Gum Recession Treatment in Kitchener
Causes, Sensitivity and Treatment Options for Exposed Tooth Roots
Gum recession occurs when the edge of the gum moves away from its previous position and exposes part of the tooth root.
It may affect one tooth, several teeth or much of the mouth. Some areas remain stable for years, while others gradually progress. Recession can be associated with periodontal disease, but it can also develop around otherwise healthy teeth because of thin gum tissue, tooth position, brushing trauma, orthodontic movement or other local factors.
At MI Dental in Kitchener, we assess:
- Why the gumline has changed
- Whether the recession is stable or progressing
- Whether active gum disease is present
- Whether the exposed root is sensitive, worn or decayed
- Whether treatment is required
- Whether referral to a periodontist would be beneficial
The objective is not simply to cover an unattractive root. We first identify the condition of the gums, bone, tooth surface and bite so that treatment addresses the actual problem.
Gum Recession at a Glance
| Question | General answer |
|---|---|
| Is recession always gum disease? | No. Recession can occur with or without active periodontitis |
| Can receded gums grow back naturally? | The gumline generally does not return to its previous position on its own |
| Does every case need treatment? | No. Stable, healthy and symptom-free recession may be monitored |
| Can recession cause sensitivity? | Yes. Exposed root surfaces can react to cold, touch, sweets or air |
| Can the root develop a cavity? | Yes. Root surfaces are more vulnerable to decay than enamel-covered crowns |
| Can brushing cause recession? | Traumatic technique may contribute, particularly where the tissues are thin, but recession rarely has only one cause |
| Can an electric toothbrush cause recession? | The brush itself is not automatically harmful; excessive pressure and poor technique are more important |
| Can a filling repair recession? | A restoration can protect a worn or decayed root, but it does not replace missing gum tissue |
| Can gum grafting cover the root? | Often, but the achievable coverage depends on the defect and surrounding support |
| Will I need a periodontist? | Referral may be recommended for progressive, extensive, sensitive or aesthetically significant recession |
What Is Gum Recession?
Gingival recession is the movement of the gum margin toward the root end of the tooth, leaving part of the root surface exposed.
The exposed root is covered by cementum and dentin rather than thick enamel. These tissues are more vulnerable to:
- Temperature sensitivity
- Abrasive wear
- Acid erosion
- Root decay
- Discolouration
- Plaque retention
- Non-carious cervical lesions
Recession is common and is associated with several anatomical, inflammatory and behavioural factors rather than one universal cause. Recent evidence identifies associations with periodontitis, plaque, smoking, high frenum attachment, traumatic oral-hygiene practices and other patient-specific factors.
Is Gum Recession the Same as Gum Disease?
No.
Recession without active periodontitis
A patient may have an exposed root but:
- Healthy-looking gums
- Minimal bleeding
- Healthy probing measurements
- No periodontal bone loss
- No active periodontal inflammation
This may occur around a tooth positioned toward the outside of the bone, where gum tissue is thin, or after previous orthodontic movement or local trauma.
Recession associated with periodontitis
Periodontitis can destroy the attachment and bone supporting the teeth. As the supporting tissues are lost, the gumline may recede and the teeth may appear longer.
Other findings may include:
- Periodontal pockets
- Bleeding on probing
- Bone loss
- Tooth mobility
- Food trapping
- Tooth migration
- Persistent bad breath
Modern periodontal classification recognizes that clinical gum health can exist on either an intact or a reduced periodontium. Therefore, the presence of recession alone does not prove that active periodontitis is present.
Our Gum Disease page explains gingivitis, periodontitis and periodontal treatment in greater detail.
Signs and Effects of Gum Recession
A tooth that appears longer
The visible crown has not necessarily grown. More of the root has become exposed.
A notch near the gumline
Wear or loss of tooth structure may accompany recession.
