Dental Implants

Gum Recession Around Dental Implants: Why It Happens and Can It Be Fixed?

October 26, 2026

If the gum around a dental implant appears to be moving downward or pulling away from the implant crown, it should be evaluated – but it does not automatically mean the implant is failing.

Gum recession around implants can happen for several very different reasons.

These include:

naturally thin gum tissue;
limited keratinized tissue;
loss or deficiency of the facial bone wall;
implant placement too far toward the lip or cheek;
normal tissue remodeling after treatment;
an unfavorable crown shape;
inflammation around the implant;
or peri-implantitis with progressive bone loss.

The correct treatment depends entirely on which of these problems is present.

For example, an implant with healthy bone but thin receded gum may potentially benefit from a connective tissue graft.

An implant with active peri-implantitis, however, requires treatment of the inflammatory disease and bone-loss problem rather than simply covering the area with more gum.

And when an implant has been positioned too far toward the facial side, gum grafting alone may not completely correct the problem.

This guide explains why gum recession around a dental implant develops, what it means when implant threads or metal become visible, how dentists diagnose the cause and when gum grafting, crown modification, peri-implant treatment or implant replacement may be considered.

This article provides general educational information. A receding implant site should be clinically examined because appearance alone cannot show whether the underlying bone is healthy.

Quick Answer: Can Gum Recession Around a Dental Implant Be Fixed?

Often it can be improved, but treatment depends on the cause.

Possible treatments include:

professional cleaning and improved plaque control;
monitoring a stable minor recession;
changing the implant crown or temporary restoration;
connective tissue grafting;
coronally advancing the gum tissue;
increasing keratinized tissue;
combined prosthetic and soft-tissue treatment;
treating peri-implantitis;
bone-regenerative procedures in selected defects;
or, in severe cases, removing and replacing a poorly positioned or failing implant.

The first step is therefore not:

“Which gum graft do I need?”

It is:

“Why did the gum recede?”

What Does Gum Recession Around an Implant Look Like?

Patients may notice:

the implant crown suddenly looks longer;
the gum line is higher than around the neighboring tooth;
a grey or metallic color near the gum;
part of the implant or abutment becoming visible;
implant threads becoming exposed;
a dark triangular space between teeth;
food trapping around the implant;
or an uneven gum line in the smile.

Some people describe this as:

“my gum is pulling away from my implant”;
“I can see metal around my implant”;
“my implant is showing through the gum”;
or “the implant tooth looks longer than before.”

All of these descriptions can represent peri-implant soft-tissue recession, but they do not necessarily have the same underlying cause.

What Is Peri-Implant Soft Tissue Dehiscence?

The more precise clinical term for certain types of implant gum recession is peri-implant soft tissue dehiscence, often abbreviated as PSTD.

It describes an apical displacement or deficiency of the soft-tissue margin around an implant-supported restoration.

In simple terms:

the gum margin has moved away from its ideal position around the implant crown.

This is particularly noticeable around front teeth because even a small difference in gum height can affect the appearance of the smile.

Is Implant Gum Recession Common?

It is not a rare complication.

A large 2025 systematic review evaluating 221 studies found that soft-tissue recession or dehiscence was frequently reported around dental implants.

The exact prevalence varied according to:

how recession was defined;
implant location;
treatment protocol;
follow-up period;
and the patient population studied.

The review identified several factors associated with greater recession risk, including:

limited mucosal thickness;
limited keratinized tissue;
immediate implant therapy in some situations;
and lack of soft-tissue augmentation.

This means gum recession should be viewed as a recognized implant complication rather than an extremely unusual event.

Does Gum Recession Mean the Dental Implant Is Failing?

No.

An implant can remain:

completely stable;
osseointegrated;
free from infection;
and surrounded by stable bone

while having a soft-tissue recession problem.

In that situation, the primary concerns may be:

aesthetics;
tissue thickness;
cleaning;
food trapping;
or long-term tissue stability.

However, recession can also occur together with bone loss and peri-implant disease.

That distinction is essential.

Gum Recession vs Peri-Implantitis

Soft-Tissue Recession	Peri-Implantitis
Gum margin has moved apically	Inflammatory peri-implant disease
May occur around a healthy implant	Associated with progressive supporting bone loss
May mainly be an aesthetic problem	Can threaten implant survival
Bleeding may be absent	Bleeding and/or suppuration are often present
Bone may remain stable	Radiographic bone loss is part of the disease process
Soft-tissue grafting may be appropriate	Disease control must be addressed first

You cannot reliably distinguish these conditions by looking in the mirror.

Why Do Gums Recede Around Dental Implants?

There is rarely one universal cause.

The final gum position is influenced by a combination of:

implant position;
facial bone;
soft-tissue thickness;
keratinized tissue;
implant timing;
grafting;
prosthetic design;
oral hygiene;
inflammation;
and individual healing.

1. Thin Gum Tissue Around the Implant

Some patients naturally have a thin peri-implant soft-tissue phenotype.

Thin tissue provides less volume between:

the implant;
abutment;
crown;
and outer surface of the gum.

