Receding gums are one of the most commonly ignored dental problems – until teeth become painful, sensitive, or loose. The gum tissue doesn’t disappear overnight, and the process is gradual enough that most people don’t notice it happening until meaningful recession has already occurred. By then, the tissue that’s gone is gone permanently. What’s still possible is stopping it from getting worse – and understanding the causes is the first step toward doing that.
This guide covers why gums recede, what each stage means for your treatment options, and the honest answer to the question most patients ask: can receding gums grow back?
6 Causes of Gum Recession
Receding gums rarely have a single cause. More often, they result from a combination of factors – some behavioral, some biological – that put sustained pressure on gum tissue over time. Here are the six most common.
1. Aggressive Brushing
Brushing too hard, or using a hard-bristled toothbrush, is one of the most preventable causes of gum recession. The mechanical force gradually wears away both enamel and gum tissue. The damage happens slowly enough that most people don’t connect their brushing habits to the recession they eventually notice. A soft-bristled toothbrush with light pressure – enough to clean the tooth, not scrub it – is all that’s needed. Electric toothbrushes with pressure sensors can help break the habit for people who overbrus without realizing it.
2. Gum Disease
Periodontal disease is the most common cause of significant gum recession. It begins as gingivitis – inflammation driven by plaque buildup at the gumline – and progresses to periodontitis when bacteria invade below the gum tissue, destroying the ligaments and bone that anchor teeth in place. As that supporting structure is lost, the gum tissue recedes. This is the pathway that leads to the most severe cases of recession and, eventually, tooth loss if left untreated.
3. Genetics
Some people are born with thinner gum tissue than others, or with a gum attachment pattern that makes recession more likely regardless of oral hygiene quality. If your parents had significant gum recession, your risk is higher. Genetics don’t make recession inevitable – but they do mean that even with good habits, more frequent monitoring and professional cleanings may be warranted.
4. Teeth Grinding and Clenching
Bruxism – grinding or clenching the teeth, most often during sleep – creates repeated lateral forces on teeth and gum tissue. Over time this contributes to both gum recession and bone loss around teeth. Many people who grind don’t know they do it until a dentist points out the wear patterns. A custom night guard doesn’t stop the grinding reflex, but it redirects the force and protects the teeth and gum tissue from its effects.
5. Tobacco Use
Smoking and chewing tobacco reduce blood flow to gum tissue, impair the immune response to bacterial infection, and slow healing. Tobacco users are significantly more likely to develop gum disease and recession than non-users – and their gum disease tends to be more advanced and harder to treat. One of the more insidious effects is that tobacco can mask the classic signs of gum disease (bleeding gums) by constricting blood vessels, which means the disease progresses further before it’s detected.
6. Misaligned Teeth or Bite Issues
When teeth are significantly misaligned, some teeth bear more pressure than they should during biting and chewing. This uneven force distribution can cause localized gum recession on the overloaded teeth. Similarly, poorly fitting dental work – a crown that’s slightly too high, for example – creates abnormal bite forces that contribute to recession over time. Correcting the underlying alignment issue is part of treating the recession in these cases.
Stages of Recession and What Each Means for Treatment
Gum recession is typically classified using the Miller Classification system, which grades severity based on how far the gum has pulled back and whether underlying bone and tissue loss has occurred. In plain terms, here’s what each stage means practically.
Early Recession (Miller Class I)
The gum has pulled back slightly, but only the gum tissue is involved – the underlying bone and tissue between teeth is still intact. There is no loss of the interdental tissue (the gum that fills the triangular space between teeth). At this stage, recession can often be halted entirely with improved oral hygiene habits, technique corrections, and more frequent professional cleanings. Surgical intervention is usually not required yet, though the situation should be actively monitored. The five stages of receding gums are worth understanding in detail to know where you fall.
Moderate Recession (Miller Class II)
The recession has extended to or beyond the mucogingival junction – the boundary between the firmer attached gum tissue and the looser tissue below. Some root surface is now exposed. The interdental tissue is still intact. At this stage, surgical treatment (gum grafting) becomes a realistic option to restore coverage and prevent further loss. Without intervention, continued recession is likely.
Advanced Recession (Miller Class III)
Significant root exposure is present, and there is some loss of interdental bone or tissue. Complete root coverage through grafting may not be achievable – the goal shifts from full restoration to stabilization and partial improvement. Teeth may be sensitive, and the exposed root surfaces are at higher risk of decay. Active periodontal treatment is essential at this stage.