These defects can be:
- Smooth and shallow
- Wedge-shaped
- Sensitive
- Discoloured
- Deep enough to weaken the cervical tooth structure
Cold or touch sensitivity
Dentin contains microscopic tubules that communicate with the internal pulp. When exposed, cold drinks, air, brushing or sweet foods may produce a brief sharp sensation.
Sensitivity associated with recession can often be treated, but the tooth should first be assessed to exclude decay, a fracture or pulpal disease.
Root decay
Root surfaces are less resistant to decay than enamel.
Risk may increase with:
- Dry mouth
- Frequent sugar exposure
- Inadequate plaque control
- Reduced dexterity
- Multiple exposed roots
- Previous root cavities
Aesthetic concerns
Recession may create:
- Uneven gum levels
- Longer-looking teeth
- Darker root colour
- Triangular spaces between teeth
- Asymmetry in the smile
Difficulty cleaning
Irregular gum contours and open spaces can trap plaque and food. The patient may require different interdental tools in different parts of the mouth.
Why Do Gums Recede?
Gum recession is usually the result of several predisposing and contributing factors acting together.
Thin Gum Tissue and Bone Anatomy
Some people naturally have:
- Thin gingival tissue
- A narrow zone of keratinized tissue
- Thin bone over the front of a root
- A root positioned close to the edge of the jawbone
- Prominent tooth contours
These anatomical features can make the gumline more susceptible to recession when exposed to inflammation, tooth movement or mechanical trauma.
A tooth positioned toward the cheek or lip side of the dental arch may have less bone and soft tissue covering its root.
Periodontal Disease
Periodontitis can cause loss of the attachment and bone surrounding teeth.
Recession may appear as:
- Generalized exposure around many teeth
- Irregular gum margins
- Loss of the papillae between teeth
- Black triangular spaces
- Deep pockets in some areas
- Mobility or tooth movement
Treating the inflammation may stabilize the disease, but routine periodontal treatment does not automatically restore the gumline to its former level.
Toothbrushing Technique
Forceful brushing may traumatize the gums and exposed root surfaces, especially when the tissue is already thin.
Potentially harmful patterns include:
- Aggressive horizontal scrubbing
- Repeated pressure in one area
- Medium or hard bristles
- A worn brush with distorted bristles
- Highly abrasive toothpaste
- Brushing immediately after frequent acidic exposure
- Assuming that harder brushing cleans better
However, recession should not automatically be blamed on the toothbrush. Reviews describe recession as multifactorial and note uncertainty about precisely how brushing trauma, anatomy and other factors interact.
The answer is not to stop brushing. It is to use:
- Soft bristles
- Gentle pressure
- Controlled movements
- A head that reaches the area comfortably
- A pressure sensor when helpful
Our Choosing an Electric or Manual Toothbrush guide explains these features further.
Tooth Position and Orthodontic Treatment
Orthodontic treatment does not inevitably cause recession.
Risk may increase when a tooth is moved outside the available bony envelope or when thin tissue, plaque, inflammation and other local factors are present. A systematic review found that recession after orthodontic treatment is influenced by several patient, periodontal and treatment-related factors rather than orthodontic movement alone.
Patients considering orthodontic movement may benefit from periodontal assessment when they already have:
- Thin tissue
- Existing recession
- Minimal keratinized tissue
- Prominent roots
- Periodontal attachment loss
- Teeth positioned outside the arch
In selected cases, orthodontic repositioning may improve the environment around the tooth. In other cases, soft-tissue grafting may be discussed before or after orthodontic treatment.
Plaque and Local Inflammation
Plaque accumulation can inflame the tissues and increase susceptibility to recession.
Local plaque retention may be encouraged by:
- Crowded teeth
- Rough filling margins
- Calculus
- Orthodontic appliances
- Poorly contoured crowns
- Open contacts
- Difficult-to-clean root surfaces
Improving plaque control may reduce inflammation, but it does not make an already exposed root disappear.
High or Pulling Frenum Attachment
A frenum is a band of tissue connecting the lip or cheek to the gums.