This may make the site more susceptible to:

visible grey discoloration;
soft-tissue contour changes;
and recession.

Recent evidence identifies limited mucosal thickness as an important risk indicator for peri-implant soft-tissue dehiscence.

Why Does the Gum Sometimes Look Grey Around an Implant?

Thin gum tissue can allow the underlying:

titanium implant;
metallic abutment;
or darker restorative components

to influence the visible tissue color.

This can occur even before actual metal becomes physically exposed.

A grey gum line therefore does not necessarily mean infection.

It may indicate inadequate tissue thickness.

2. Limited Keratinized Tissue

Keratinized mucosa is the firmer type of gum tissue surrounding teeth and implants.

Not every implant requires the same amount.

However, limited or absent keratinized mucosa can make:

brushing uncomfortable;
plaque control more difficult;
and tissue stability less favorable in some patients.

Recent evidence has associated limited keratinized tissue with greater risk of certain peri-implant mucosal changes.

The European Federation of Periodontology also states that increasing keratinized or attached mucosal width may be considered when its absence is associated with discomfort during brushing.

3. Thin or Missing Facial Bone

The gum does not exist independently from the supporting bone underneath it.

At a front implant, the facial bone wall can be extremely thin.

If that bone:

was already missing;
was damaged during extraction;
is extremely thin;
or remodels after treatment,

the soft tissue above it may lose support.

This can contribute to recession.

How Much Bone Should Be in Front of an Implant?

There is no single number that guarantees stable tissue in every patient.

However, implant planning aims to maintain a sufficient facial bone envelope rather than positioning the implant directly against an extremely thin outer plate.

The final result depends on:

implant diameter;
implant position;
original ridge anatomy;
bone thickness;
grafting;
and tissue phenotype.

This is one reason three-dimensional implant planning is important.

Learn more about CBCT planning before dental implants.

4. The Implant Is Positioned Too Far Toward the Lip or Cheek

Implant position is one of the most important factors in aesthetic tissue stability.

If an implant is positioned too far toward the facial side, there may be insufficient space for:

stable facial bone;
adequate soft-tissue volume;
and a natural crown emergence profile.

This can increase the risk of:

gum recession;
visible metal;
an unnaturally long crown;
and difficulty obtaining complete coverage with a graft.

Why Can’t You Just Put More Gum Over a Poorly Positioned Implant?

Because gum grafting cannot always compensate for unfavorable implant anatomy.

If the implant head is positioned far outside the ideal prosthetic envelope, the tissue may have inadequate:

bone support;
space;
vascular supply;
or restorative contour

for predictable coverage.

In these situations, treatment may require a combination of:

changing the crown;
modifying the abutment;
soft-tissue grafting;
or, in severe cases, replacing the implant.

5. Immediate Implant Placement

An immediate implant is placed at the same appointment that a tooth is extracted.

This can be a very successful treatment when case selection and implant positioning are appropriate.

However, extraction sockets naturally remodel after tooth removal.

The outer facial bone wall can change during healing.

Studies have therefore shown greater variability in the soft-tissue margin with immediate implants, particularly when:

the facial bone is thin;
the tissue phenotype is thin;
the implant is positioned too facially;
or tissue augmentation is not performed in higher-risk anatomy.

Does This Mean Immediate Implants Are Bad?

No.

Immediate implant placement can provide excellent outcomes.

The issue is patient and site selection.

Modern protocols emphasize:

prosthetically driven implant position;
careful socket assessment;
facial bone evaluation;
soft-tissue phenotype;
and grafting when appropriate.

6. Natural Tissue Remodeling After Implant Treatment

Some change in the gum contour can occur as tissues mature after:

tooth extraction;
implant surgery;
bone grafting;
and provisional crown placement.

This is why the gum line immediately after implant placement should not automatically be considered the final long-term position.

Temporary implant crowns can sometimes be used to help shape the peri-implant tissue during healing.

Learn more about temporary teeth after dental implants.

7. The Implant Crown Has an Unfavorable Shape

The crown can influence the tissue surrounding an implant.

If the emergence profile is excessively:

bulky;
convex;
facially overcontoured;
or compressive,

it can contribute to an unfavorable soft-tissue environment.

In selected recession cases, replacing or modifying the implant restoration is therefore part of treatment.

What Is the Emergence Profile?

The emergence profile describes the shape of the crown and abutment as they transition from the implant through the gum into the visible tooth.

A well-designed emergence profile helps create a natural transition.

A poorly designed profile can:

compress tissues;
make cleaning difficult;
push the facial tissue outward;
or contribute to an unnatural contour.

8. Peri-Implant Mucositis

Peri-implant mucositis is inflammation in the soft tissues around an implant without progressive supporting bone loss.

Signs can include:

redness;
bleeding during brushing or probing;
swelling;
and tenderness.

Inflamed tissue can change in shape and appearance.

If inflammation is present, improving tissue health is essential before considering purely aesthetic treatment.

9. Peri-Implantitis

Peri-implantitis is more serious.

It is an inflammatory condition around an implant associated with progressive loss of supporting bone.