Severe Recession (Miller Class IV)
Severe bone and tissue loss has occurred. The recession extends well beyond the mucogingival junction and the interdental tissue is significantly reduced. Complete root coverage is not achievable with current surgical techniques. Treatment focuses on preventing further progression, managing sensitivity, protecting exposed root surfaces from decay, and preserving the teeth that remain. At this stage, some teeth may already be mobile or at risk of loss.
Can Receding Gums Grow Back?
No. Gum tissue that has receded does not regenerate on its own. Unlike some body tissues, gingival tissue does not regrow once it has pulled away from the tooth. This is the honest answer – and it’s an important one, because a significant amount of misleading information circulates about “natural remedies” that claim to reverse recession.
What is possible – and what makes early detection so valuable – is stopping further recession. The gum tissue that remains can be stabilized. The cause of the recession can be addressed. And in moderate cases, surgical procedures can restore coverage over exposed root surfaces using tissue grafted from elsewhere in the mouth. But none of that undoes recession that has already occurred – it prevents more from happening.
The practical implication: if you notice your gums have pulled back, the time to act is now, not when symptoms become severe. Every millimeter of additional recession narrows the treatment options available.
Treatment Options by Severity
Treatment for receding gums is matched to how far the recession has progressed and what’s driving it. There is no single treatment – the right approach depends on the stage, the cause, and the individual patient’s gum tissue characteristics.
Early Stage: Habit Changes and Improved Oral Hygiene
For mild recession where the cause is behavioral – overbrushing, poor technique, or tobacco – correcting the behavior and improving oral hygiene is the foundation of treatment. This means switching to a soft-bristled brush, adjusting technique, quitting tobacco, and returning to regular professional cleanings. If grinding is a factor, a night guard is added.
Building a consistent at-home routine matters. Our guide on how to restore gum health covers the daily habits that make the most meaningful difference – brushing angle, flossing technique, and the role of antimicrobial mouthwash. For patients weighing different oral hygiene approaches, the comparison of mouthwash vs. oil pulling for gum health is also worth reviewing.
Moderate Stage: Scaling and Root Planing
When gum disease is driving the recession, scaling and root planing – commonly called deep cleaning – is typically the first professional treatment. This procedure removes plaque and calculus (hardened tartar) from below the gumline and smooths the root surface to make it harder for bacteria to reattach. It is performed under local anesthetic and may require multiple appointments depending on how many teeth are involved.
Scaling and root planing does not restore lost tissue, but it addresses the bacterial infection that is causing ongoing destruction. It stops the active disease process – which is the prerequisite for any other treatment to be effective. Many patients who complete a full course of deep cleaning and maintain good hygiene afterward see their recession stabilize and require no further intervention beyond regular periodontal maintenance cleanings.
Moderate to Advanced Stage: Gum Grafting
When root surfaces are significantly exposed and coverage is both desired and surgically achievable, a gum graft is the standard procedure. The most common type is a connective tissue graft, where a small amount of tissue is taken from the roof of the mouth (palate) and placed over the exposed root surface at the recession site. The graft is sutured in place and, over several weeks, integrates with the surrounding gum tissue.
The results depend on the stage of recession – Class I and Class II recession typically achieves near-complete or complete root coverage. Class III recession achieves partial coverage. Class IV recession generally does not achieve meaningful coverage through grafting alone.
Recovery from gum grafting involves several days of eating soft foods, avoiding the surgical site during brushing, and some soreness at both the graft and donor sites. Most patients return to normal activity within a week, though the tissue takes several weeks to fully heal and integrate.
Severe Stage: Periodontal Surgery and Stabilization
In advanced cases where bone loss has occurred alongside recession, more involved periodontal surgery may be recommended. This can include open flap debridement (lifting the gum tissue to access and clean deep pockets) or bone regeneration procedures where bone grafting material is placed to rebuild lost support structure. These procedures don’t reverse advanced recession, but they can stabilize the situation and preserve remaining bone and tissue.
Cost of Gum Recession Treatment in Ontario
Treatment costs vary significantly depending on the procedure and how many teeth are involved. Here is a realistic overview of what patients in the GTA can expect.
- Scaling and root planing – typically billed per quadrant. In Ontario, a full-mouth deep cleaning commonly runs $600 to $1,200 depending on the number of quadrants treated and the severity of buildup. Most private insurance plans cover scaling as a basic or preventive benefit, though annual maximums apply. CDCP covers scaling for eligible patients.