In selected cases, a prominent or unfavourably positioned frenum may place tension on a vulnerable gum margin or make effective cleaning difficult. Its importance must be assessed clinically rather than inferred from appearance alone.
Oral Piercings and Local Trauma
Lip or tongue jewellery can repeatedly contact the gums and teeth.
Possible effects include:
- Localized recession
- Chipped teeth
- Wear
- Gum trauma
- Tooth movement
- Infection
Removing the source of trauma may help prevent progression, but established tissue loss may remain.
Smoking and Tobacco
Smoking is associated with periodontal disease and may also contribute to recession and impaired tissue healing.
It may reduce visible bleeding even when periodontal disease is present. This can make the tissues appear deceptively calm.
Smoking can also reduce the predictability of periodontal and root-coverage procedures.
Age and Previous Treatment
Recession becomes more common with increasing age because contributing exposures accumulate over time.
It may also become visible after:
- Periodontal treatment
- Resolution of swollen tissue
- Tooth movement
- Crown or filling replacement
- Extraction of a neighbouring tooth
- Changes in plaque control
When inflamed, swollen gums become healthier and shrink to a firmer contour, previously hidden root exposure may become more noticeable.
Bite Forces, Bruxism and Occlusal Trauma
Bite forces can injure teeth and their supporting structures, particularly when periodontal support is already reduced.
However, it is too simplistic to say that a high filling or tooth grinding directly makes the gum retreat. Consensus evidence indicates that occlusal trauma does not initiate periodontitis, and evidence regarding its contribution to recession and cervical tooth defects remains incomplete or mixed.
We evaluate the bite when there is:
- Tooth mobility
- Pain on biting
- Wear facets
- Fractures
- Muscle symptoms
- An obvious premature contact
- A history of grinding or clenching
Bite adjustment or a night guard may be appropriate for a separate occlusal problem, but neither should be sold as a universal cure for gum recession.
What Are Abfraction Lesions?
The original page described wedge-shaped defects as abfractions caused by tooth flexure.
That conclusion is too definite.
The preferred descriptive term is non-carious cervical lesion: loss of tooth structure near the gumline that is not caused by decay.
Possible contributing processes include:
- Abrasion from brushing or other mechanical contact
- Acid erosion or biocorrosion
- Tooth loading
- Tooth anatomy
- Age
- A combination of factors
The role of occlusal stress remains debated. A wedge-shaped appearance alone cannot prove that “abfraction” caused the defect.
How We Assess Gum Recession
Medical and dental history
We review:
- When the recession was first noticed
- Whether it appears to be changing
- Sensitivity
- Brushing habits
- Toothbrush and toothpaste
- Smoking
- Orthodontic history
- Grinding or clenching
- Previous gum treatment
- Dry mouth
- Medical conditions and medications
Measurement of the gumline
We may record:
- Depth of recession
- Probing depth
- Clinical attachment level
- Width of keratinized tissue
- Tissue thickness
- Bleeding
- Plaque
- Tooth mobility
- Root-surface wear or decay
Photographs and previous records can help determine whether the condition is progressing.
Examination of the surrounding support
We assess:
- Interdental gum and bone levels
- Tooth position
- Root prominence
- Frenum attachment
- Periodontal pockets
- Restorations
- Contact points
- Occlusal findings
Interdental attachment is particularly important because it helps predict how much surgical root coverage may be achievable. The Cairo recession classification uses interproximal attachment levels to categorize defects and assist with prognosis.
Dental X-rays
X-rays may be used to evaluate:
- Periodontal bone levels
- Root shape
- Decay
- Existing restorations
- Neighbouring teeth
- Other causes of sensitivity
The thin facial bone associated with isolated recession may not always be shown clearly on routine two-dimensional dental X-rays.
Is the Recession Stable or Progressing?
One examination provides a measurement but not always the rate of change.
Progression may be evaluated through:
- Previous periodontal charts
- Earlier photographs
- Comparison with old digital scans
- Previous radiographs
- Changes in sensitivity
- New root wear
- Patient observations
A stable one-millimetre recession without disease or symptoms may require monitoring rather than surgery.