As bone and tissue are lost, patients may notice:

recession;
exposed implant surface;
visible threads;
bleeding;
pus;
food trapping;
or, in advanced cases, implant mobility.

This is not simply an aesthetic gum problem.

The underlying disease must be diagnosed and treated.

10. Plaque Accumulation and Difficult Cleaning

A crown or bridge that is difficult to clean can encourage plaque accumulation around the implant.

This becomes particularly important when:

the crown is too bulky;
the implant is very deep;
the bridge sits too close to the tissue;
or the patient cannot access the implant with appropriate hygiene tools.

Persistent inflammation can compromise long-term peri-implant tissue health.

11. Smoking

Smoking affects:

wound healing;
peri-implant tissues;
inflammatory response;
and long-term implant health.

It can therefore complicate both the original implant treatment and any later soft-tissue grafting procedure.

12. Previous Periodontal Disease

Patients who lost teeth because of periodontitis require careful long-term maintenance after receiving implants.

An implant cannot develop periodontal disease because it has no periodontal ligament.

But it can develop peri-implant disease.

A history of periodontitis is therefore relevant when assessing recession, inflammation and supporting bone around implants.

Can Brushing Too Hard Cause Implant Gum Recession?

Traumatic brushing may contribute to soft-tissue injury in susceptible sites.

However, significant peri-implant recession should not automatically be blamed on brushing technique.

Other factors such as:

implant position;
bone anatomy;
tissue thickness;
prosthetic contour;
and peri-implant disease

need to be evaluated.

Do not stop cleaning the implant because the gum has receded.

Instead, ask your dentist to demonstrate an atraumatic cleaning method appropriate for the restoration.

What Do Exposed Implant Threads Mean?

Visible implant threads deserve clinical evaluation.

There are several possible scenarios.

Scenario 1: Soft tissue has receded over an existing bone deficiency

The implant may already have had limited facial bone coverage.

Scenario 2: Bone has been lost around the implant

This may occur with peri-implantitis or another biological complication.

Scenario 3: The implant was positioned outside the ideal bony envelope

The facial threads may have had limited or no bone coverage from the beginning.

Scenario 4: Bone and soft tissue both remodeled after implant placement

This may gradually reveal part of the implant surface.

A photograph cannot reliably determine which situation is present.

Does Seeing One Implant Thread Mean the Implant Has Failed?

No.

A stable implant can sometimes remain functional despite limited exposed surface.

But the clinician should determine:

whether the condition is stable;
whether bone loss is progressing;
whether inflammation is present;
whether the area can be cleaned;
and whether treatment is indicated.

Can Exposed Implant Threads Be Covered With Gum?

Sometimes.

Soft-tissue grafting may provide meaningful coverage in selected cases.

However, complete coverage is less predictable when:

the implant is too facial;
supporting bone is severely deficient;
interproximal tissue has been lost;
peri-implantitis is active;
or the restorative contour remains unfavorable.

This is why the implant’s three-dimensional position must be evaluated before surgery.

How Does a Dentist Diagnose Implant Gum Recession?

A proper assessment may include:

medical and dental history;
when the implant was placed;
when the recession first appeared;
clinical photographs;
probing around the implant;
bleeding on probing;
suppuration;
implant mobility;
amount of keratinized tissue;
soft-tissue thickness;
implant crown contour;
implant position;
and radiographic bone levels.

Why Is Probing Around an Implant Important?

Gentle clinical probing can provide information about:

peri-implant inflammation;
bleeding;
pocket-depth changes;
suppuration;
and the level of the mucosal margin.

Current EFP guidance recommends monitoring peri-implant probing measurements and changes in the mucosal margin during supportive implant care.

Do You Need an X-Ray?

Often, yes.

A periapical radiograph can help compare the current bone level with previous imaging.

This is particularly important when recession occurs together with:

bleeding;
deepening pockets;
pus;
pain;
or suspected bone loss.

Do You Need a CBCT?

Not every recession case requires CBCT.

However, three-dimensional imaging may be helpful when the clinician needs to understand:

facial bone thickness;
implant position;
bone defects;
implant trajectory;
or whether reconstructive surgery is possible.

CBCT should be ordered only when the additional information is clinically useful.

Why Are Old X-Rays Important?

One X-ray tells the dentist what the bone looks like now.

Previous radiographs can show whether the bone level is:

stable;
or progressively changing.

This distinction can significantly change the diagnosis.

A stable old bone deficiency is different from active progressive peri-implantitis.

Can Gum Recession Around an Implant Stop by Itself?

Some minor recession may become stable.

But it is not possible to predict this simply from appearance.

If you notice a new change in the gum line, the safest approach is to establish:

the baseline recession depth;
bone level;
inflammation status;
and implant position.

The site can then be monitored for change.

Can Receding Gum Grow Back Around an Implant?

Significant lost peri-implant tissue usually does not simply regenerate to its previous position on its own.

Inflamed tissue may improve after treatment and swelling can change.

But established soft-tissue recession generally requires a surgical or prosthetic intervention if coverage is desired.

