Receding Gums: What Stops Them, and What a Graft Costs
Clinically reviewed by Dr. Abinaash Kaur, DDS, RCDSO, on 2026-09-03. Dr. Kaur is a general dentist in Toronto (Bloor West Village) registered with the Royal College of Dental Surgeons of Ontario.
Receding gums are two jobs, not one. Stopping the recession means finding what's driving it and taking that away. Covering the exposed root means a gum graft, because gum tissue doesn't climb back up a root on its own.
Those two jobs have different odds and different price tags. Most pages on this topic blur them together.
I've practised in Bloor West Village for about 25 years, and the question I get in the chair is some version of "can you put it back?" Sometimes yes. Often the better move is stopping the slide first and leaving the root alone.
Our post on why teeth suddenly get sensitive covers how common recession is and what causes it. This one is about what you can do.
What's receding, and can it grow back?
Gum recession is the exposure of the root surface when the gum margin slides down past the point where the crown of the tooth meets the root (Cochrane Database of Systematic Reviews via PubMed). What gets uncovered is root. Root has no enamel over it, so it's softer, darker, and quicker to feel cold.
Here's the honest answer on regrowth. Researchers pooled six studies of recession left untreated for at least two years, covering 1,647 spots, and 78.1% of them got deeper while the rest stayed the same or improved slightly (Journal of Periodontology via PubMed).
So it doesn't heal shut. A minority do hold steady.
The same review found the number of receded spots rose 79.3% over the follow-up (Journal of Periodontology via PubMed). New ones showed up on teeth that had started out fine.
So is it your brushing?
Most people think hard brushing is the whole story. The Canadian Dental Association says it plainly: "Brushing too hard over time can cause your gums to recede" (Canadian Dental Association). Sensible advice, and following it costs you nothing.
The research is less settled than the advice sounds. A systematic review built around exactly that question read 18 studies and concluded the data "to support or refute the association between tooth brushing and gingival recession are inconclusive" (Journal of Clinical Periodontology via PubMed). Eight of those studies found a link with how often people brushed. Two found none.
What gives. Brushing is one input among several, and those studies weren't built to separate it from the rest.
One popular fix doesn't hold up either. A 2026 review pooling randomized trials found no meaningful difference between manual and powered toothbrushes on recession at 6 or 12 months, and rated the certainty of that evidence very low (International Journal of Dental Hygiene via PubMed).
Buying an electric brush isn't a treatment plan on its own. A soft brush used gently is still worth your time, and our guide to picking a toothbrush covers how.
What can you do to stop it getting worse?
The uncomfortable finding first. Those 1,647 untreated spots weren't in people who'd given up on their teeth. The reviewers wrote that untreated recession "in individuals with good oral hygiene" has a high probability of progressing over the long term, with pooled odds of 2.43 for new recession by patient and 2.16 by site (Journal of Periodontology via PubMed).
Brushing well is necessary. It isn't always sufficient.
What helps is naming the driver. If your gums bleed and there are pockets, you're treating gum disease, which is a different problem with its own path, and our post on bleeding gums walks through the stages. Gum disease that keeps eating attachment will keep pulling the margin down with it.
Nicotine pouches sit in this lane too, since the gum holding the pouch takes the hit. We covered that in our post on nicotine pouches and your mouth.
Then there's measurement. We record recession in millimetres at each tooth, so next year's number can be compared to this year's instead of to your memory of it. A spot that hasn't moved in three years is a different conversation than one that's moved a millimetre a year.
That difference is what decides whether we watch or refer.
What decides whether a graft can cover the root?
Not the notch you can see in the mirror. The gum and bone between your teeth.
Periodontists sort recession into three types by how much gum and bone has been lost between the teeth, rather than by what shows on the front surface. Type 1 has no loss between the teeth, type 2 has loss less than or equal to the front, and type 3 has more between the teeth than on the front (Journal of Clinical Periodontology via PubMed).
That sorting predicted how much recession could be reduced after surgery across 109 treated sites, and two examiners scoring blind agreed almost perfectly (Journal of Clinical Periodontology via PubMed).
Did you know about this? Two people with identical-looking recession can get different answers, and the reason sits in the space between their teeth.
What happens during a gum graft?
The standard operation lifts the gum beside the recession and moves it up over the root, then tucks a small piece of tissue underneath it. The tissue usually comes from the roof of your own mouth.
Adding that tissue is what makes the difference. In a network analysis of 48 trials, the graft gave more root coverage than moving the gum by itself (13.41%, 95% CI 8.06 to 18.75) and more complete coverage (14.41%, 95% CI 4.21 to 24.61), while platelet-rich fibrin and enamel matrix products, two add-ons sold in place of taking tissue from your palate, added nothing significant over moving the gum alone (Journal of Periodontology via PubMed).