More concern may be warranted when there is:
- Measurable progression
- Increasing sensitivity
- Root decay
- Thin or fragile tissue
- Difficulty cleaning
- Persistent inflammation
- Significant aesthetic concern
- Planned orthodontic or restorative treatment
- Insufficient tissue around a strategic tooth
Does Every Receding Gum Need Treatment?
No.
Observation may be appropriate when the recession is:
- Stable
- Cleanable
- Free of inflammation
- Not sensitive
- Not decayed
- Not interfering with planned treatment
- Acceptable to the patient aesthetically
The treatment should be proportionate to the problem.
A patient should not be frightened into grafting merely because one root is visible. Conversely, progressive recession should not be dismissed simply because it is painless.
Gum Recession Treatment at MI Dental
Treatment depends on the cause, symptoms, extent and patient priorities.
Improving Brushing Technique
Recommendations may include:
- Switching to a soft-bristled brush
- Reducing pressure
- Guiding rather than scrubbing an electric brush
- Using a pressure sensor
- Choosing a smaller brush head
- Avoiding highly abrasive toothpaste where appropriate
- Waiting after substantial acidic exposure before brushing
- Demonstrating cleaning around the recessed site
The goal is effective plaque removal without repeated tissue trauma.
Treating Gum Inflammation
When plaque-related inflammation is present, treatment may involve:
- Professional cleaning
- Scaling and root planing when periodontitis is diagnosed
- Improved daily brushing
- Appropriate interdental cleaning
- Treatment of rough plaque-retentive restorations
- Periodontal maintenance
- Smoking cessation support
- Management of relevant medical risk factors
Controlling inflammation is important before considering cosmetic root coverage.
Managing Tooth Sensitivity
Depending on the diagnosis, treatment may include:
- Desensitizing fluoride toothpaste
- Professional fluoride varnish
- Dentin-desensitizing agents
- Modification of brushing technique
- Treatment of root decay
- Bonding or restoration of a significant cervical defect
- Gum-grafting referral
Sensitivity treatment aims to reduce fluid movement within exposed dentinal tubules, but persistent or localized pain should be investigated for other causes.
Treating Root Cavities
Root decay requires separate management.
Treatment may involve:
- Fluoride exposure
- Dietary modification
- Dry-mouth management
- Professional remineralizing treatment
- A tooth-coloured restoration
- More frequent monitoring
A root surface should not be filled merely because it is exposed. Restoration is considered when there is active decay, structural loss, sensitivity, progression or another clinical reason.
Restoring a Non-Carious Cervical Lesion
A composite restoration may be appropriate when a lesion:
- Is progressing
- Is sensitive despite conservative care
- Traps plaque
- Compromises the tooth structurally
- Has active root decay
- Creates an aesthetic concern
- Is needed to support another treatment
A filling restores lost tooth structure; it does not move the gumline or regenerate periodontal attachment.
Restorative contours must be carefully planned because a bulky or rough margin can make plaque control more difficult.
Correcting Local Restorative Factors
A rough filling, overcontoured crown or poorly positioned margin can contribute to plaque retention or tissue irritation.
Treatment may include:
- Polishing
- Reshaping
- Replacing the restoration
- Improving contact and contour
- Coordinating restorative and periodontal treatment
Orthodontic Management
In selected cases, orthodontically moving a tooth toward a more favourable position within the supporting bone may improve the periodontal environment.
This requires coordinated assessment because tooth movement can also increase risk when the tissues are thin or active inflammation is present.
Gum Grafting and Root-Coverage Procedures
A periodontist may recommend a root-coverage or tissue-augmentation procedure when recession is:
- Progressive
- Sensitive
- Difficult to clean
- Aesthetically concerning
- Associated with thin tissue
- Affecting a strategically important tooth
- Relevant to planned orthodontic or restorative treatment
Gum grafting may use:
- Connective tissue from the palate
- A free gingival graft
- A coronally advanced flap
- A tunnel approach
- Selected donor or biomaterial substitutes
- A combination of approaches
The American Academy of Periodontology notes that gum graft surgery may cover exposed roots, reduce sensitivity, improve appearance and help protect against additional recession.