When Does Implant Gum Recession Need Treatment?

Treatment may be considered when recession causes:

visible metal or implant threads;
aesthetic concerns;
progressive tissue loss;
difficult cleaning;
food trapping;
brushing discomfort;
inflammation;
or an unstable peri-implant environment.

A small stable recession in a non-visible posterior site may sometimes require monitoring rather than surgery.

Can a Gum Graft Fix Recession Around a Dental Implant?

Yes, in selected cases.

Soft-tissue augmentation is an established treatment for certain peri-implant recession defects.

The most commonly studied approach involves:

moving the existing gum toward the crown;
and adding a connective tissue graft underneath it.

The graft increases tissue thickness and can help improve coverage and aesthetics.

What Is a Connective Tissue Graft?

A connective tissue graft uses a thin layer of tissue, commonly obtained from beneath the surface of the palate.

The graft is placed underneath the gum around the implant.

Its objectives may include:

increasing tissue thickness;
improving soft-tissue volume;
reducing visible recession;
masking grey implant components;
and improving long-term tissue stability.

How Successful Is Gum Grafting Around Implants?

Results depend strongly on the type of defect.

A 2025 systematic review and meta-analysis of selected peri-implant buccal recession defects found that soft-tissue augmentation with coronally advanced flap techniques produced:

an average recession reduction of approximately 2.2 mm;
improved professional aesthetic scores;
improved patient-reported aesthetics;
and an estimated complete coverage rate of approximately 71%.

These are encouraging results.

But complete coverage cannot be promised.

The review included a relatively limited number of patients and selected clinical situations.

Can Gum Grafting Cover 100% of the Implant?

Sometimes.

But the likelihood depends on:

implant position;
recession depth;
papilla height;
soft-tissue thickness;
bone support;
crown position;
and surgical technique.

Implant recession is often less predictable to cover completely than recession around a natural tooth.

What Is a Coronally Advanced Flap?

A coronally advanced flap is a periodontal plastic-surgery technique in which the gum is carefully mobilized and repositioned toward the crown.

A connective tissue graft may be placed underneath the flap to increase:

thickness;
volume;
and stability.

A randomized clinical trial comparing two approaches for isolated peri-implant recession found better 12-month recession coverage with a coronally advanced flap plus connective tissue graft than with a tunnel technique plus the same type of graft.

What Is the Tunnel Technique?

The tunnel technique creates a soft-tissue space underneath the gum without completely separating the papillae.

A graft is inserted through this space.

This technique can be useful in specific situations.

However, the appropriate method depends on:

defect type;
implant position;
papilla anatomy;
tissue thickness;
and surgeon preference.

Do All Gum Grafts Use Tissue From the Palate?

No.

Depending on the objective, clinicians may consider:

autogenous connective tissue;
free gingival grafts;
collagen matrices;
acellular dermal materials;
or other soft-tissue substitutes.

Autogenous connective tissue remains an important reference treatment when significant soft-tissue thickening and recession coverage are required.

What Is a Free Gingival Graft?

A free gingival graft is usually used primarily to increase the width of keratinized tissue.

It may be useful when a patient has:

very little attached or keratinized mucosa;
discomfort when brushing;
or difficulty maintaining plaque control.

Its objective is not necessarily the same as an aesthetic connective tissue graft around a front implant.

Can the Implant Crown Need to Be Changed Before a Gum Graft?

Yes.

This is one of the most important concepts in treating implant recession.

If the existing crown is too:

wide;
facially positioned;
bulky;
or compressive,

the tissue may not have enough space to move into the desired position.

The dentist may therefore:

remove the crown;
modify it;
replace it with a narrower temporary crown;
modify the abutment;
allow the tissue to adapt;
then perform the soft-tissue procedure.

Why Would a Temporary Crown Be Used Before Gum Surgery?

A temporary restoration can be designed to provide more space for soft tissue.

It may help:

reduce facial tissue compression;
improve the emergence profile;
guide tissue healing;
and create a better environment for grafting.

After the gum stabilizes, a new definitive crown can be made to support the corrected tissue contour.

What Is a Combined Prosthetic-Surgical Approach?

In some implant recession cases, the problem cannot be solved optimally with surgery alone.

A combined approach may involve:

removing or modifying the existing crown;
changing the abutment or temporary restoration;
allowing soft-tissue adaptation;
performing a connective tissue graft;
repositioning the gum;
then creating a new final crown.

This strategy is especially relevant when the implant restoration itself contributes to the recession.

Can a Gum Graft Fix a Poorly Positioned Implant?

Not always.

Mild positional problems may sometimes be managed with:

prosthetic modification;
soft-tissue augmentation;
and careful restorative camouflage.

Severe facial implant malposition is more difficult.

If the implant is significantly outside the ideal anatomical and prosthetic envelope, grafting may:

provide incomplete coverage;
relapse;
or create a bulky tissue contour without correcting the underlying problem.

When Does an Implant Need to Be Removed Because of Recession?

Removal is generally reserved for more severe situations.

