You've noticed your teeth look longer. Or maybe your hygienist mentioned it. Now you're worried. We sat down with Dr. Doug Hudoba to ask the questions Columbus patients are asking—without the guilt trip or overselling.
Dr. Doug: No. Here's why: receding gums are incredibly common. In fact, the numbers might actually surprise you. About 80% of patients over the age of 65 have gum recession to some degree. Almost 9 out of 10 adults over 65 have it. Even in younger age groups, it's about 50%. So if you're worried you're alone or that you've done something catastrophically wrong—you haven't. This is very normal.
Dr. Doug: That's a great question because most people don't understand the actual mechanics of it. Recession, or receding gums, is when the gum tissue peels away from the tooth and the bone that anchors the tooth into your mouth.
But here's the critical part that most people get wrong:
"In order for the gums to recede, the bone underneath those gums first has to go away."
So it's not just that your gums are retreating on their own. The bone underneath is shrinking, and your gums are following it down. It's a bone problem, not just a gum problem.
Dr. Doug: That's where it gets interesting because there are multiple factors, and they vary from patient to patient. Some people have one contributing factor. Some have several. Let me walk you through them.
First, there's your brushing habits. Brushing too hard or too often can contribute to recession. Then there's your bite and how your teeth are aligned. Misaligned teeth or crowded teeth can contribute profoundly to recession.
We also see it with clenching and grinding—those unconscious habits put a lot of force on your teeth. And then there are lifestyle habits: chewing tobacco, smoking, nicotine pouches—all can contribute to recession as well.
Dr. Doug: Here's where I need to be honest, and this is important: there's a big genetic component to recession.
"You know, there are patients due to the nature of the tissue in their mouths, how thick or thin the bone is in certain areas, are much more prone to recession than others."
So yes, habits matter. But your genetics matter too. Some people can check every box—brushing too hard, clenching, using tobacco—and not see much recession because their bone is thick and their tissue is resilient. Other people might do just one of these things and see significant recession because of how they're built. Don't blame yourself for biology.
Dr. Doug: That's the key question, and this is where I try to be honest with patients about what actually needs to happen versus what could happen.
Receding gums is a problem for oral healthcare, but it's very common and it doesn't always require immediate treatment. So the first thing I ask is: Is this stable, or is it getting worse? Has the recession been the same for the last 5 years, or is it noticeably progressing?
Dr. Doug: Several things would concern me. If the recession is visibly progressing—getting worse year after year. If you're experiencing sensitivity to cold. If there's visible notching or cavities forming at the gum line. If the tooth itself feels loose or mobile. Those are signs that we should address this.
But if it's been stable, you have no sensitivity, and you just noticed it for the first time—you might have had it for years. In that case, we monitor it and manage the contributing factors rather than jump to surgery.
Dr. Doug: When we treat gum recession surgically, we use a procedure called a graft. We take a piece of tissue—it could be synthetic, donated tissue, or a piece of tissue from elsewhere in your mouth—and we stitch it over the receded areas to restore the gum line and protect the root.
These grafts work well. But here's what's important to understand: a graft isn't a permanent fix for the underlying causes. If you're grinding your teeth, if your bite is misaligned, if you're using tobacco—those things are still happening. So we need to address those too.
Dr. Doug: That's a really good question. If teeth being in the wrong position contributes to gum recession, then moving those teeth into the right position can actually help recession improve. That's true.
But—and this is important—moving teeth can also cause recession in some cases if it's not done carefully. So having an honest conversation with your provider about the risks and benefits of straightening your teeth matters. You want to make sure you're not trading one problem for another.
Dr. Doug: First, we assess your situation. We look at how much recession you have, whether it's localized to one tooth or generalized across your mouth. We look at your medical history, your medications, your bite, your habits. We do blood work if needed to check for vitamin deficiencies that can contribute to gum health.
If we can identify the causes and manage them here—and if the recession is stable—we monitor it. But if the recession is progressing significantly, if we need surgical intervention, or if we identify something systemic we can't manage alone, then we talk about a periodontist.
"Communication and honesty with your provider, making sure that you're educated about the benefits and the risks, is the way to ensure that you make decisions that make sense for you."
Dr. Doug: Not necessarily. Advanced recession can lead to tooth loss if it goes untreated and progresses significantly. But most of the time, with proper management of the contributing factors, you can stabilize it. The key is catching it, understanding what's causing it, and addressing those causes—not just treating the symptom.
"In order for the gums to recede, the bone underneath those gums first has to go away." — Gum recession is fundamentally a bone problem, not just a cosmetic one.
"There's a big genetic component to recession." — Don't blame yourself entirely. Your genetics matter as much as your habits.
"Almost 9 out of 10 adults over the age of 65 have gum recession." — This is normal. You're not alone, and you're not a failure.
"Communication and honesty with your provider is the way to ensure that you make decisions that make sense for you." — The best treatment is one you understand and actually need.
Gingivitis is inflammation of the gums—they're swollen, red, and bleeding. Recession is when the gum tissue actually pulls away from the tooth, exposing more tooth structure and the bone underneath. You can have gingivitis without recession, but recession is often caused by or worsened by untreated gingivitis.
Unfortunately, no. Once the gum tissue and bone recede, they won't regenerate without intervention. This is why early detection and management of the contributing factors is important—to prevent further recession.
That often points to a localized problem—maybe your bite is off in that area, or you're clenching/grinding on that side, or perhaps you brush too hard on that specific tooth. A periodontist or dentist can assess this specifically.
It significantly increases your risk, but it's not automatic. Some people who use tobacco don't see recession; others do. The combination of tobacco plus other factors (grinding, misalignment, poor oral hygiene) amplifies the risk.
Genetics load the gun, but habits pull the trigger. Even if you're predisposed, managing your brushing technique, avoiding smoking and tobacco, addressing teeth grinding, and maintaining good oral hygiene can slow or prevent progression.
Not at all. Most people don't feel pain from recession itself. What they feel is sensitivity to cold if the root is exposed. Some don't feel anything until they notice their teeth look longer.
Graft recovery typically takes 2-3 weeks for initial healing, though full maturation of the grafted tissue takes longer. Your dentist will give you specific aftercare instructions. Most people can return to normal eating within a few days with soft foods.
It depends on your plan and whether the graft is deemed medically necessary versus cosmetic. Some plans cover it, some don't. It's worth checking with your insurance before scheduling. We can help you navigate that conversation.
Not always. If your recession is stable, mild, and you understand the contributing factors, we can manage it here. But if it's progressive, severe, or requires surgical intervention, a periodontist (gum specialist) is the right choice. We'll make that recommendation if needed.
Moving teeth can cause recession if it's done incorrectly or if underlying factors (grinding, clenching, bone thinning) aren't accounted for. This is why honest conversation about risks before starting any orthodontic treatment is important.
Panic and either: (1) brush even harder trying to "clean" the area, which makes it worse, or (2) avoid brushing that area because they're afraid of it, which allows plaque buildup and accelerates the problem. Both are counterproductive. Gentle, consistent care and addressing the root causes is what works.
Receding gums don't have to be a catastrophe. What matters is understanding what's happening in your mouth, whether it's progressing, and what's actually causing it.
If you're a Columbus patient concerned about receding gums and want straight answers without unnecessary procedures or guilt—schedule your assessment. We'll tell you exactly what we see, why it's happening, and what needs to happen next (if anything).