- Gum grafting (connective tissue graft) – costs vary by the number of teeth treated and the complexity of the case. Single-tooth graft procedures in Ontario typically run $800 to $1,500. Multi-tooth cases are higher. Most insurance plans categorize gum grafts as a major benefit, covering 50% to 80% depending on the plan and annual maximum remaining.
- Night guard – a custom-fabricated night guard from your dentist typically costs $400 to $700 in Ontario. Many plans cover a portion under major benefits. Over-the-counter options are available but do not offer the fit and protection of a custom guard.
- Periodontal maintenance cleanings – after active treatment, patients typically move to maintenance cleanings every 3 to 4 months rather than every 6. Each visit costs similarly to a regular cleaning, typically $150 to $300, though insurance coverage for the frequency may vary by plan.
The most cost-effective point of intervention is always the earliest one. A scaling appointment at mild recession costs considerably less than a gum graft at moderate recession, which costs considerably less than the restorative work required once teeth are lost to advanced periodontal disease.
Frequently Asked Questions About Receding Gums
How do I know if my gums are receding?
The most common signs are teeth that appear longer than they used to, increased sensitivity to cold or touch along the gumline, a visible notch at the base of a tooth where the gum has pulled back, and roots that are partially exposed. Some people first notice it when their gum tissue looks uneven – one tooth sits higher than adjacent teeth. Because recession is gradual, it often goes undetected until a dentist measures it during a periodontal assessment. If you have any of these signs, a dental appointment is the right next step – the earlier recession is caught, the more options are available.
Can I stop receding gums from getting worse without surgery?
In many cases, yes – particularly at earlier stages. If the recession is mild and driven by overbrushing, technique correction and switching to a soft-bristled brush can halt further loss. If gum disease is involved, professional scaling and root planing combined with improved home care effectively stops active disease progression in most patients. Surgery is not always necessary, but it depends heavily on the cause, the stage, and whether conservative treatment achieves stability. Your dentist or periodontist will monitor the recession at each visit to determine if it is progressing or stable.
Does gum recession cause tooth sensitivity?
Yes, frequently. The root surfaces exposed by recession do not have the protective enamel layer that covers the crown of the tooth. Dentin – the softer layer beneath enamel – makes up most of the root surface, and it contains tiny channels that connect to the tooth’s nerve. When exposed to temperature changes, air, or touch, these channels transmit sensation more readily. Sensitivity along the gumline or at the base of teeth is one of the earliest functional symptoms many patients notice. Desensitizing toothpastes can reduce sensitivity somewhat, but they don’t address the recession itself.
Is receding gum treatment covered by insurance in Ontario?
Scaling and root planing is typically covered under basic or preventive benefits in most Ontario dental plans, often at 70% to 100% with annual maximums. Gum grafts are usually categorized as major restorative or periodontal benefits, covered at 50% to 80% depending on the plan. Night guards are covered under major benefits by many plans. CDCP covers periodontal services including scaling for eligible patients, with co-payment amounts depending on household income. Always check your specific plan and request a pre-determination from your dentist before scheduling major periodontal work – this gives you a confirmed cost estimate before treatment begins.
When should I see a dentist about receding gums?
As soon as you notice it. The earlier receding gums are assessed, the more treatment options are available and the less intervention is typically needed. Warning signs worth calling about immediately include teeth that have visibly pulled free from the gum, significant root exposure on multiple teeth, loose teeth, bleeding that persists despite good oral hygiene, or pain along the gumline. If you’ve been managing sensitivity with over-the-counter products for months without a dental assessment, that’s overdue. Recession that is caught at Class I is a very different clinical situation from recession caught at Class III – the difference in treatment complexity and cost is substantial.
Book a Periodontal Evaluation at The Dental Team
If you’ve noticed your gums pulling back, increased sensitivity, or teeth that look longer than they used to, a periodontal evaluation is the right next step. The assessment is straightforward – your dentist or hygienist measures recession at each tooth, probes the depth of any gum pockets, reviews X-rays for bone levels, and gives you a clear picture of where things stand and what treatment, if any, is needed.
The Dental Team provides periodontal assessments and treatment across locations in Milton, Mississauga, and Brampton. We accept CDCP coverage and most private insurance plans, and we review your coverage and out-of-pocket costs before any treatment begins.
Contact The Dental Team for more information about compassionate dental care services – or book directly at the location nearest to you.
