Gum Recession and Wear at the Neck of the Tooth
As the gum recedes, the root surface becomes exposed and notch-shaped wear can develop at the neck of the tooth. Causes, the link with sensitivity, and treatment.
What Happens When the Gum Recedes?
The gum surrounds the tooth like a collar and protects the root surface beneath it from the oral environment. When this tissue recedes, the root surface, which is not covered by enamel, becomes exposed. The root surface does not have the hardness of enamel and is far more vulnerable to external factors. Over time, notch-shaped loss of structure can develop in this area.
Why does recession occur?
- Gum disease: Inflammation caused by tartar and bacterial plaque affects the supporting tissues and the gum margin recedes.
- Incorrect brushing: Horizontal brushing with pressure using a hard-bristled brush is one of the most common causes. Notably, this type of recession is often seen in people who brush a great deal.
- Clenching and grinding: Forces on the tooth concentrate at the cervical region and can fatigue the structure there.
- Anatomical factors: Thin gum tissue, the position of the tooth within the jawbone and the location of lip and cheek attachments can create a predisposition.
Why does it cause sensitivity?
The dentine on the root surface contains microscopic channels extending towards the tooth nerve. When these channels open to the outside environment, cold drinks, sweetness and even brushing can produce a brief sharp sensation. Sensitivity usually becomes more pronounced as the wear progresses.
Does receded gum grow back on its own?
No. Gum tissue lost through recession does not return on its own. The main aim is therefore to preserve the current situation and halt its progression. In some advanced cases, surgical coverage methods may be considered; suitability is determined individually.
How is cervical wear addressed?
When the loss of structure becomes marked, the area is restored with composite resin matched to the tooth colour. As the work is carried out very close to the gum margin, isolating the area from moisture and achieving a smooth marginal fit are important; an overhanging margin creates the ground for gum inflammation. The restoration both reduces sensitivity and prevents the wear from deepening.
You can find detailed information about the assessment and restoration of cervical lesions on our cervical tooth wear page.
Preventing recurrence
The restoration closes the loss of structure but does not remove the cause. Switching to a soft-bristled brush, using a gentle circular technique, rinsing with water and waiting rather than brushing immediately after acidic food, and assessing any clenching habit all reduce recurrence.
When Should You See a Dentist?
- Teeth starting to look longer, or recession becoming noticeable within a short time
- Gum bleeding when brushing or on its own
- Loose teeth or new gaps appearing between the teeth
- A notch at the neck of the tooth that you can feel with a fingernail, or a change in colour there
- Sensitivity to cold lasting for weeks, or pain that starts on its own
If gum disease lies behind the recession, restorations placed without treating it do not provide a lasting solution; the cause therefore needs to be identified first. Treatment of gum disease is explained on the gum treatment page and sensitivity on the tooth sensitivity treatment page.
This article is for general information purposes and does not replace a clinical examination. The cause of the recession and the right approach for you are determined by clinical examination.
Frequently Asked Questions
Should floss be used on a tooth with gum recession?
Yes, it should. A common worry is that flossing where there is recession will make it worse, but continued plaque accumulation is what actually drives recession forward. Technique is what matters: the floss is not pressed into the gum but wrapped against the tooth surface and moved gently up and down. Where the spaces have widened, an interdental brush may be more effective; the appropriate size is determined by your dentist.
Which toothbrush and toothpaste are suitable?
A soft-bristled brush is preferred; medium and hard bristles wear the exposed root surface more quickly. The motion should be from gum towards tooth or circular, rather than horizontal back and forth. Toothpastes with low abrasivity are appropriate; highly abrasive pastes marketed as whitening can increase loss of tooth substance in this region. Where there is sensitivity, those containing potassium nitrate or stannous fluoride may be considered.
Is gum recession hereditary?
It is not a directly inherited disease, but certain structural features that create susceptibility can run in families: a thin gingival biotype, the position of the tooth within the jaw bone, and thinness of the overlying bone. These features alone do not produce recession; the process begins when they combine with acquired factors such as brushing habits, plaque control and clenching.
If recession and wear occur together, which is addressed first?
The factor sustaining the wear and the recession is removed first: brushing technique is corrected, calculus is cleaned, and clenching is assessed if present. A restoration placed without this continues to be subject to the same forces and may debond again. Once the cause is under control, restoration of the exposed surface and, where required, gum coverage procedures are planned.