Gum Recession Around Implants: Causes & Management

Gum recession around a dental implant can be unsettling. You might notice a longer-looking crown, a grayish shadow near the gumline, or small “black triangle” spaces that catch food. You may also feel tenderness or see occasional bleeding when brushing. The good news: recession around implants is common, treatable, and the sooner you address it, the simpler the solution tends to be. This guide explains why recession can happen, how Dr. Rana Baroudi evaluates it, and the step-by-step treatments that restore health and esthetics.

Quick refresher: what a dental implant does

A dental implant is a small titanium post that fuses with your jawbone to replace a missing tooth root. Once healed, it supports a custom crown, bridge, or even a full-arch restoration so you can chew comfortably and smile confidently. If you’re exploring options or want a thorough overview, start here: Dental Implants. For patients missing many or all teeth, Dr. Baroudi also offers streamlined full-arch solutions: All-on-4 Dental Implants.

Why gums can recede around implants

Recession is the movement of the gum margin toward the implant neck or abutment. Around implants, several factors can contribute:

• Thin or delicate gum tissue (biotype). Some people naturally have finer, more translucent gums that are less resistant to everyday forces. Augmenting this tissue often improves long-term stability and aesthetics.
• Plaque accumulation and inflammation. Biofilm around implant crowns can trigger peri-implant mucositis (gum inflammation) and, if unaddressed, peri-implantitis (inflammation with bone loss). A chronically inflamed margin is more likely to recede.
• Aggressive brushing or abrasive toothpaste. Stiff bristles, gritty pastes, and aggressive technique can wear away delicate tissue at the margin.
• Prosthetic contours that are hard to clean. If a crown or bridge is bulky or contacts are too tight, it can trap plaque and stress the gumline.
• Insufficient bone or soft tissue volume at placement. For the most natural, stable result—especially in the front—implants often benefit from strategic bone and/or soft-tissue enhancement. Learn more about preparatory procedures like Bone Grafting and, in the upper back jaw, Sinus Lift.

Signs it’s time to get your implant checked

• Your implant crown looks “longer” than before
• A dark edge or metal shimmer near the gumline
• Bleeding when brushing or flossing close to the implant
• New sensitivity or tenderness when chewing
• Food impaction between the implant and adjacent tooth

If you notice any of these, schedule an evaluation. Dr. Baroudi will examine gum thickness and architecture, check pocket depths, assess crown contours and contacts, and, when needed, take images to gauge bone support.

Step one: calm the tissues and control biofilm

Before any regenerative or cosmetic procedure, the foundation of care is to reduce inflammation and make the area easy to keep clean:

• Professional debridement (“deep clean”) around the implant. Specialized instruments and gentle techniques remove biofilm and polish implant surfaces. Many patients also benefit from comprehensive cleaning on natural teeth—including Periodontal Scaling & Root Planing—to bring the whole mouth back to a healthier baseline.
• Adjunctive laser therapy where appropriate. Dr. Baroudi may use gentle laser energy to decontaminate the pocket lining and reduce inflamed tissue with minimal discomfort. Learn more about Laser Periodontal Therapy (LANAP).
• Personalized home care. A soft-bristle manual or powered brush, non-abrasive toothpaste, and implant-safe interdental brushes or flossers are key. Water flossers can also help under bridges or full-arch prosthetics. Technique coaching ensures you’re effective without overbrushing.

Rebuilding the gumline: soft tissue (gum) grafting

When recession is visible or the tissue is too thin to protect the implant long term, soft tissue grafting can enhance both health and esthetics:

• What it does: Adds a layer of thick, resilient tissue to reinforce the margin, reduce sensitivity, and create a more natural, symmetric gumline—especially critical in the front (the “esthetic zone”).
• Where tissue comes from: Options include your own palate (connective tissue graft), nearby donor sites, or biocompatible donor materials.
• Comfort and predictability: Modern microsurgical techniques prioritize small incisions, precise handling, and a smooth recovery. Explore the procedure here: Gum Grafting.

By thickening fragile tissue and improving the seal around the implant, grafting not only improves appearance but also protects the area from future irritation and plaque-related inflammation.

When pockets or bone loss are present

If inflammation has created deep pockets or affected the underlying bone, Dr. Baroudi may recommend additional procedures—sometimes staged for best predictability:

• Laser periodontal therapy (LANAP). A minimally invasive option that targets infected pocket lining and supports better tissue attachment with less tenderness and faster recovery for many patients. Details: Laser Periodontal Therapy.
• Pocket reduction surgery. Carefully reshaping and reducing the pocket depth creates a more maintainable environment and helps deter future plaque accumulation. Learn more about Pocket Reduction Surgery.
• Targeted bone regeneration. In areas where support has diminished, carefully placed graft materials can reinforce stability before soft-tissue refinement. See Bone Grafting and, for the upper back teeth, Sinus Lift.

Will the implant crown need an adjustment?

