One of the things patients say surprisingly often is: “I feel like my teeth are getting longer.” They usually say it with a slightly puzzled expression, because they know teeth do not actually grow. What they are noticing is often gum recession. Sometimes the first sign is increased sensitivity around the gum line. Others become aware that food traps more easily between certain teeth, or that the gum levels no longer look symmetrical when they smile or see themselves in photographs.

Very often, the changes have been developing gradually for many years. Patients simply do not notice them until they reach a point where they become more visible.

Gum Recession Is Not Always Gum Disease

One of the biggest misconceptions about receding gums is that they automatically mean severe gum disease. Whilst periodontal disease can certainly contribute, gum recession is often much more complex than patients realise. Some people naturally have thinner gum tissue and more delicate bone anatomy around their teeth. In these patients, relatively small amounts of inflammation, brushing trauma, grinding, orthodontic tooth movement or bite pressure can gradually contribute to recession over time.

In reality, there is often no single cause. More commonly, several smaller factors slowly combine together over many years. This is one reason why two patients with seemingly similar oral hygiene habits can present very differently.

Sometimes the Most Conscientious Patients Develop Recession

Many patients are surprised to learn that gum recession is often seen in people who take excellent care of their teeth. In practice, some of the patients with the healthiest intentions have simply been brushing with too much force for many years. Brushing harder does not necessarily mean brushing better.

Healthy gums are surprisingly resilient, but repeated trauma to thin tissues over time can contribute to recession and root exposure. This is particularly common around canine teeth and premolars, where the supporting bone is often naturally thinner. The technique, pressure and type of toothbrush used frequently matter more than people expect.

Grinding and Clenching Can Play a Role

Another factor that often surprises patients is the relationship between gum recession and excessive bite forces. Patients who grind or clench heavily sometimes present with a combination of:

  • gum recession
  • tooth wear
  • sensitivity
  • notches near the gum line
  • and tension in the jaw muscles

Often, the recession itself is not caused by one isolated problem. Instead, it reflects the cumulative effect of anatomy, pressure, inflammation and time.

Orthodontics, Smoking and Gum Health

Orthodontic treatment can create wonderful improvements in both function and aesthetics. However, teeth that are moved outside their natural bony support may sometimes become more vulnerable to recession, particularly where the gum tissues are already thin. Smoking can also affect the health of the gums in ways that patients do not always appreciate. One of the challenges is that smoking may reduce visible signs of bleeding even when inflammation is present, allowing problems to progress more quietly.

Most importantly, it is essential to determine whether active periodontal disease is present underneath the recession itself. Sometimes recession is largely cosmetic and stable. At other times, it may indicate ongoing inflammation and attachment loss that requires treatment. This is why proper assessment matters.

It Is Not Just About Appearance

Many patients first seek advice because they are concerned about how their gums look. However, recession can also affect comfort and long-term dental stability. As roots become exposed, sensitivity to cold drinks, brushing and sweet foods often increases. Areas of recession may also become more difficult to clean comfortably.

In more advanced situations, exposed roots may become vulnerable to decay, ongoing inflammation or progressive instability. Patients are often reassured to learn that gum recession does not automatically mean tooth loss. Nevertheless, early diagnosis remains important because treatment is usually more predictable before significant damage occurs.

Treatment Depends on the Cause

One of the reasons gum recession requires an individual approach is that the underlying causes vary considerably between patients. For some people, improving oral hygiene technique and reducing brushing trauma may be enough to stabilise the tissues. For others, managing grinding habits and excessive bite forces becomes an important part of treatment.

Where active periodontal disease is present, controlling the inflammation is essential before considering any cosmetic correction. Certain patients may also benefit from soft tissue grafting procedures designed to improve gum thickness, protect exposed roots or improve symmetry in carefully selected areas. The important thing is understanding why the recession developed in the first place rather than simply trying to cover exposed roots.

Healthy Gums Frame the Smile

Patients naturally focus on their teeth. Yet healthy gums play an enormous role in how natural and harmonious a smile appears. Some of the most attractive smiles are not necessarily the whitest or the most perfectly aligned. They are the smiles where the teeth and gums remain balanced, healthy and proportionate together. Patients are often relieved to discover that gum recession does not automatically mean they will lose their teeth. The most important thing is understanding why it has happened.

Because once we understand the cause, we can usually make much better decisions about how to protect the teeth that remain. At Implant & Perio Clinic in Marylebone, near Harley Street, we take a comprehensive approach to assessing gum recession, tooth wear, bite forces and long-term periodontal stability. Where specialist periodontal care is required, patients may be referred internally to our specialist periodontist, Dr Federico Tinti, for further assessment and treatment planning.

