Gum Recession (Periodontitis)
Gum disease is the most common reason adults lose teeth, and its defining feature is that it is almost painless until it is advanced. There is no toothache to prompt a visit. What there is instead is bleeding when you brush — which too many people accept as normal. Healthy gums do not bleed.
Gingivitis and periodontitis are not the same thing
The distinction matters because one is fully reversible and the other is not.
- Gingivitis is inflammation of the gum surface caused by plaque sitting at the gum line. Gums are red, puffy and bleed easily. Bone is not yet involved, and with proper cleaning and good home care it resolves completely, leaving no lasting damage.
- Periodontitis is what gingivitis becomes if it persists. The inflammation spreads below the gum, and the bone that holds the tooth in place begins to dissolve. Pockets form between gum and tooth, gums recede, and teeth eventually loosen. Lost bone does not grow back on its own. Treatment stops the process; it does not rewind it.
This is the reason bleeding gums deserve attention now rather than later.
What to look for
- Bleeding when brushing or flossing, or blood in the sink.
- Gums that look red and swollen rather than firm and pale pink.
- Persistent bad breath or a bad taste.
- Teeth that look longer, or sensitivity at the exposed root near the gum line.
- Dark triangular gaps appearing between teeth.
- Teeth that feel loose, or a bite that has started to feel different.
Why gums recede
Periodontitis is the main cause, but not the only one. Brushing too hard, or with a hard-bristled brush, physically abrades the gum and is a frequent cause of recession in people whose oral hygiene is otherwise excellent. Grinding stresses the neck of the tooth — see teeth grinding. Smoking constricts the blood supply, masks bleeding and roughly doubles the risk of periodontitis. Diabetes, hormonal change and genetics all play a part, and orthodontic movement can expose thin gum tissue.
How it is treated
- Professional cleaning (scaling). Removes the hardened deposits that brushing cannot. For gingivitis this is often all that is needed. See detertrage.
- Root planing. For established pockets, cleaning extends below the gum line to smooth the root surface so the gum can reattach. Usually done under local anaesthetic across a few visits.
- Surgical treatment. Deep pockets that do not respond may need access surgery, and in selected cases bone or tissue grafting.
- Gum grafting can cover exposed roots where recession is localised and the aesthetics or sensitivity warrant it.
- Maintenance. Periodontitis is a chronic condition. Once treated, it is kept stable with hygiene visits at intervals your dentist sets — often every three to four months rather than annually.
One important point for anyone planning cosmetic work: crowns and veneers fitted to inflamed gums fail at the margin. Gum health comes first, always — before veneers, before implants. Implants can develop the same disease process around them, so untreated periodontitis is a genuine risk factor for implant failure.
Preventing it
Brush twice daily for two minutes with a soft brush, angled at the gum line rather than scrubbed across it. Clean between the teeth every day — floss or interdental brushes reach where a toothbrush cannot, and that is exactly where gum disease starts. Stop smoking. Keep regular hygiene appointments. See oral hygiene for technique.
Frequently Asked Questions
Is bleeding when I brush my teeth normal?
No. Healthy gums do not bleed. Bleeding when brushing or flossing is the earliest sign of gum inflammation, and at the gingivitis stage it is fully reversible with professional cleaning and good home care. Left alone it can progress to periodontitis, where the bone supporting the tooth is lost permanently.
What is the difference between gingivitis and periodontitis?
Gingivitis is inflammation of the gum surface only. Bone is not involved and it resolves completely with proper cleaning. Periodontitis is what gingivitis becomes if it persists: the inflammation spreads below the gum, pockets form and the supporting bone dissolves. That bone loss is permanent, so treatment halts the process rather than reversing it.
Can receding gums grow back?
Gum tissue does not regrow on its own once it has receded, and lost bone does not return without intervention. Treatment aims to stop further loss. Where recession is localised and causing sensitivity or aesthetic concern, a gum graft can cover the exposed root surface.
Does gum disease affect dental implants?
Yes. Implants can develop a similar inflammatory disease in the tissue and bone around them, so untreated periodontitis is a genuine risk factor for implant failure. Gum health must be established before implants are placed, and ongoing maintenance visits are part of keeping them.