The most common causes of gum recession around individual teeth are:
 

1. Occlusal trauma
   
   When closing the jaws, certain teeth may come into contact earlier than others. This relationship is called traumatic contact because it leads to overloading (traumatization) of those teeth. The result of such early or traumatic contact is destructive changes in the gums and bone tissue. The most common causes of early tooth contact include:
    

Tooth loss
Tooth loss causes neighboring teeth to tilt, which leads to uneven distribution of chewing forces. Additionally, opposing teeth may "drift" into the empty space created by the missing tooth, hindering mandibular movement and subjecting some teeth to increased forces. These opposing teeth may also become overloaded.
 

Orthodontic anomalies of individual teeth and/or dental arches
Similar to tooth loss, various irregularities—especially in the position of one or more teeth—alter how forces act within the mouth. As a result, affected teeth are subjected to abnormal pressure and become overloaded.
 

As a consequence of these forces, gum recession and bone loss typically occur on one side of the tooth. In addition, such anomalies impair natural self-cleaning and make oral hygiene more difficult, leading to increased accumulation of plaque, tartar, and calculus, which worsens the clinical condition.

2. Poor tooth brushing technique
Using horizontal strokes, hard-bristled toothbrushes, and applying more pressure than necessary is defined as aggressive brushing. It causes damage to the soft tissues (i.e., the gums), which manifests as gum recession, and may lead to shallow defects on the exposed part of the tooth – the root. 
 

3. High attachment of frenulum and oral folds (plica)
Due to developmental anomalies, the frenulum and mucosal folds in the mouth may attach too close to the gum margin. During chewing, facial expressions, brushing, etc., these attachments exert tension on the gum, causing it to pull away from the tooth and exposing the root surface.
 

4. Inadequate prosthetic work and fillings
Over-contoured crowns, overhanging fillings, and prosthetic work that causes traumatic contacts can all lead to chronic irritation of the gums, disrupt oral balance, and contribute to gum recession.

Non-surgical treatments are the foundation for managing mild to moderate forms of periodontal disease. Their goal is to eliminate the cause of infection—dental plaque and tartar—while reducing inflammation and the depth of periodontal pockets.

1. Removal of supragingival soft and hard deposits

This procedure is performed using ultrasonic devices and specialized hand instruments and includes:
 

• Scaling (removal of tartar):
  Tartar is mineralized plaque that forms on the surface of the teeth above the gum line. It is one of the main causes of gum inflammation and bad breath. Scaling involves the thorough removal of these deposits to allow tissues to heal and regenerate.
   

• Air polishing:
  After scaling, air polishing is performed – a procedure where a stream of water and fine abrasive powder is used under pressure to remove remaining stains from food, coffee, tobacco, and other pigments on the tooth surface.
   

• Tooth polishing:
  At the end of treatment, teeth are polished using special pastes to smooth their surfaces. This makes it more difficult for plaque to reaccumulate and prolongs the effects of the therapy.

2. Removal of subgingival calculus and dental plaque

As periodontal disease progresses, so-called "pockets" form – spaces between the teeth and gums where bacteria, tartar, and plaque accumulate. This treatment includes:
 

• Curettage of periodontal pockets:
  This is a mechanical removal of subgingival deposits (below the gum line) using special instruments called curettes. The treatment can be closed (without lifting the gum flap) or open (as part of a surgical procedure).
   

This procedure helps reduce pocket depth, eliminates bacterial infection, and allows the gums to reattach to the tooth surface. It is often repeated as part of ongoing periodontal therapy.

When periodontitis progresses to an advanced stage and non-surgical measures are no longer sufficient, surgical procedures are performed to regenerate lost tissue, reduce pocket depth, and improve both function and aesthetics.

1. Flap surgery with or without bone augmentation

Flap surgery involves lifting the gums to allow direct access to the tooth root and affected structures. During the procedure, deep deposits and inflamed tissue that cannot be removed non-surgically are eliminated.

In cases of bone loss, augmentation is performed – rebuilding bone using biocompatible materials (such as synthetic bone, autogenous grafts, or collagen membranes) to regenerate the tooth’s supporting structures.

This intervention significantly improves the tooth’s prognosis and reduces the risk of tooth loss.

2. Free mucosal autograft (SMAT)

SMAT involves harvesting a piece of mucosal tissue (usually from the palate) and transplanting it to a site with gum recession. It is used to:
 

• Increase thickness and resistance of the marginal gingiva

• Improve esthetics and functionality

• Prevent further gum recession and root exposure
   

SMAT is recommended for patients with a thin gingival biotype and visible recession.

3. Connective tissue graft (CTG)

CTG involves taking connective tissue from beneath the epithelium of the palate and transplanting it into the affected area. This procedure is highly effective in:
 

• Covering exposed tooth roots

• Increasing soft tissue thickness and stability

• Achieving a high aesthetic result
   

Unlike SMAT, this graft is placed beneath the surface, making it invisible externally and allowing faster healing with less postoperative discomfort.

