Treatment for receding gums ranges from deep cleanings and sensitivity management for mild cases to surgical grafting for more advanced recession. What your dentist or periodontist recommends depends on how far your gums have pulled back, whether the bone underneath is still intact, and what’s causing the recession in the first place.
How Severity Shapes Your Options
Dentists classify gum recession into four grades based on how much gum tissue and underlying bone have been lost. In the earliest stages (Class I and II), the bone and soft tissue between teeth are still preserved, and complete root coverage is possible with treatment. Class III recession involves some loss of that bone or tissue, so only partial coverage can be achieved. In the most advanced cases (Class IV), the tissue between teeth is gone entirely, and full root coverage is no longer realistic regardless of which procedure is used.
This grading matters because it determines the ceiling of what treatment can accomplish. Catching recession early gives you the most options and the best cosmetic outcome.
Deep Cleaning for Early Gum Disease
When recession is caused by mild to moderate gum disease, the first step is usually a non-surgical deep cleaning called scaling and root planing. A dentist or hygienist numbs your gums with local anesthesia, then uses hand instruments or ultrasonic tools to remove plaque and tartar from above and below your gumline. After that, they smooth the root surfaces of your teeth so gum tissue can reattach more easily.
The procedure takes one to two hours. Your provider may also place antibiotics around the tooth roots or prescribe oral antibiotics to clear any remaining infection. One thing to be aware of: if your gums were swollen before the cleaning, they’ll shrink once the infection resolves. That can temporarily make your teeth look a bit longer, since the swelling was masking how much recession had already occurred. Deep cleaning won’t regrow lost gum tissue, but it stops the disease process that’s driving the recession forward.
Gum Grafting Surgery
When recession is more advanced or you have exposed roots that need coverage, a periodontist will typically recommend a gum graft. There are three main types, each suited to different situations.
Connective Tissue Grafts
This is the most common approach. The surgeon removes a small piece of tissue from beneath the surface of your palate (the roof of your mouth) and stitches it over the exposed root. It’s used for recession caused by gum disease, trauma, or aggressive brushing, and it works well for covering roots in moderate cases.
Free Gingival Grafts
Similar to a connective tissue graft, but reserved for patients with minor recession or early-stage cases. The surgeon takes a smaller amount of tissue directly from the palate surface, which allows for more precise placement. Because less tissue is harvested, the donor site on your palate tends to heal faster.
Pedicle Grafts
Instead of taking tissue from your palate, the surgeon borrows gum tissue from an area right next to the recession site on your jaw. The tissue stays partially attached to its original blood supply, which can improve healing. The catch is that you need enough healthy gum tissue nearby for the surgeon to work with.
The Pinhole Surgical Technique
A newer, less invasive alternative to traditional grafting skips the incisions and stitches entirely. Developed by periodontist Dr. John Chao, the Pinhole Surgical Technique (PST) involves making a tiny hole in your gum tissue, then gently loosening and repositioning it to slide down over the exposed root. No tissue is cut from your palate.
Recovery is significantly faster than with grafting. Most patients return to normal activities within 24 to 48 hours, and full healing of the gum tissue generally takes one to two weeks. Not every case is a candidate for this approach, but it’s worth asking about if you want to avoid the palate donor site that makes traditional grafts uncomfortable.
Recovery After Gum Graft Surgery
Traditional gum grafts require more patience during healing. For the first one to two weeks, you’ll eat only soft foods and avoid chewing anywhere near the surgical site. Cool, non-acidic foods are ideal. Anything hot, spicy, or carbonated can irritate the graft, and carbonated drinks can actually cause it to fail. Skip straws too, since the suction can dislodge healing tissue.
After about two weeks, you can gradually reintroduce more solid foods on the opposite side of your mouth. During this entire period, avoid alcohol for at least the first week, hold off on hot coffee for 48 to 72 hours, and don’t smoke for at least a week. Smoking delays healing and raises the risk of complications significantly. Take small bites, use a small spoon, and be patient with chewing on one side.
Managing Sensitivity From Exposed Roots
Even before or alongside surgical treatment, your dentist can address the tooth sensitivity that comes with recession. Exposed roots lack the protective enamel that covers the rest of your teeth, so cold drinks, hot food, and even air can trigger sharp pain.
The first line of defense is usually at-home products: desensitizing toothpastes that contain ingredients to block the tiny channels in exposed root surfaces. If that’s not enough, your dentist has several in-office options. Fluoride varnish creates a physical barrier on the root by forming crystals that plug those channels, reducing fluid movement that triggers nerve pain. Bonding agents can seal the surface more permanently. Arginine-calcium carbonate pastes create a mineral plug that blocks the channels from a different angle. For stubborn cases, laser-assisted treatments can provide both immediate and longer-term relief, especially when combined with desensitizing agents.
These treatments don’t fix the recession itself, but they can make daily life much more comfortable while you decide on or wait for a more definitive procedure.
Preventing Further Recession
Whatever treatment you receive, protecting your results long-term comes down to how you brush. Aggressive brushing with a hard-bristled toothbrush is one of the most common causes of recession in people who don’t have gum disease. The American Dental Association recommends a technique called the Modified Bass method: hold a soft-bristled toothbrush at a 45-degree angle to your gumline and use short, gentle back-and-forth strokes. After cleaning along the gumline, sweep the brush away from the gum toward the edge of the tooth. This cleans effectively without grinding down tissue.
If you clench or grind your teeth at night, a custom night guard can reduce the mechanical stress on your gums and bone. And if gum disease was the original cause, staying consistent with professional cleanings (often every three to four months rather than the standard six for people with a history of periodontal problems) keeps bacteria from re-establishing below the gumline and starting the cycle over again.