Can Complete Root Coverage Be Guaranteed?
No.
The result depends on:
- Amount of recession
- Interdental attachment and bone
- Position of the tooth
- Root prominence
- Tissue thickness
- Presence of a cervical restoration or wear lesion
- Ability to identify the original enamel-root junction
- Plaque control
- Smoking
- Surgical technique
- Healing response
Root-coverage surgery is often predictable for favourable isolated defects, particularly when interdental support is intact. Complete coverage becomes less predictable when attachment or bone has been lost between the teeth. Even favourable recession defects do not always achieve complete coverage.
A realistic goal may be:
- Complete root coverage
- Partial root coverage
- Increased tissue thickness
- Improved stability
- Reduced sensitivity
- Easier cleaning
- Better appearance
Can Receded Gums Grow Back Naturally?
The gum margin generally does not grow back to its former position without a root-coverage procedure.
However, controlling the cause can help:
- Stabilize the area
- Reduce inflammation
- Limit further trauma
- Decrease sensitivity
- Protect the exposed root
Some apparent recession may look different after swelling resolves, but this should not be confused with regeneration of lost tissue.
Does Scaling and Root Planing Fix Recession?
Scaling and root planing treats periodontitis by removing plaque and calculus from affected root surfaces.
It may:
- Reduce inflammation
- Reduce bleeding
- Improve periodontal-pocket conditions
- Help stabilize disease
It does not ordinarily move an already receded gum margin back over the root. In fact, reduction of inflamed swelling may make existing recession more visible after periodontal treatment.
Will a Night Guard Stop Gum Recession?
Not necessarily.
A night guard can protect teeth from selected effects of grinding, such as wear or fracture, but it is not a direct root-coverage treatment.
It may be recommended when there is independent evidence of:
- Bruxism
- Tooth wear
- Fractures
- Muscle symptoms
- Occlusal discomfort
- Risk to restorations
It should not be prescribed solely because recession is present.
Gum Recession and Dental Implants
Soft-tissue recession can also occur around dental implants.
The evaluation differs because implants do not have the same periodontal ligament or root surface as natural teeth.
Concerns may include:
- Visibility of the implant or metal components
- Thin tissue
- Bone loss
- Inflammation around the implant
- Implant position
- Restorative contour
- Aesthetic asymmetry
Implant recession may require coordinated periodontal, surgical and restorative assessment.
How Much Does Gum Recession Treatment Cost?
The fee depends on the required care.
Possible components include:
- Periodontal examination
- Dental X-rays
- Desensitizing treatment
- Fluoride varnish
- Treatment of root decay
- Composite restoration
- Periodontal therapy
- Orthodontic consultation
- Periodontist consultation
- Gum-grafting or root-coverage surgery
After assessment, we explain:
- Whether treatment is required
- Which problem the proposed treatment addresses
- Alternatives
- Limitations
- Expected fees
- Whether specialist referral is recommended
Insurance coverage varies. Root-coverage surgery performed mainly for appearance may be treated differently from medically or functionally necessary periodontal care.
Why Choose MI Dental for Gum Recession Assessment?
We do not assume recession equals gum disease
The gums, bone, tooth position and root surface are assessed separately.
We look for multiple contributing factors
Recession is rarely explained by one slogan such as “you brush too hard” or “your bite is heavy.”
We distinguish monitoring from treatment
Stable, healthy recession does not automatically require intervention.
We treat sensitivity conservatively
Desensitizing products, fluoride and technique changes may be attempted before restorative or surgical care when appropriate.
We avoid overdiagnosing abfraction
Cervical lesions are assessed as potentially multifactorial rather than attributed automatically to tooth flexure.