Those reviewers called the graft plus the gum move "the gold-standard in root coverage therapy" (Journal of Periodontology via PubMed). If you're offered a pricier add-on in place of the graft, that finding is worth raising.
The Cochrane review of 48 randomized trials agrees on direction and is careful about strength. It rated only one trial at low risk of bias and 12 at high risk, and found connective tissue grafts, the kind taken from your own palate, gave "a slight improvement in outcome" where both root coverage and a wider band of firm gum were wanted (Cochrane Database of Systematic Reviews via PubMed).
Have no fear about the appointment itself. It's done with freezing, and in my experience the palate is the part patients notice most, for a few days rather than weeks.
Most general offices refer this out, and ours is no exception. A periodontist has at least three years of extra university training in treating gum disease and in restoring bone and gum tissue that have been lost (Canadian Dental Association).
Does a graft stay put?
Mostly, and it drifts.
A 2024 systematic review of 41 reports followed root coverage surgery for at least five years and found an upward trend in recession depth over time across the procedures it pooled (Journal of Clinical Periodontology via PubMed).
Two things tracked with staying power. The wider the band of firm gum at 6 to 12 months, the more stable the margin stayed afterward, and grafts using your own tissue were linked with less recession creeping back (Journal of Clinical Periodontology via PubMed).
A 2025 review of 17 trials names the limit outright: only one randomized trial has shown long-term stable root coverage with a connective tissue graft (Dentistry Journal via PubMed).
Worth doing when there's a reason. Not a reset button.
What does a gum graft cost in Toronto?
When my patients come back with a periodontist's estimate, a single-tooth graft tends to land somewhere around $1,000 to $1,800, and treating several neighbouring teeth in one surgery works out cheaper per tooth than doing them one at a time. That's a ballpark from what I see, not a quote.
Fees differ across the city because Ontario dentists aren't required to follow any fee schedule. They set their own fees, so a dentist's fees may fall above or below the provincial guide (Ontario Dental Association).
Ask for the procedure codes and a written estimate, then send it to your insurer before anything gets booked. Insurers call that a predetermination, and we walk through it in our post on deep cleaning costs.
Frequently Asked Questions
Q: Can receding gums grow back on their own? No. Gum tissue doesn't climb back up an exposed root without surgery. In pooled data on 1,647 untreated recession sites followed at least two years, 78.1% got deeper and the remainder stayed the same or improved slightly (Journal of Periodontology via PubMed). Covering the root means a graft.
Q: Does brushing too hard cause receding gums? It's the usual explanation, and the evidence is thinner than you'd expect. The Canadian Dental Association advises against scrubbing because "brushing too hard over time can cause your gums to recede" (Canadian Dental Association), while a systematic review of 18 studies concluded the data are "inconclusive" either way (Journal of Clinical Periodontology via PubMed). Brush gently with a soft brush anyway.
Q: Will an electric toothbrush stop my gums receding? Not on the evidence available. A 2026 pooled analysis of randomized trials found no meaningful difference between manual and powered brushes on recession at 6 or 12 months, at very low certainty (International Journal of Dental Hygiene via PubMed). Technique and pressure matter more than the motor.
Q: Do I need a gum graft, or can I leave it? It depends on whether the spot is moving, whether the root hurts, and how much attachment has been lost between the teeth, which is what predicts how much coverage surgery can achieve (Journal of Clinical Periodontology via PubMed). A stable, comfortable recession you don't mind looking at can be watched and measured. One that's deepening year over year deserves an opinion.
Q: Does a gum graft fix sensitivity? Covering the root removes the exposed surface that reacts to cold, so it can help. Sensitivity has several causes though, and it's worth sorting out which one you have before booking surgery for it. Our guide to tooth sensitivity goes through the options that don't involve an operation.
Q: How long does a gum graft last? Longer than people fear, and not forever. A review of 41 long-term reports found recession depth creeping upward over five years and beyond, with the widest bands of firm gum staying most stable (Journal of Clinical Periodontology via PubMed). Only one randomized trial has demonstrated long-term stable coverage so far (Dentistry Journal via PubMed).
Reviewed by Dr. Abinaash Kaur, B.Sc., DDS (University of Toronto Faculty of Dentistry), who has practised general and family dentistry in Bloor West Village for about 25 years. This article is general oral health information, not a diagnosis or a substitute for an examination.
Noticed a tooth looking longer than it used to? Come in and we'll measure it, write the number down, and tell you honestly whether it needs watching or an opinion from a periodontist. We're at 750 Annette Street in Bloor West Village, serving the Junction, High Park, and Baby Point. Book a visit with The Village Dentist and we'll take a look.
