One tooth looks longer than before. Cold water catches a sensitive spot near the gumline. Should you change your toothbrush, book a deep cleaning or ask about a gum graft?
Managing receding gums starts with finding the cause. Gentle cleaning and professional care can help address contributing factors, while selected surgical procedures can cover exposed roots. The right approach depends on the condition of the tooth and its surrounding tissues.
What Does Gum Recession Actually Mean?
Gum recession occurs when the gum margin moves towards the root, exposing tooth surface that was previously covered. It can affect appearance, cause sensitivity and leave the root vulnerable to decay or wear.
Recession does not automatically mean you have periodontitis. Thin gum tissue, tooth position, brushing trauma, periodontal disease and local factors such as an unsuitable restoration can contribute. Some orthodontic movements also require closer assessment of the surrounding tissues.
A dentist therefore checks more than how much root is visible. Gum thickness, cleaning habits, inflammation and the support around the tooth all matter.
Types of Gum Recession: Understanding RT1, RT2 and RT3
Dentists may use the Cairo classification to describe recession according to attachment loss between the teeth compared with the cheek-facing surface.
| Recession type | What It Means |
|---|---|
| RT1 | There is no attachment loss between the teeth. |
| RT2 | Attachment loss between the teeth is less than or equal to the loss on the cheek-facing surface of the same tooth. |
| RT3 | Attachment loss between the teeth is greater than the loss on the cheek-facing surface. |
These are clinical types, not a fixed sequence of stages. RT1 does not automatically progress through RT2 to RT3. Clinical measurements are needed to identify the type.
Some websites describe four classes using the older Miller classification. This article uses Cairo RT1 to RT3, adopted in the 2017 World Workshop consensus published in 2018.
How Can You Help Stop Further Gum Recession?
1. Clean Thoroughly With Less Pressure
Use a soft-bristled toothbrush and light pressure. Avoid forceful back-and-forth scrubbing, and ask your dentist or hygienist to demonstrate a technique suited to the affected area.
Brushing habits can contribute to local trauma, but they should not become the explanation for every case. Heasman and colleagues found that evidence linking toothbrushing to recession remained largely inconclusive.
Gentle cleaning still needs to remove plaque. Clean between your teeth daily using appropriately sized interdental brushes, floss or another method recommended for your mouth.
2. Have Bleeding or Inflamed Gums Assessed
Bleeding, swelling or persistent bad breath need attention. If periodontitis is present, home care alone may not remove deposits below the gumline.
Professional periodontal care combines cleaning, support with oral hygiene, risk-factor management and reassessment. Ongoing maintenance helps preserve the improvements achieved through treatment.
3. Address the Factors Affecting Your Own Teeth
If you smoke, ask about cessation support. If a tooth sits outside the arch, or you are considering braces or aligners, discuss how tooth position and gum thickness may affect your care.
A stable, comfortable site may be monitored without immediate surgery. Your dentist can record the gumline and review it for change.
Can Receding Gums Grow Back Naturally?
No home remedy has been established to predictably restore lost gum coverage. Toothpaste may reduce sensitivity or help with plaque control, but it does not replace missing tissue.
Oil pulling is sometimes promoted for gum health. A 2024 systematic review found possible benefits for some gingival-health measures, but the certainty of evidence was very low. Trials lasted only 7 to 45 days and did not establish reversal of recession.
Be cautious of promises that a toothpaste, oil or home routine will regrow gums within a set number of months.
Gum Recession Treatment Options by Cairo Type
The Cairo type helps estimate potential root coverage. It does not assign one treatment to every tooth. Symptoms, recession depth, gum thickness, root damage and disease activity also influence the decision.
The table below summarises options a dentist or periodontist may consider.
| Cairo type | Treatment options that may be considered | Root-coverage expectations |
|---|---|---|
| RT1 | Tailored home care and monitoring for stable sites. Where coverage is needed, a coronally advanced flap, often combined with a connective tissue graft, may be considered. | Generally the most favourable potential for complete coverage, although results are not guaranteed. |
| RT2 | Address contributing factors and any active periodontal disease. Selected sites may benefit from a coronally advanced flap with a connective tissue graft. | Complete coverage is possible in selected cases, but is less predictable than in RT1. |
| RT3 | Focus on periodontal stability and root protection. Selected grafting procedures may improve tissue thickness or provide partial coverage after specialist assessment. | Complete coverage is generally unlikely because of the loss of support between the teeth. |
These options reflect the evidence on root coverage and the limitations associated with attachment loss between teeth.
