What This Guide Covers and Who It Is For
This guide explains how gum recession is treated at each stage, from early tissue loss to advanced cases involving bone damage.
Gum recession means your gum tissue has pulled back from the tooth, exposing part of the root surface. The root is softer than enamel and more vulnerable to decay, sensitivity, and further breakdown. Recession can affect one tooth or many teeth, and it tends to get worse over time without treatment. [1]
If you have noticed that your teeth look longer than they used to, or if cold drinks cause a sharp sting along your gum line, this guide is for you. It is also useful if your dentist has already mentioned recession and you want to understand what comes next.
Throughout this guide, you will see treatments grouped by severity: mild, moderate, and severe. A the periodontics page can help you find a specialist qualified to evaluate your specific situation.
Understanding Gum Recession: Causes, Classification, and Treatment Options
Gum recession happens when the gingiva (gum tissue) moves away from the crown of the tooth and exposes the root.
What Causes Gums to Recede
The two most common causes are aggressive tooth brushing and periodontal (gum) disease. [1] Both are preventable, which makes early awareness especially valuable.
Brushing too hard, or using a medium- or hard-bristle brush, can physically wear away gum tissue over months and years. The damage is gradual, so many people do not realize it is happening until a dentist points it out. [2]
Periodontal disease is a bacterial infection that breaks down gum tissue and the bone that supports your teeth. It often starts as gingivitis, which is the earliest, reversible stage of gum disease. Left untreated, gingivitis can progress to periodontitis, where the tissue and bone destruction becomes permanent. [1]
Other contributing factors include genetics, tobacco use, teeth grinding (bruxism), misaligned teeth, and hormonal changes. Some people have naturally thin gum tissue that is more prone to recession.
How Recession Severity Is Measured
A periodontist measures recession in millimeters using a small probe placed between the tooth and the gum. The measurement runs from where the gum should be (the cementoenamel junction) to where it actually sits today.
Mild recession is generally 1 to 2mm. Moderate recession falls in the 3 to 4mm range. Severe recession is 5mm or more. The periodontist also checks how much bone support remains, because bone loss affects which treatments will work.
The Miller classification system groups recession into four classes based on how much tissue and bone have been lost and whether the tissue between teeth (interdental papilla) is still intact. Class I and II cases typically respond very well to grafting. Class III and IV cases involve more extensive tissue and bone loss, meaning full root coverage may not be achievable.
Treating Mild Recession (1–2mm)
Mild recession often does not require surgery. The main goal at this stage is to stop the recession from getting worse.
Your dentist or periodontist will typically recommend switching to a soft-bristle toothbrush and using a gentle, circular brushing technique rather than a back-and-forth scrubbing motion. [2] An electric toothbrush with a pressure sensor can help if you have trouble controlling force.
If early gum disease is contributing to the recession, a professional cleaning called scaling and root planing may be recommended. This non-surgical procedure removes plaque and tartar from below the gum line and smooths the root surface so the gum can reattach more easily. [1]
At this stage, the periodontist will monitor your gums at regular intervals, typically every three to six months. If the recession stabilizes, no further treatment may be needed.
Treating Moderate Recession (3–4mm)
Moderate recession usually calls for a gum graft, a surgical procedure that adds tissue over the exposed root.
In a connective tissue graft, the most common type, the periodontist takes a small piece of tissue from the roof of your mouth (the palate) and stitches it over the exposed root. The grafted tissue heals in place and forms a new band of attached gum. Other donor options include tissue from a tissue bank (allograft) or collagen-based materials, which avoid the need for a palate donor site.
A second option is the pinhole surgical technique, where the periodontist makes a tiny hole in the gum tissue and uses special instruments to loosen and reposition the existing tissue over the root. Small collagen strips are placed underneath to hold the tissue in its new position. This approach avoids a separate donor site, but not all recession patterns qualify for it.
In many cases, grafting procedures achieve significant root coverage and reduce sensitivity. Results vary based on the severity of recession, the type of graft, and whether gum disease is also present.
Treating Severe Recession (5mm or More)
Severe recession often involves bone loss and may require both a gum graft and a bone graft.
When the jawbone beneath the gum has deteriorated, a gum graft alone may not have enough structural support to succeed. A bone graft places bone material (from you, a donor, or a synthetic source) into the area of bone loss. This gives the body a scaffold to grow new bone. The gum graft is then placed over the regenerated site. [1]
In some severe cases, the periodontist may use guided tissue regeneration (GTR). GTR involves placing a small barrier membrane between the gum tissue and the bone graft. The membrane keeps fast-growing gum tissue from filling the space before slower-growing bone has a chance to regenerate.
Full root coverage becomes harder to achieve when bone loss is extensive. The periodontist will explain realistic expectations for your specific case. Even partial coverage can reduce sensitivity, protect the root from further decay, and improve the long-term outlook for the tooth.
Practical Details Before You Seek Treatment
Knowing when to act, how to prepare, and what factors affect your outcome can help you make better decisions about gum recession treatment.
