Periodontology – Gingival Recession

Gingival recession, also referred to as receding gums, occurs when the roots of the teeth are exposed. This issue is a result of the loss of gum tissue and occurs when the gingival margin retracts from the crown of the teeth. In adults who are over 40 years old, gum recession is an especially common issue. However, the condition may begin for patients who are just 10 years old.

Classification Systems

There are numerous classification systems which can be used to classify gingival recession. The most popular version is Miller’s classification system. Unfortunately, many cases cannot be effectively classified using the criteria found in the standard classification systems. The classification system created by Kumar & Masamatti, provides a comprehensive depiction of recession defect. In addition, this system can be used to properly classify cases which cannot be classified based on the existing systems. There is a separate classification system which is used for palatal recessions (PR). A new comprehensive classification system is being used to classify recession based on the position of interdental papilla and the buccal, lingual and palatal recessions. The classification system designed by Kumar & Masamatti, works to overcome the limitations associated with the Miller classification system.


While there are numerous potential causes for gingival recession, below are a few of the most prevalent causes:

  • Abnormal tooth position or crowding
  • Acute necrotizing ulcerative gingivitis
  • Aggressive teeth brushing
  • Dipping tobacco, which impacts the mucous membrane which lines the mouth and can lead to receding gums
  • Gum disease
  • Incorrect flossing, such as flossing in an aggressive manner
  • Intentional gingival retraction
  • Piercings in the lip or tongue which can wear away the gum from persistent rubbing
  • Scurvy or a vitamin C deficiency
  • Self-inflicted trauma. This can include habits such as digging an object into the gum.
  • Thin, fragile or inadequate gingival tissue, a condition which is often hereditary


Gum recession is not typically classified as an acute condition. For most patients, receding gums is a progressive condition which takes place slowly over the course of an extended time period. Because of this, is more common for patients over the age of 40 to experience gum recession. The change in the gums is usually minor, meaning the patient does not always recognize the condition right away. Patients can even get used to the minor adjustments which take place slowly over time. In many cases, receding gums go unnoticed until the condition starts to result in symptoms.

Below are some of the most common signs and symptoms which indicate a patient has receding gums:

  • Cavities occur below the gum line Changes in the color of the teeth, which is often a result of the color difference between the enamel and cementum
  • Extremely sensitive teeth. Including short or sharp pain
  • Roots of the teeth are exposed and visible
  • Spaces appear between teeth. While the space actually remains the same, it appears larger because the gums no longer fill in the space between the teeth
  • Teeth movement
  • Teeth can appear longer because a larger part of the crown is visible with receding gums
  • Teeth have the sensation of having notches at the gum line

In cases where the gum recession is from gingivitis, the patient may experience the following symptoms:

  • Bad breath or halitosis
  • Bleeding gums with brushing and/or flossing
  • Swollen, puffy, inflamed or red gums

For some patients, when gingivitis is treated, it reveals that their gum recession already existed and was camouflaged with swollen gums.