Receding gums: what causes it, and what can be done.

Recession is the loss of gum tissue at the margin, so more of the tooth — and eventually the root — is exposed. The root has no enamel to protect it, which is why recession brings sensitivity and a higher risk of root decay. The tissue that is lost does not regenerate by itself, so treatment is about halting the cause and, where needed, replacing tissue surgically. Catching it early, while it is mild, keeps things simple.

The two biggest causes pull in opposite directions: gum disease, where infection destroys the supporting tissue, and over-brushing — scrubbing hard with a stiff brush, which physically wears the gum away. Others include grinding/clenching, a misaligned bite, smoking, lip or tongue piercings that rub, and simply genetics (thin gum tissue recedes more easily). Identifying which applies to you decides the fix — gentler brushing solves a very different problem from treating periodontitis.

Tell-tale signs are teeth that look longer, a visible notch or step at the gum line, sensitivity to hot, cold and sweet as the root is exposed, and teeth that feel slightly rough near the gum. If recession is from gum disease you may also see bleeding, redness or swelling. Because it is gradual, comparing against an old photo or a dentist's records is often how the change is first confirmed.

First, the cause is addressed: a gentler brushing technique and soft brush for over-brushing, gum-disease treatment (cleaning below the gum line) where infection is the driver, or a night guard for grinding. Exposed sensitive roots can be soothed with fluoride or bonding. Where recession is significant or progressing, a periodontist can perform a gum graft to cover the root and rebuild the margin. The right step depends entirely on the cause and how far it has gone.

Most recession is preventable or stoppable: brush gently with a soft brush (let the bristles do the work, don't scrub), clean between the teeth daily to keep gum disease away, don't smoke, and treat grinding with a guard. Regular check-ups track the gum margin so any change is caught while it is small. You can't regrow lost gum at home, but you can almost always stop it getting worse — which is the realistic and worthwhile goal.