high chance of complete or near-complete root coverage.
The most common causes of recession — and why this matters
Traumatic brushing
Overly vigorous, overly fast, overly frequent brushing — especially with a hard toothbrush — is one of the most common causes of recession in individuals with good oral hygiene but poor technique.
Periodontal disease (periodontitis)
Advanced periodontitis destroys the alveolar bone, and the gum recedes along with it. Recession from this cause usually affects many teeth simultaneously and is associated with deep pockets and bone loss.
Thin gingival phenotype
Some people are born with thinner gum — genetically. Thin gum is more susceptible to recession from every cause: small forces that thick gum would tolerate can cause thin gum to recede.
Incorrect occlusal forces and tooth grinding
Bruxism and other disorders of masticatory muscle activity (e.g. clenching) subject the teeth to excessive forces, which may co-exist with wedge-shaped defects at the cervical area and gum recession.
Lip piercing and frenum
Jewellery in the lower lip often causes localised recession on the lower front teeth. An abnormal frenum attachment (upper or lower) can pull the gum margin and contribute to recession.
Myth: "recession reverses naturally" — why this is untrue
An important point is that gum recession does not reverse on its own. Once the gum has exposed the root, the tissue does not regrow without intervention. Every promise of "natural gum regeneration" found in internet adverts is misleading.
This information matters because many patients postpone a visit to the periodontist, hoping for spontaneous reversal. In the meantime the recession progresses, the root becomes exposed further, and the prognosis for future surgical treatment worsens.
Practical advice: if you notice recession, do not wait for it to "go away on its own". Book an appointment, establish the cause and halt the progression. If the recession is moderate and bothers you, surgical treatment (CTG) can give excellent results.
When is surgical treatment of recession worthwhile?
Not every recession requires a procedure. The decision on surgical treatment is made jointly with the patient on the basis of four criteria:
- Aesthetics — particularly for recessions on the front teeth, which are visible in the smile.
- Sensitivity — when the exposed root reacts painfully to cold, heat and sweet foods, and other methods (desensitising toothpastes, fluoride varnishes) are insufficient.
- Progression — when the recession continues to advance despite removal of the cause, threatening loss of tooth attachment.
- Preparation for orthodontics — if the patient is planning braces and the gum in the area of the planned tooth movement is thin, reinforcing the gum before orthodontics is a preventive measure.
Available surgical techniques include: free gingival graft (FGG), connective tissue graft (CTG — the most commonly used), the tunnel technique, coronally advanced flaps, and xenogeneic collagen matrix. At our clinic in Wola, Warsaw, the most frequently performed procedure is CTG in a tunnel technique.
What the patient can do themselves (to halt progression)
Regardless of whether you are planning surgical treatment or not, you can and should do the following — without these steps, any surgery will be short-lived:
- Change your brushing technique. Less force, more precision. The recommended technique: gentle, short vibratory movements at a 45° angle to the gum (modified Bass technique). Consider a sonic toothbrush — most models have a pressure sensor.
- Switch to a soft or medium-soft toothbrush — especially if you have been using a hard one.
- Floss once daily or use interdental brushes. Without interdental hygiene, recession progresses despite good brushing of the outer surfaces.
- If you grind your teeth — consult about an occlusal splint. Bruxism is a silent cause of many recessions.
- Avoid frequent use of alcohol-based mouthwashes — they dry the gums.
- If you have an oral piercing — consider removing it, especially if you already see recession in its vicinity.
The most frequently asked questions from patients
Does recession hurt?
Recession itself is painless. What hurts is the exposed root — it reacts to cold air, cold drinks, sweet food, and sometimes even toothbrush contact. This sensitivity can be reduced with desensitising toothpastes or professional fluoride varnishes.
Can a filling simply be placed on the exposed root?
A cosmetic procedure of this kind (a cervical composite restoration) is possible and sometimes used, but it is an aesthetic and analgesic solution, not a causal one. It does not restore the gum and does not protect against further recession.
How much does recession treatment cost?
The cost depends on the technique, the number of teeth involved and whether tissue needs to be harvested from the palate (which usually applies to CTG). This involves a consultation and individual assessment.
Read more:
- Periodontist Warsaw — Klinika MDO services
- Bleeding gums when brushing — when is it normal and when is it a sign of disease?
- Smile design step by step — how does smile design work?
Sources
Source 1
Links
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Santamaria MP, Mathias-Santamaria IF, Tavelli L, Barootchi S, Pini Prato GP. „An updated evidence-based recommendation for the treatment of gingival recession associated with non-carious cervical lesions.” Journal of Periodontology. 2026 Jan 7. doi:10.1002/jper.70049. Online ahead of print.
Source 2
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Links
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Source 4
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