Examples can include:

extreme facial malposition;
major supporting bone deficiency;
advanced peri-implantitis;
implant mobility;
an implant that cannot be restored adequately;
or an aesthetic problem that cannot predictably be corrected while retaining the implant.

The decision should consider the consequences of removal because explantation itself may create an additional bone defect.

What Happens After a Poorly Positioned Implant Is Removed?

Depending on the remaining anatomy, treatment may involve:

healing of the site;
bone grafting;
soft-tissue grafting;
replacement implant surgery;
and a new provisional and definitive restoration.

This can transform a relatively simple implant case into a much more complex reconstruction.

Can Bone Grafting Fix Implant Recession?

Bone grafting may be part of treatment when a true bone defect exists.

However, simply adding bone around an already integrated implant is not always predictable.

Regenerative treatment depends on:

defect morphology;
implant surface;
implant position;
inflammation;
ability to decontaminate the implant;
and the amount of remaining bone.

When peri-implantitis is present, treatment needs to address the disease itself rather than treating recession as an isolated cosmetic defect.

Can Peri-Implantitis Be Treated Without Removing the Implant?

Often, treatment initially aims to retain the implant when clinically reasonable.

Management can involve:

improving plaque control;
professional mechanical cleaning;
modifying an uncleanable prosthesis;
non-surgical peri-implant treatment;
surgical access;
implant surface decontamination;
resective therapy;
or reconstructive treatment in suitable defects.

Advanced cases may eventually require implant removal.

Should You Put a Gum Graft Over Active Peri-Implantitis?

The disease needs to be diagnosed and controlled.

Simply covering an inflamed, contaminated implant surface with more tissue does not correct the underlying peri-implantitis.

The treatment sequence should address:

inflammation;
biofilm;
prosthetic accessibility;
bone loss;
and implant-surface conditions

before or as part of any reconstructive approach.

Can Antibiotics Fix Gum Recession Around an Implant?

No.

Antibiotics do not grow back:

gum tissue;
keratinized mucosa;
or facial bone.

They are also not routinely indicated simply because recession is present.

If infection or peri-implant disease exists, treatment should be based on the diagnosis rather than automatically prescribing antibiotics.

Can Laser Treatment Grow the Gum Back?

There is no laser that reliably recreates lost peri-implant tissue simply by shining energy on the area.

Laser technologies can have specific applications in periodontal and peri-implant therapy.

But patients should be cautious about claims that a laser alone can predictably regenerate:

lost bone;
lost gum;
and complete implant coverage.

The structural defect still needs to be diagnosed.

Can PRF or PRP Fix Implant Gum Recession?

Platelet concentrates can be used as adjuncts in some surgical procedures.

But they do not replace the need to correct:

implant malposition;
inadequate tissue volume;
bone defects;
or peri-implant disease.

A treatment should not be selected primarily because a clinic advertises a particular biological product.

How Long Does a Gum Graft Around an Implant Take to Heal?

Initial soft-tissue healing occurs over the first weeks.

However, the graft continues to:

revascularize;
remodel;
mature;
and integrate with surrounding tissues

for much longer.

The final aesthetic result should therefore not be judged after only a few days.

Clinical studies commonly evaluate soft-tissue augmentation outcomes at:

six months;
12 months;
and longer follow-up intervals.

Does Gum Grafting Around an Implant Hurt?

Postoperative discomfort depends on:

the size of the procedure;
whether tissue is harvested from the palate;
number of implants treated;
and surgical technique.

If a palatal connective tissue graft is harvested, the donor area may be more noticeable during early healing than the implant site itself.

Your surgeon should provide individualized postoperative instructions.

Can Gum Recession Return After Grafting?

Yes.

Soft-tissue surgery cannot guarantee lifelong complete coverage.

Stability depends on factors including:

implant position;
bone support;
tissue thickness;
crown contour;
oral hygiene;
smoking;
and maintenance.

This is why correcting the cause matters as much as performing the graft.

Can Gum Grafting Be Done Years After Implant Placement?

Yes.

A soft-tissue defect can potentially be treated years after the implant was originally placed.

The relevant question is not the age of the implant alone.

The clinician needs to determine whether:

the implant is stable;
the bone is healthy;
the implant position is compatible with correction;
and there is sufficient tissue anatomy for the planned procedure.

Can Recession Around a Front Implant Be Fixed?

Front implants are the area where recession is usually most noticeable.

Treatment can be highly successful in selected cases, particularly when:

the implant is well positioned;
the interproximal tissue is preserved;
there is no active peri-implantitis;
and sufficient tissue can be mobilized and augmented.

Current evidence supports connective tissue grafting combined with appropriate flap techniques for selected isolated aesthetic defects.

Can Recession Around a Back Implant Be Fixed?

Yes, but the treatment objective may be different.

For a molar implant, the main concern may be:

health;
cleaning;
comfort;
and tissue stability

rather than perfect aesthetic coverage.

Increasing keratinized tissue or improving prosthesis cleansability may be more important than completely covering every visible implant thread.

What if the Implant Is Showing Through Thin Gum but the Gum Has Not Receded?

This can happen.