4. Gingivectomy with or without osteotomy

Gingivectomy is an aesthetic surgical procedure that involves removing excess gingival tissue to create a harmonious smile line. It is indicated when:
 

• Too much gum is visible when smiling (“gummy smile”)

• There is gingival overgrowth (hyperplasia)

• There is a need to lengthen the clinical crown of the tooth
   

In some cases, the procedure is combined with osteotomy – reshaping of the alveolar bone to better expose the tooth, achieving optimal aesthetic results.

Periodontal therapy includes a series of specialized procedures aimed at preserving the health of the gums and the supporting structures of the teeth – the periodontium. Gum diseases, known as periodontal diseases, are among the most common chronic infections in adults and represent the leading cause of tooth loss.

They usually develop gradually, starting with a milder form – gingivitis (gum inflammation) – and, if left untreated, can progress into periodontitis, a serious condition that affects the deeper structures around the teeth, including the periodontal ligament and alveolar bone.

Symptoms such as redness, swelling, bleeding during brushing, gum recession, tooth mobility, or bad breath may indicate the presence of periodontal problems. That’s why it is essential for therapy to be carried out in a timely and personalized manner for each patient.

Periodontal therapy can be non-surgical (in the early stages of the disease) or surgical (in advanced cases). It includes procedures such as tartar and plaque removal, deep cleaning of periodontal pockets (scaling and root planing), as well as sophisticated surgical interventions – from bone regeneration to soft tissue grafts.

The goal of any periodontal therapy is not only to improve the aesthetics of the gums but above all, to ensure a stable foundation for the long-term preservation of natural teeth. Regular check-ups, proper oral hygiene, and professional treatments by a periodontist are the keys to a healthy, lasting smile.

Gingivitis
The initial stage of periodontal disease. Gums are swollen, red, and bleed when touched. If left untreated, it can progress to periodontitis.

Periodontitis
A chronic infection that destroys the connective tissue and bone around the teeth. It can cause gum recession, tooth shifting, and tooth loss.

Necrotizing periodontal diseases
Rare but serious gum infections that are very painful and rapidly destructive. They usually occur in individuals with weakened immune systems, high stress levels, and poor nutrition.

• Bleeding gums while brushing

• Gum recession and “longer-looking” teeth

• Persistent bad breath

• Tooth mobility

• Periodontal pockets (space between tooth and gum)

• Inflammation around dental implants (peri-implantitis)

Prevention starts at home but is completed in the dental office:

• Proper and regular tooth brushing (twice a day for 2 minutes)

• Use of dental floss and interdental brushes

• Avoiding smoking

• Blood sugar control in diabetic patients

• Regular check-ups and early treatment

• Professional dental cleaning every 3–6 months

Laser therapy is highly effective on both soft and hard tissues of the oral cavity.

Its effect on soft tissues enables less invasive "bloodless surgery", minimal postoperative complications, and painless procedures. Surgical indications for laser use on soft tissues are numerous: gingivectomy, frenulum removal, incision and drainage of abscesses, fistula closure, implant uncovering, peri-implantitis treatment...

Laser application is now an essential part of successful periodontal therapy due to its anti-inflammatory and bactericidal effects. By destroying bacteria in inflamed gums, gingivitis is healed and the progression of periodontitis – the most common oral disease in modern humans – is stopped.

How can I recognize gum inflammation (gingivitis)?
The most common early signs are redness and bleeding of the gums while brushing. Although gingivitis in its early stage is easily treatable, if left untreated, it can progress to periodontitis – a more serious condition requiring complex therapy and professional supervision. Timely reaction is key to preserving gum and tooth health.

Can gums grow back after receding?
Not on their own, but surgical procedures such as tissue grafting can improve the condition.

Are periodontal treatments painful?
Most treatments are performed under local anesthesia and are painless. Mild discomfort after the procedure is possible.

Bleeding gums while brushing?
Bleeding gums are the most common sign of gum inflammation. In most cases, improved oral hygiene and a soft-bristled toothbrush can reduce inflammation. However, if bleeding persists, it’s important to visit a dentist promptly to prevent the problem from progressing.

Is it possible to get dental implants if I have periodontitis?
Periodontitis is not an absolute contraindication for dental implants, but it requires careful assessment and monitoring by a periodontist. Since the disease affects both soft and hard tissues, successful implantation requires excellent oral hygiene and strict adherence to specialist advice. Regular check-ups and professional cleanings are key to maintaining oral health and implant stability.

How long does periodontitis treatment take?
It depends on the severity – from a few weeks to several months. This is followed by a maintenance phase.

Can periodontitis be stopped?
Yes, but it requires early detection, thorough treatment, and lifelong maintenance.

Do teeth become loose with periodontitis?
They can, especially in advanced stages. Successful treatment often stabilizes the condition.