When to Address Recession
There is no specific age at which recession treatment is recommended. Recession can develop in adults of any age, though it becomes more common after 40. [1] The key factor is not age but how quickly the recession is progressing and whether symptoms like sensitivity or root decay are present.
If your recession has been stable for years and measures only 1 to 2mm, your dentist may suggest monitoring alone. If it is worsening or causing symptoms, earlier treatment typically leads to a better outcome because there is more tissue and bone to work with.
How to Prepare for a Gum Graft
Before surgery, the periodontist needs your gums to be as healthy as possible. If you have active gum disease, you will likely need scaling and root planing first. This may take one to two visits and a few weeks of healing before grafting.
You may be asked to stop smoking for several weeks before and after the procedure. Tobacco reduces blood flow to the gums and significantly lowers the success rate of grafts. Your periodontist will also review your medications, because blood thinners and certain supplements can affect healing.
Plan for soft foods for one to two weeks after surgery. Stock up on yogurt, mashed potatoes, smoothies, and scrambled eggs before your appointment.
Factors That Affect Treatment Success
Several factors influence how well gum recession treatment works. The amount of remaining bone support is one of the most important predictors. More bone typically means better results from grafting.
Smoking is the strongest modifiable risk factor. Patients who smoke heal more slowly and have higher rates of graft failure. Uncontrolled diabetes, teeth grinding, and poor oral hygiene after surgery also reduce the chance of a successful outcome. [1]
Your anatomy matters too. Teeth that are severely out of alignment or have a thin band of existing gum tissue may be harder to treat. The periodontist will evaluate all of these factors and explain how they apply to your case.
What to Expect During and After Treatment
Most gum recession procedures are performed in the periodontist's office under local anesthesia, and recovery takes one to two weeks.
During the Procedure
For a connective tissue graft, the periodontist numbs the treatment area and the palate. A small flap is opened on the palate to remove a thin strip of connective tissue. That tissue is placed over the exposed root and secured with tiny stitches. The palate flap is closed with stitches as well. The entire process typically takes 60 to 90 minutes per tooth or group of adjacent teeth.
If a bone graft is also needed, the periodontist places the bone material first, covers it with a membrane if guided tissue regeneration is being used, and then positions the gum graft on top. This adds some time to the procedure.
Sedation options, such as oral sedation or nitrous oxide, are available for patients who feel anxious. Discuss this with your periodontist during the consultation.
Recovery and Aftercare
Most patients report mild to moderate discomfort for the first few days, managed with over-the-counter pain medication or a short prescription. The palate donor site is usually the most uncomfortable area, often described as similar to a pizza burn on the roof of your mouth.
You will be asked to avoid brushing or flossing the grafted area for about two weeks. A prescription mouth rinse is typically provided to keep the area clean. Stick to soft, cool foods and avoid straws, as suction can disturb the graft.
A follow-up appointment is usually scheduled one to two weeks after surgery so the periodontist can check healing and remove any non-dissolving stitches. Full maturation of the grafted tissue takes several months, but most people return to normal eating and brushing within two to three weeks.
Gum Recession Treatment Costs and Insurance
Gum graft surgery typically costs between $600 and $1,200 per tooth. Costs vary by location, provider, and case complexity.
Non-surgical treatments like scaling and root planing are less expensive, often ranging from $200 to $400 per quadrant (one-quarter of the mouth). If bone grafting is added to a gum graft, the total can increase, sometimes reaching $1,500 to $3,000 or more per site. These figures are general estimates; your periodontist's office can provide a specific fee after an examination.
Many dental insurance plans cover a portion of gum recession treatment when it is classified as medically necessary rather than cosmetic. Scaling and root planing is commonly covered under periodontal benefits. Gum grafts are often covered at least partially, though you may need pre-authorization. Bone grafts may have separate coverage limits.
Ask your periodontist's office to submit a pre-treatment estimate to your insurance company. This gives you a clearer picture of your out-of-pocket cost before you commit to a procedure. Many offices also offer payment plans.
When to See a Periodontist vs. a General Dentist
A general dentist can monitor mild recession and perform preventive care, but a periodontist should evaluate recession that is moderate, worsening, or causing symptoms.
Periodontists complete an additional three years of specialty training beyond dental school, focused on the gums, bone, and soft tissue around teeth. They perform gum grafts, bone grafts, and guided tissue regeneration procedures regularly. [1]
You should see a periodontist if your recession measures 3mm or more, if it is progressing despite good home care, if you have sensitivity or root decay on the exposed area, or if your dentist has recommended a gum graft. You should also see a periodontist if you have been diagnosed with periodontitis, because the underlying disease needs to be controlled before or alongside any recession treatment.
Your general dentist may refer you directly, or you can search for a periodontist in your area through a specialist directory. Visit the periodontics page to learn more about what periodontists do and how to find one near you.
Find a Periodontist Near You
If you are dealing with receding gums, a periodontist can evaluate the severity, explain your treatment options, and help you protect your teeth for the long term. Use the the periodontics page on My Specialty Dentist to search for a board-eligible or board-certified periodontist in your area and schedule a consultation.
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