Why Has My Gum Recession Happened In Symmetry At Tooth Number 5, 12, 21 and 28?

Gum recession happens when the gum tissue around your teeth wears away or shrinks. There are several causes but it is commonly seen in symmetry at the premolars following orthodontic treatment during childhood.  Learn more about why gum recession happens in symmetry at teeth numbers 5,12, 21 and 28 in this post.

The Signs and Symptoms of Gum Recession

Gum recession, or to give it its formal name gingival recession is where the gum tissue shrinks back. 

It can be caused directly by 

  • Aggressive brushing or oral piercings can wear the tissue away
  • Periodontal disease – which leads to the loss of bone that supports the gum tissue
  • Recovery from periodontal treatment – healthy gums shrink back
  • Trauma from the excessive force on the teeth

You can also be predisposed to gum recession. If you have

  • Decreased thickness at the top of the jaw bone, where the teeth insert into the bone – you may be genetically predisposed to this
  • Thin bone and gum tissue along the front wall of the bone (the side close to the cheek). The tooth root is not covered by bone. When this occurs from the edge of the bone along the tooth root dentists call this dehiscence. When bone coverage is present at the edge of the bone but it becomes uncovered part way down the tooth root dentists call this fenestration. 
  • A tight frenum – your lip is joined to the gums by the frenum. When this is tight it can pull your gums away from the teeth.
  • Smoking
  • Uncontrolled Diabetes
  • Poor nutrition 
  • Misaligned teeth

Why Gum Recession Happens In Symmetry at Tooth Numbers 5, 12, 21 and 28

why my gum recession happened symmetry at tooth number 5, 12, 21, 28 

Tooth numbers 5, 12, 21 and 28 are the premolars (or the bicuspids). A possible cause of symmetrical gum recession of these teeth is orthodontic treatment. Several other causes may also lead to the symmetrical gum recession. 

How Does Orthodontic Treatment Cause Gum Recession?

Moving the teeth with braces or clear aligners does not cause damage to the gum tissue but it can move the tooth or teeth towards the front of the alveolar bone leaving the tooth roots covered by an extremely thin layer of bone (dehiscence or fenestration). Studies have shown that if the thickness of the gum tissue is less than 0.5mm it increases the risk of gingival recession (1). 

This change in bone morphology around the tooth roots can make gum recession more likely to occur from aggressive tooth brushing or periodontal disease.

It’s frequently seen in symmetry at tooth numbers 5, 12, 21 and 28. These teeth are the premolars (or the bicuspids). It’s often seen in dental offices when patients had orthodontic treatment during childhood straightening and the teeth were moved too quickly or were expanded too far.  

Orthodontic treatment can also make it harder to clean the gum line and lead to periodontal disease, bone loss as well as gum recession. 

Misaligned Teeth

Misaligned, crooked and tilted teeth often have a very thin bone layer. It can also lead to an unbalanced bite. Thin bone results in gum recession and the unbalanced bite can destroy the thin bone plates. As the bone is no longer present to support the gum tissue it pulls back.

If your premolars are crooked this can lead to gum recession around these teeth. 

Oral Hygiene

Poor oral hygiene can lead to gum disease and gum recession. It can occur around the premolars if you unintentionally fail to clean the gum line around these teeth. This can happen when cleaning your teeth if you change the direction of your brushing action when you reach these teeth. 

Similarly, you may brush these teeth more or press on more aggressively around these teeth causing the tissue to wear away. 

Dental Treatment For Receding Gums 

Unfortunately, gum recession isn’t reversible. But the good news is that there are several treatment options available. 

Reducing Sensitivity

Dentinal hypersensitivity is one of the most commonly encountered clinical problems of gum recession. You may experience short, sharp pain when you eat or drink something cold, hot, sweet or sour. This sensitivity can be reduced with the following treatments.

  • Desensitizing toothpaste, mouthwashes or chewing gums can be used at home – they act by either close up the dentinal tubules or blocking the neural transmission.
  • Fluoride varnish – applied by a dentist or hygienist 
  • Desensitizing agents to reduce discomfort associated with receding gum

Gum Grafts

Gum grafts are commonly used to cover exposed tooth roots. Tissue is taken from the roof of the mouth, healthy gum tissue or donor tissue and placed over the exposed root and sutured into place. There are three different gum grafting procedures used 

  • Connective tissue
  • Free gingival grafts 
  • Pedicle grafts 

Orthodontic Treatment

Braces can cause gum recession and they can also improve its appearance and prevent gum recession from occurring due to misaligned teeth. 

Traditional braces or clear aligner therapy can improve the position of misaligned teeth. They can also help increase the thickness of bone and gums and better distribute chewing forces to prevent the gums from receding.


Smoking, uncontrolled diabetes and poor nutrition put you at risk of gum disease and gum recession. Addressing these risk factors can prevent your gum recession from worsening. 

Final Thoughts

It’s very common to see gum recession in symmetry at teeth numbers 5, 12, 21 and 28 following childhood orthodontic treatment when the teeth have been expanded too quickly or too far.  It can also be caused or exacerbated by poor technique when cleaning your teeth. We recommend a Gum Pocket Brush as the gold standard to remove the harmful bacteria causing periodontal disease.

Beat Gum Disease Now

References for “Why Has My Gum Recession Happened In Symmetry At Tooth Number 5, 12, 21 and 28 “

Correlation analysis of gingival recession after orthodontic treatment in the anterior region: an evaluation of soft and hard tissues – PMC.

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Written by Gareth Edwards

Co-Founder & GDG Dentist

Dr. Gareth Edwards BDS (Hons) MFDS (RCPS Glasgow) is GDG Co-Founder and Gum Disease Expert.

He is a practicing dentist based in Bournemouth, UK and has treated thousands of patients with gum-related diseases.

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