We coordinate specialist care
Periodontist referral is recommended when tissue augmentation, root coverage or advanced periodontal management is appropriate.
Frequently Asked Questions About Gum Recession
Is gum recession always caused by gum disease?
No.
Recession may be associated with periodontitis, but it can also occur because of tissue anatomy, tooth position, brushing trauma, orthodontic movement and other local factors.
Can receding gums grow back naturally?
The gumline generally does not return to its previous position naturally.
Controlling contributing factors may stabilize the area. Root-coverage procedures can be considered when additional tissue or coverage is needed.
Can an electric toothbrush cause gum recession?
An electric toothbrush does not automatically cause recession.
Excessive pressure, prolonged scrubbing and poor positioning may traumatize vulnerable tissues. A soft head and pressure sensor can help.
Should I stop brushing a receding area?
No.
Plaque still needs to be removed. Use a soft brush, gentle pressure and an appropriate technique rather than avoiding the area.
Can brushing too hard cause recession?
Traumatic brushing may contribute, especially around teeth with thin tissue or prominent roots.
Recession is usually multifactorial, so the complete periodontal and anatomical picture should be assessed.
Is gum recession painful?
It may be painless.
Some patients experience sharp sensitivity to cold, sweets, touch or air because the root dentin is exposed.
Why are my teeth becoming more sensitive?
Possible causes include recession, root wear, decay, acid erosion, a crack, whitening or pulpal disease.
Persistent or one-tooth sensitivity should be assessed rather than assumed to be harmless recession.
Does recession mean I am losing bone?
Not always.
Isolated recession can occur without periodontal bone loss. Periodontitis-related recession may be accompanied by loss of attachment and supporting bone.
Does gum recession always get worse?
No.
Some recession remains stable for years, particularly when inflammation and trauma are controlled. Comparison with previous measurements and photographs helps determine progression.
Can a filling repair receding gums?
No.
A filling can restore a worn, sensitive or decayed root surface, but it does not replace missing gum tissue.
Do all cervical notches need fillings?
No.
A stable, shallow and symptom-free non-carious cervical lesion may be monitored. Restoration may be recommended for decay, sensitivity, structural concern, progression or aesthetic reasons.
Are abfraction lesions caused by grinding?
Occlusal stress has been proposed as a contributing factor, but the evidence is mixed.
These lesions are better regarded as potentially multifactorial rather than diagnosed from their wedge shape alone.
Will I need a gum graft?
Not everyone does.
A graft or another root-coverage procedure may be considered for progressive recession, sensitivity, thin tissue, cleaning difficulty, aesthetic concerns or planned dental treatment.
Is gum grafting painful?
Local anaesthesia is used during the procedure.
Postoperative tenderness depends on the technique and whether tissue is taken from the palate. The periodontist provides individualized medication and aftercare instructions.
Does a gum graft permanently fix recession?
Root-coverage procedures can provide long-term improvement, but no treatment can guarantee that recession will never recur.
Plaque control, gentle brushing, smoking status, tissue anatomy and maintenance remain important.
Can gum grafting completely cover every exposed root?
No.
Complete coverage is more predictable when the bone and gum support between the teeth remains intact. Advanced attachment loss, root wear and tooth position can limit the result.
Can braces cause gum recession?
Orthodontic treatment does not inevitably cause recession.
Risk depends on tissue thickness, tooth position, plaque control, inflammation and the direction and amount of tooth movement.
Is gum recession treatment covered by insurance?
Coverage depends on the treatment and the individual plan.
Desensitizing treatment, restorations, periodontal care and grafting may each be reimbursed differently. The insurer determines final payment.
Request a Gum Recession Assessment in Kitchener
An exposed root does not automatically require a filling, bite adjustment or gum graft.
The correct treatment depends on whether the recession is stable, whether disease is active, whether the root is damaged and what the patient hopes to improve.
Call MI Dental at (519) 894-9444 or contact our office to arrange a gum-recession assessment in Kitchener.