After the tissues are healthy, the next question is whether crown shape or contacts are contributing to the problem. In collaboration with your restorative dentist, Dr. Baroudi may recommend:

• Refining the crown’s emergence profile to reduce plaque traps
• Adjusting contact points to minimize food impaction
• Polishing or remaking a restoration if contours or materials compromise cleanability or esthetics

These nuanced changes can dramatically improve long-term maintenance and help grafted tissue remain stable.

Esthetics: managing “black triangles” and gray show-through

Recession in the smile zone can make the gumline look uneven or create triangular gaps between teeth. Management may include:

• Soft-tissue thickening via Gum Grafting to mask underlying components and support papilla height.
• Prosthetic refinements to close small gaps or alter emergence profiles.
• Staged therapy (stabilize, graft, then refine the crown) to maximize predictability.

Everyday habits that protect the margin

Small, consistent habits protect your investment:

• Use gentle tools. Soft bristles only, light pressure, and non-abrasive paste.
• Clean the “in-betweens.” Interdental brushes (sized for your implant), floss designed for implants, or a water flosser for bridges and full-arch prosthetics.
• Mind your bite. If you clench or grind, a custom nightguard helps distribute forces that might otherwise stress the margin.
• Rinse, don’t rush. If you can’t brush after meals, a quick rinse reduces lingering debris.
• Act early. Subtle changes are easiest to correct—don’t wait for sensitivity or bleeding to become routine.

Periodic maintenance: where long-term success is won

Healthy implants thrive with consistent monitoring. Dr. Baroudi will recommend a tailored interval—often every 3–4 months for patients with a history of periodontal issues—to check pocket depths, review home-care techniques, and make proactive tweaks. This rhythm keeps tissues calm, margins stable, and aesthetics on point. Ask at your next visit about creating a maintenance plan that matches your unique risk profile.

What to expect from treatment—and why timing matters

The ideal outcome combines health (a cleanable, well-sealed environment) and harmony (a natural-looking gumline). Many patients achieve both with a staged approach:

1. Stabilize—professional cleaning, laser adjuncts as needed, and home-care upgrades.
2. Reinforce—soft-tissue grafting to thicken fragile gums and improve the seal.
3. Refine—adjust crown contours or contact points for long-term cleanability and esthetics.
4. Maintain—customized checkups and coaching to keep everything stable.

Addressing recession early usually means less invasive care, more predictable esthetics, and a lower risk of progressive bone loss.

Who is a good candidate for soft-tissue grafting?

Most healthy adults with thin or receded tissue around an implant are candidates. Ideal factors include good plaque control, a stable bite, and a commitment to maintenance. If bone support is inadequate, Dr. Baroudi may first recommend site reinforcement via Bone Grafting or, in the upper back jaw, a Sinus Lift before soft-tissue optimization.

Recovery and comfort

With modern microsurgical techniques, most patients describe post-op soreness as mild to moderate for a few days, managed with routine medications and careful hygiene instructions. You’ll receive a clear, written plan for brushing, rinsing, diet, and follow-up so healing stays on track. If donor tissue is used from your palate, additional comfort strategies and a protective stent may be discussed.

Prevention checklist you can start today

• Switch to a soft-bristle brush and non-abrasive toothpaste
• Add implant-safe interdental cleaning (brushes, floss, or water flosser)
• Schedule professional cleanings at the interval Dr. Baroudi recommends
• Wear a nightguard if you clench or grind
• Ask about crown/contact refinements if food impaction is common
• Book an exam promptly if you notice bleeding, tenderness, or a changing gumline

Frequently asked questions

Will recession around an implant always show metal?
Not necessarily. Some restorations are entirely ceramic. However, even without metal show-through, recession can create shadows or black triangles that change the smile line. Thickening the tissue with Gum Grafting often improves both health and esthetics.

Can a graft “fail”?
Grafts are highly predictable in experienced hands, but success depends on good blood supply, gentle handling, and excellent post-op care. Dr. Baroudi will review your specific risk factors and post-op instructions to support a smooth recovery.

If I have bone loss, do I need surgery right away?
Not always. The first step is to stop active inflammation through professional cleaning and home-care optimization. If pockets remain or bone support is compromised, procedures like Pocket Reduction Surgery or Bone Grafting may be recommended—often in a staged plan.

Are full-arch options easier to keep clean?
For patients with multiple failing teeth or ill-fitting dentures, full-arch solutions such as All-on-4 Dental Implants can improve function and simplify hygiene when designed with cleanability in mind. Dr. Baroudi will review your goals and anatomy to recommend the right approach.

Considering comprehensive solutions

If you’re dealing with several problem areas—loose teeth, advanced gum disease, or an uncomfortable denture—comprehensive implant therapy may deliver the function and esthetics you want with a simpler daily routine. Dr. Baroudi sequences treatment to include site preparation when needed—such as Bone Grafting or a Sinus Lift—and offers streamlined full-arch options like All-on-4 Dental Implants.

Ready for a calm, healthy gumline?

If you’ve noticed gum changes around an implant—or just want a second opinion—Dr. Rana Baroudi can help. From gentle cleanings and Laser Periodontal Therapy to precision Gum Grafting and esthetic refinements, your plan will be tailored to your goals and timeline. Get started here: Contact Dr. Baroudi.