For RT1, a 2022 network meta-analysis covering 38 studies supported a connective tissue graft combined with a coronally advanced flap for single recession defects without tissue loss between teeth.
RT2 does not rule out complete coverage. A 10-year follow-up of a randomised trial found better maintenance of complete coverage with a connective tissue graft plus a coronally advanced flap than with the flap alone in selected upper-jaw RT2 defects.
Evidence for treating RT3 is more limited. Small clinical studies have reported partial improvement in selected defects, supporting realistic, individual treatment goals.
When Is Scaling and Root Planing Needed?
Deep cleaning is based on periodontal disease findings, rather than the RT number alone.
When periodontitis is present, scaling and root planing, also called subgingival instrumentation, removes bacterial biofilm and calculus beneath the gumline. Clinicians commonly use hand instruments, sonic or ultrasonic instruments, or a combination. Treatment helps control inflammation; it does not replace missing gum tissue.
For example, where a clinician selects rotary instrumentation for an appropriate root-surface procedure, the MR.BUR Surgical Root Planing Kit offers fine and super-fine RA diamond burs for compatible low-speed contra-angle use. The manufacturer describes calculus removal and root-surface preparation among its applications. Selection and operating settings should follow the clinical indication and manufacturer’s instructions.
The kit supports a selected instrumentation step. It is not required simply because a root is exposed.
What Helps With Sensitivity or Root Damage?
Sensitivity may need treatment regardless of whether a site is RT1, RT2 or RT3.
A 2023 network meta-analysis of 32 studies supported selected desensitising toothpaste formulations containing stannous compounds, potassium with or without stannous compounds, or arginine. These can reduce discomfort without restoring the gumline.
Root decay or cervical tooth wear may require restorative care. Your dentist can assess whether a restoration, root-coverage procedure or combined approach would best address the affected area.
Does Every Recession Site Need a Gum Graft?
No. Surgery may be considered for progressive recession, persistent symptoms, tissue concerns or a patient’s wish to improve appearance.
A coronally advanced flap moves gum tissue towards the crown. A connective tissue graft adds tissue beneath it. This combination is well supported for suitable defects, but the achievable coverage depends on the clinical findings.
When Should You See Your Dentist?
Book an assessment for a changing gumline, persistent sensitivity or bleeding. Swelling, pus or a loose tooth deserve prompt attention.
Ask: “Is this recession stable, what is contributing to it, and how much improvement is realistic?”
That conversation helps you understand whether the tooth needs monitoring, periodontal treatment, sensitivity relief, a restoration or assessment for root coverage.
References
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Cairo F et al. The interproximal clinical attachment level to classify gingival recessions and predict root coverage outcomes. Journal of Clinical Periodontology. 2011.
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Jepsen S et al. Consensus report of workgroup 3 of the 2017 World Workshop. Journal of Periodontology. 2018.
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Heasman PA et al. Evidence for gingival recession and cervical lesions associated with traumatic toothbrushing. Journal of Clinical Periodontology. 2015.
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Sanz M et al. Treatment of stage I–III periodontitis: The EFP S3 clinical practice guideline. Journal of Clinical Periodontology. 2020.
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Cortellini P, Bissada NF. Mucogingival conditions in the natural dentition. Journal of Periodontology. 2018.
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Jong FJX et al. Oil pulling and oral health: A systematic review and meta-analysis. International Journal of Dental Hygiene. 2024.
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Chambrone L et al. Connective tissue graft with coronally advanced flap for single recession defects: Systematic review and network meta-analysis. Journal of Periodontology. 2022.
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Cairo F et al. Root coverage at single RT2 maxillary recessions: Ten-year randomised trial follow-up. Journal of Clinical Periodontology. 2023.
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Bendary MG et al. Connective tissue graft wall technique for Cairo RT3 recession and intrabony defects: A case series.
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MR.BUR. Surgical Root Planning Kit. Manufacturer product information.
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Pollard AJ et al. Dentifrices for dentine hypersensitivity: Systematic review and network meta-analysis. Journal of Dentistry. 2023.
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National Institute of Dental and Craniofacial Research. Periodontal (Gum) Disease.
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