About the Author

Dr Sanaz Tehrani, DDS (Germany), is Principal Dentist and Clinical Director of Implant & Perio Clinic in Marylebone, Central London.

She has a particular interest in prevention, long-term oral health and helping patients understand the small changes that can have a significant impact on their teeth and gums over time.

Implant & Perio Clinic is located on Portland Place, Marylebone, near Harley Street, London W1

Dr. Pedram Negahban

Dr. Pedram Negahban

Principal Dentist

DDS (Germany)

GDC: 82959

Dr Pedram Negahban is a Principal Dentist at Implant & Perio Clinic in Marylebone, London, near Harley Street, where he works alongside his wife, Dr Sanaz Tehrani.

Born in Iran and educated in Germany, Dr Negahban graduated as a dentist from RWTH Aachen University in 2003. Fluent in English, German and Persian (Farsi), he has been caring for patients for more than 23 years.

Following graduation, he pursued extensive postgraduate education and was awarded a Diploma in Implantology. Over the course of his career, he has developed a particular interest in implant dentistry, restorative dentistry and complex treatment planning, dedicating much of his professional life to helping patients restore function, comfort and confidence.

Patients often meet Dr Negahban when they are facing significant decisions about their oral health. Some have failing teeth, some have been told they need extensive treatment, and others are simply unsure which option is right for them.

What many patients notice very quickly is that he takes his time.

For Dr Negahban, one of the most important parts of dentistry happens before any treatment begins. Reviewing scans, studying records, considering different options and carefully planning treatment are not tasks to be rushed. He believes that thoughtful planning is often the difference between a good result and a successful result that continues to serve a patient well for many years.

One of the qualities patients frequently comment on is his calm and measured approach. He believes that good dentistry is not about doing more treatment. It is about making the right decisions. Sometimes that means proceeding with treatment. Sometimes it means preserving what is already there. Sometimes it means waiting.

Over the years, he has helped patients with everything from replacing a single missing tooth to more complex implant and full-mouth rehabilitation cases. While he enjoys the technical aspects of dentistry, what continues to motivate him is finding the most appropriate long-term solution for each individual patient.

Even after more than two decades in practice, he remains committed to continuing education and professional development. He believes that experience is invaluable, but that good clinicians never stop learning.

Together with Dr Sanaz Tehrani, he has helped shape Implant & Perio Clinic around a philosophy of careful diagnosis, honest advice and treatment designed to serve patients well into the future.

What motivates Dr Negahban most is helping patients regain comfort, confidence and quality of life while knowing that the decisions made today will continue to benefit them many years from now.

His philosophy is simple:

The right treatment is not always the most complex treatment. It is the treatment that is right for the individual patient.

Dr. Federico Tinti

Dr. Federico Tinti

Specialist Periodontist

DDS (Italy), MSc Periodontology

GDC: 78429

Dr Federico Tinti is a Specialist Periodontist at Implant & Perio Clinic in Marylebone, London, near Harley Street.

Originally from Italy, Dr Tinti qualified as a dentist in 1998 and has dedicated more than 25 years of his professional career to the prevention, diagnosis and treatment of periodontal (gum) disease. Following graduation, he pursued postgraduate training in periodontology in both New York and London before completing a Master of Science in Periodontology. He later joined the GDC Specialist Register in Periodontology and has since focused his clinical practice on helping patients preserve their teeth and maintain long-term oral health.

Patients are often referred to Dr Tinti when they are experiencing bleeding gums, gum recession, loose teeth or advanced periodontal disease. Others seek his opinion because they have been told they may lose teeth and want to understand whether there are alternatives.

For Dr Tinti, periodontics is about much more than treating gums. It is about preserving the biological foundations that support every tooth, every restoration and every smile. He believes that healthy gums are the foundation of successful dentistry and that preserving natural teeth whenever possible should always be a priority.

One of the aspects of periodontology he finds most rewarding is that treatment can often help patients keep their teeth healthy and functional for many years longer than they expected. Through careful diagnosis, patient education and long-term maintenance, many conditions that were once considered inevitable can be stabilised and successfully managed.

Patients frequently comment on his calm and thoughtful approach. He believes that understanding why a condition has developed is just as important as treating it. Taking the time to explain findings, answer questions and involve patients in decisions about their care is an important part of his philosophy.