Very thin tissue may allow the grey implant or abutment to become visible through the gum.

The tissue margin may remain in an acceptable position while the color is aesthetically unfavorable.

A connective tissue graft may sometimes be used primarily to:

thicken the tissue;
increase volume;
and mask the underlying implant components.

Why Is the Crown Sometimes Removed During Treatment?

Removing the crown can provide:

better surgical access;
more space for the graft;
less tissue compression;
and the opportunity to redesign the emergence profile.

A temporary crown can then guide healing before the definitive restoration is made.

Can the Implant Crown Simply Be Made Longer to Hide Recession?

Sometimes the restoration can be modified aesthetically, but making the crown longer does not restore missing tissue.

It can also create:

unnatural tooth proportions;
poor symmetry;
difficult cleaning;
or an undesirable emergence profile.

Prosthetic camouflage is therefore appropriate only in selected situations.

Why Do Black Triangles Appear Around Implant Crowns?

A black triangular space can develop when the papilla between an implant and neighboring tooth does not completely fill the contact area.

This can relate to:

bone level;
implant-tooth distance;
contact-point position;
papilla height;
and restoration shape.

A gum graft cannot always recreate a missing papilla predictably.

Sometimes the prosthetic contact point also needs modification.

Can Gum Recession Cause Food to Get Stuck Around the Implant?

Yes.

Changes in the soft-tissue contour can create spaces around:

the implant crown;
bridge;
or interproximal areas.

Food trapping can then make hygiene more difficult and contribute to inflammation.

The dentist may need to modify both:

the tissue;
and the restoration.

Can Recession Cause Implant Sensitivity?

A dental implant itself does not develop root sensitivity like a natural tooth because:

there is no natural tooth root, pulp or periodontal ligament inside the implant.

However, the surrounding tissues can still feel:

sore;
inflamed;
tender;
or uncomfortable when brushing.

Pain around a receded implant should therefore be investigated rather than assumed to be ordinary tooth sensitivity.

Can Receding Gum Make an Implant Loose?

Soft-tissue recession by itself does not necessarily make an implant mobile.

The implant obtains stability from its integration with the jawbone, not from the gum.

But if recession is accompanied by severe progressive bone loss, implant support can eventually become compromised.

If the implant or crown feels mobile, read our guide to loose dental implants and implant crowns.

Can Bruxism Cause Gum Recession Around an Implant?

The strongest current evidence for bruxism concerns:

implant failure risk;
screw loosening;
fractures;
and other mechanical complications.

A direct causal relationship between bruxism and peri-implant soft-tissue recession is less clearly established.

However, excessive forces should still be evaluated as part of the complete implant environment.

Read more about dental implants and bruxism.

Can Gum Recession Be Prevented Before Implant Placement?

Risk cannot be eliminated completely, but planning can reduce avoidable causes.

Important factors include:

prosthetically driven implant positioning;
three-dimensional bone assessment;
appropriate implant diameter;
preserving or reconstructing facial bone;
evaluating soft-tissue thickness;
soft-tissue grafting in selected higher-risk sites;
appropriate provisional crown design;
and long-term supportive care.

Should Thin-Gum Patients Receive a Tissue Graft When the Implant Is Placed?

Not every implant automatically requires soft-tissue grafting.

However, augmentation may be considered when the clinician identifies a significant risk of:

facial recession;
inadequate tissue thickness;
aesthetic instability;
or insufficient keratinized tissue.

A 2024 five-year randomized clinical trial of immediate implants in the aesthetic zone found more favorable mid-buccal mucosal-level stability when connective tissue grafting was performed.

Does Bone Grafting Help Prevent Recession?

Maintaining or reconstructing adequate facial bone can support the peri-implant tissue architecture.

Current systematic-review evidence has identified bone grafting at implant placement as a factor associated with greater stability of the mucosal margin in studied populations.

But grafting should be based on actual anatomical need rather than performed automatically at every implant.

Why Does Implant Position Need to Be Prosthetically Driven?

The implant should be positioned where it can support the final tooth while remaining inside a favorable biological envelope.

Placing an implant simply where there is available bone can lead to:

poor crown position;
facial implant placement;
thin bone;
recession;
unfavorable screw access;
and difficult hygiene.

The final crown should therefore be considered before the implant is surgically inserted.

Can Guided Implant Surgery Reduce Recession Risk?

Guided surgery can help transfer a carefully planned implant position to the mouth.

The 2025 systematic review on peri-implant recession identified guided implant surgery as a protective factor associated with mucosal-margin stability in the available data.

However, a surgical guide cannot compensate for:

poor treatment planning;
inadequate bone;
incorrect prosthetic design;
or inappropriate case selection.

What Should You Do if You Notice the Gum Pulling Away From an Implant?

Do not panic. Recession does not automatically mean implant failure.
Do not stop cleaning the implant.
Do not aggressively scrub the receded tissue.
Take a clear photograph so you can document whether it is changing.
Arrange an implant or periodontal examination.
Bring previous X-rays if the implant was treated elsewhere.
Tell the dentist when you first noticed the change.

