Receding Gums: Why They Don't Grow Back and Treatment Options

Gingival recession (receding gums) is irreversible without surgical intervention. Gum tissue lacks regenerative capacity once lost. Treatment focuses on covering exposed roots, halting progression, and restoring aesthetics/function.

Causes

• Periodontitis (inflammatory destruction)
• Aggressive brushing (horizontal scrub, hard bristles)
• Thin gingival biotype (genetic)
• Malpositioned teeth, orthodontic movement
• Piercings, traumatic occlusion, tobacco

Surgical Treatments (Gold Standard for Coverage)

1. Connective Tissue Graft (CTG): Subepithelial tissue from palate → root coverage. Gold standard (predictable, esthetic).
2. Free Gingival Graft (FGG): Full-thickness palate graft → increases keratinized tissue width; less root coverage.
3. Pedicle / Lateral Sliding Flap: Adjacent tissue rotated — requires sufficient donor tissue.
4. Pinhole Surgical Technique (PST): Minimally invasive; loosens gum via pinhole, repositions over roots with collagen strips. No donor site. Good for multiple teeth.
5. Guided Tissue Regeneration (GTR): Membrane (resorbable/non-resorbable) excludes epithelium → allows PDL/cementum regeneration. Often with bone graft.
6. Bone Grafting: If alveolar bone loss accompanies recession.

Non-Surgical / Adjunctive

• Scaling & Root Planing (SRP): Treats active periodontitis; halts inflammatory recession.
• Desensitizing agents: Fluoride varnish, oxalate, laser, bonding agents — for root sensitivity.
• Composite restoration: Covers cervical abrasion/erosion; esthetic.
• Orthodontics: Reposition teeth to improve gingival architecture (pre-restorative).

Prevention & Maintenance

• Soft brush, Bass technique (45°), gentle pressure.
• Interdental cleaning (floss, interdental brushes).
• Regular periodontal maintenance (3–4 mo).
• Night guard if bruxism.
• Tobacco cessation.

Early referral to a periodontist maximizes root coverage success and long-term stability.