When Should Implant Gum Recession Be Checked Quickly?

Arrange prompt clinical assessment if recession occurs together with:

pus;
increasing swelling;
persistent bleeding;
increasing pain;
a bad taste;
rapidly increasing thread exposure;
a loose crown;
or implant mobility.

When Is It an Emergency?

Minor stable recession is usually not a medical emergency.

Urgent care may be needed if you develop:

rapidly spreading swelling;
difficulty swallowing;
difficulty breathing;
uncontrolled bleeding;
or severe systemic symptoms.

What if Your Implant Was Placed Abroad?

If you develop recession after dental tourism, obtain:

the implant manufacturer;
implant system;
implant position;
previous radiographs;
CBCT when available;
and prosthetic information

from the original clinic.

A local periodontist or implant dentist can evaluate the tissue and bone even if the implant was placed in another country.

Learn more about dental implants abroad aftercare.

Can a Gum Graft Be Done Without Going Back to the Original Implant Dentist?

Yes.

A periodontist or appropriately experienced implant clinician can assess and treat peri-implant soft-tissue recession regardless of who originally placed the implant.

However, having the original:

radiographs;
implant records;
and prosthetic information

can make diagnosis and treatment planning easier.

How Can You Keep the Gum Healthy After Treatment?

Long-term peri-implant maintenance remains essential.

This includes:

effective daily plaque control;
appropriate brushing technique;
cleaning between implants and teeth;
cleaning beneath implant bridges;
professional maintenance;
monitoring bleeding;
and periodic assessment of tissue and bone stability.

The EFP recommends structured supportive peri-implant care for patients with implants.

Should You Use a Water Flosser?

A water flosser can be useful around some implant restorations, especially fixed bridges.

But it does not replace:

toothbrushing;
appropriate interdental cleaning;
or professional maintenance.

If a recently grafted site is healing, follow your surgeon’s instructions before directing water pressure at the area.

Can Gum Recession Around an Implant Be Completely Prevented?

No implant treatment can guarantee that the gum margin will never change.

Soft and hard tissues continue to remodel throughout life.

However, risk can be reduced through:

correct implant positioning;
adequate bone;
appropriate tissue management;
good restorative design;
excellent hygiene;
and regular maintenance.

Frequently Asked Questions About Gum Recession Around Dental Implants

Why is my gum receding around my dental implant?

Possible causes include thin soft tissue, limited keratinized gum, inadequate facial bone, implant position, tissue remodeling, crown design or peri-implant disease. Clinical examination is needed to identify the cause.

Does gum recession mean my implant is failing?

No. Recession can occur around a completely stable and healthy implant. However, recession associated with progressive bone loss or peri-implantitis requires treatment.

Can gums grow back around a dental implant?

Established recession usually does not spontaneously return to its original position. Selected defects can be improved with soft-tissue grafting and prosthetic modification.

Can a gum graft cover a dental implant?

Yes, selected implant recession defects can be treated with connective tissue grafting and flap procedures. Complete coverage is not guaranteed.

How successful is gum grafting around implants?

Recent evidence shows meaningful recession reduction and improved aesthetics in selected cases. A 2025 meta-analysis estimated complete coverage in approximately 71% of treated defects, although the evidence base remains limited.

Why can I see metal around my implant?

The gum may have receded, or very thin tissue may allow the implant or abutment color to show through. Bone and tissue health should be evaluated.

Why can I see implant threads?

Visible threads may reflect soft-tissue recession, deficient facial bone, implant malposition, bone remodeling or progressive bone loss from peri-implant disease.

Does one exposed implant thread mean the implant needs to be removed?

No. The dentist needs to determine whether the condition is stable, whether inflammation or bone loss is progressing and whether the site can be maintained or reconstructed.

Can exposed implant threads be covered?

Sometimes. Predictability depends on implant position, remaining bone, tissue thickness, papillae and whether peri-implant disease is present.

Is implant recession the same as peri-implantitis?

No. Soft-tissue recession can occur around a healthy implant, while peri-implantitis involves inflammation and progressive supporting bone loss.

Can brushing too hard cause implant recession?

Traumatic brushing may affect vulnerable tissue, but implant position, bone, tissue phenotype and disease should also be investigated rather than assuming brushing is the only cause.

Can smoking cause gum recession around implants?

Smoking can negatively affect peri-implant tissue health and healing and may complicate treatment of soft-tissue defects.

Can a crown cause implant gum recession?

An excessively bulky or poorly contoured implant crown can contribute to an unfavorable tissue environment and may need modification as part of treatment.

Does the implant crown need to be removed for a gum graft?

Not always. In selected cases, however, removing or modifying the crown and abutment can improve space for tissue reconstruction and produce a more predictable result.

Can gum recession around a front implant be fixed?

Often it can be significantly improved when the implant is appropriately positioned, bone support is favorable and peri-implant disease is absent.

Can gum recession around a molar implant be fixed?

Yes, although treatment may prioritize tissue health, comfort and cleanability rather than complete aesthetic coverage.

Can a gum graft fix a badly positioned implant?

Mild positional problems may sometimes be compensated for, but severe facial malposition can make complete and stable tissue coverage unpredictable.

When does a poorly positioned implant need to be removed?

Removal may be considered when severe malposition, major bone loss, implant mobility or an uncorrectable restorative or aesthetic problem prevents predictable treatment.

Can bone grafting fix recession around an implant?

Bone reconstruction may be considered in selected defects, but the predictability depends heavily on implant position, defect anatomy and whether peri-implantitis is present.

Can antibiotics make implant gums grow back?

No. Antibiotics do not regenerate lost gum or bone and should not be prescribed simply because recession is present.

Can a laser regrow gum around an implant?

No laser has been shown to predictably replace the need for appropriate soft-tissue or bone reconstruction when structural tissue has been lost.

How long does gum grafting around an implant take to heal?

Initial healing occurs over several weeks, while soft-tissue maturation continues for months. Final results are commonly evaluated after several months.

Can gum recession come back after surgery?

Yes. Long-term stability depends on implant position, bone support, tissue thickness, restoration design, hygiene, smoking and maintenance.

Can gum grafting be performed years after implant placement?

Yes. The age of the implant is less important than implant stability, bone health, implant position and the anatomy of the remaining tissues.

Should I stop brushing an implant if the gum is receding?

No. Plaque control remains important. Ask your dentist to show you an atraumatic cleaning method appropriate for the affected area.

Do I need a CBCT for implant gum recession?

Not always. It may be useful when three-dimensional assessment of facial bone, implant position or a complex defect would change treatment planning.

Gum Recession Around Dental Implants: The Bottom Line

Gum recession around a dental implant is a finding, not a diagnosis.

The gum may recede because of:

thin soft tissue;
limited keratinized mucosa;
thin or missing facial bone;
implant malposition;
normal tissue remodeling;
an unfavorable crown contour;
inflammation;
or peri-implantitis.

That is why treatment varies so widely.

A healthy implant with an isolated aesthetic recession may potentially be treated with:

connective tissue grafting;
coronally advanced soft tissue;
crown modification;
or a combined prosthetic-surgical approach.

An implant with peri-implantitis requires treatment of the inflammatory disease and supporting bone loss.

A severely malpositioned implant may not be predictably corrected with gum grafting alone.

And a small stable recession around a posterior implant may sometimes require no surgical treatment at all.

Visible implant threads do not automatically mean the implant has failed, but they should not simply be ignored.

The implant should be evaluated for:

stability;
inflammation;
bone level;
implant position;
soft-tissue thickness;
and prosthetic design.

Modern soft-tissue grafting can achieve substantial improvements in selected cases, particularly when the underlying implant position and bone anatomy are favorable.

The best results come from treating the cause of the recession rather than only trying to hide the exposed implant.

At SOTA Dental – Advanced Implantology Center, implant complications can be evaluated from both the biological and prosthetic perspective, including implant position, facial bone, peri-implant tissue, crown contour and long-term implant health before deciding whether soft-tissue grafting, prosthetic correction or another treatment is appropriate.

Learn more about our dental implant treatments, periodontal treatment, bone grafting for implants, dental implant infection and peri-implantitis, loose dental implants and CBCT implant planning.

Scientific References

Tavelli L et al., 2025. Prevalence, incidence, risk, and protective factors for soft tissue dehiscences at implant sites in the absence of disease: An AO/AAP systematic review and meta-regression analysis. PMID: 40489305.

Nart J et al., 2025. Impact of soft tissue augmentation procedures on esthetics and patient satisfaction in the treatment of peri-implant buccal soft tissue dehiscences: A systematic review and meta-analysis. PMID: 40673678.

Tavelli L et al., 2023. Coronally advanced flap versus tunnel technique for the treatment of peri-implant soft tissue dehiscences with the connective tissue graft: A randomized controlled clinical trial. PMID: 36935199.

Zucchelli G et al., 2019. Classification of facial peri-implant soft tissue dehiscence/deficiencies at single implant sites in the esthetic zone. PMID: 31087334.

Tavelli L et al. Peri-implant soft tissue phenotype modification and its impact on peri-implant health: A systematic review and network meta-analysis. PMID: 32710810.

Monje A et al., 2023. Influence of buccal bone wall thickness on the peri-implant hard and soft tissue dimensional changes: ITI consensus evidence. PMID: 37750522.

Zuiderveld EG et al., 2024. Single immediate implant placement in the maxillary aesthetic zone with and without connective tissue grafting: Results of a five-year randomized controlled trial. PMID: 38228860.

Herrera D et al., 2023. Prevention and treatment of peri-implant diseases — The EFP S3 level clinical practice guideline. PMID: 37271498.

Kaddas C et al., 2022. Etiology and Treatment of Peri-Implant Soft Tissue Dehiscences: A Narrative Review. PMID: 35621539.

Medical disclaimer: This article provides general educational information and does not replace clinical examination. New recession, visible implant threads, bleeding, suppuration, pain or implant mobility should be evaluated by a dentist, periodontist or implant clinician.