Throughout his career, Dr Tinti has remained committed to continuing education and evidence-based practice. He believes that successful periodontal care is built on a combination of scientific knowledge, clinical experience and a long-term partnership between clinician and patient.

At Implant & Perio Clinic, he works closely with Dr Sanaz Tehrani and Dr Pedram Negahban as part of a multidisciplinary team, helping patients achieve and maintain healthy foundations for both natural teeth and dental implants.

What continues to motivate Dr Tinti is helping patients preserve their teeth, comfort and confidence for as long as possible. He believes that some of the most valuable dentistry is not replacing teeth, but preventing the need for replacement in the first place.

His philosophy is simple:

Healthy gums are not separate from good dentistry. They are the foundation of it.

Dr. Sanaz Tehrani

Dr. Sanaz Tehrani

Principal Dentist

DDS (Germany)

GDC: 84955

Dr Sanaz Tehrani is a Principal Dentist at Implant & Perio Clinic in Marylebone, London, near Harley Street, where she works alongside her husband, Dr Pedram Negahban.

Born in Iran and educated in Germany, Dr Tehrani graduated as a dentist from RWTH Aachen University in 2004. Fluent in English, German and Persian (Farsi), she has been caring for patients for more than 22 years and has continued to pursue postgraduate education throughout her career.

Over the years, she has developed particular interests in Invisalign, aesthetic dentistry, tooth whitening and minimally invasive treatments. She enjoys helping patients improve their smiles in ways that feel natural, appropriate and tailored to the individual, rather than following a one-size-fits-all approach.

Despite advances in dentistry, one belief has remained constant throughout her career: good dentistry begins with listening.

Many patients arrive feeling anxious, embarrassed or worried about being judged. Others have not seen a dentist for years and are unsure what to expect. Creating a calm and welcoming environment where patients feel comfortable asking questions is something she considers just as important as the dentistry itself.

Whether a patient is attending for a routine examination, considering Invisalign, composite bonding, whitening or more complex treatment, her aim is always the same: to help people understand their options and make decisions they feel comfortable with.

Dr Tehrani particularly enjoys building long-term relationships with patients and their families. One of the greatest privileges of practising dentistry for more than two decades has been caring for patients over many years and, increasingly, welcoming their children and families into the practice as well.

Together with Dr Pedram Negahban, she has helped shape Implant & Perio Clinic around a simple belief: that patients should never feel rushed, judged or pressured. Instead, they should feel listened to, respected and cared for.

What continues to motivate her after more than 22 years in dentistry is not only the clinical side of the profession, but the people. Every patient has a story. Taking the time to understand that story has always been one of the most rewarding parts of dentistry.

Her philosophy remains simple:

Treat people the way you would hope a member of your own family would be treated.

Hayley Azopardi

Hayley Azopardi

Dental Therapist and Dental Hygienist

GDC: 5922

Hayley is a dedicated dental hygienist and therapist with over 19 years of experience in the dental field. She holds a Diploma in Dental Hygiene and a Diploma in Dental Therapy from the Royal College of Surgeons of England.

Hayley is passionate about providing patients with a comfortable and supportive environment, helping them achieve optimal oral health without judgment.

In her free time, Hayley enjoys gardening, reading, exploring natural health practices, walking, following world affairs, and keeping up with Formula 1.

Kerrie Barker

Kerrie Barker

Dental Hygienist

GDC: 5133

Kerrie qualified as a dental nurse from King’s College, London, in 1995. She remained at King’s College to undergo a qualification in Dental Hygiene, graduating in 1996 with the top award for pre-clinical exam.

Kerrie joined the practice in 2003 and is an integral part of the team. She loves talking to and getting to know her patients, as well as helping them to maintain their oral health.

Outside of dentistry, Kerrie is interested in psychotherapy, and achieved her Master’s degree in Psychotherapy in 2014. She also enjoys keeping fit with pilates and bike riding, watching documentaries, socialising and eating out with friends, and talking with her family back in Canada.

Jane Dyas

Jane Dyas

Dental Hygienist

GDC: 2403

Jane qualified as a dental nurse in 1980, and went on to qualify as a dental hygienist from the Royal Dental Hospital, London, in 1982. She started working at 57 Portland Place in January 2007.

Jane finds working in a perio practice very rewarding, as she is not just cleaning teeth, but treating patients with varying degrees of gum disease. She enjoys being able to teach them how to look after their mouths and save their teeth.

Jane’s patients mean so much to her, and she has treated many loyal patients for over 30 years! She strives to keep up-to-date with advances in dentistry and improves her knowledge by attending conferences in the UK and across Europe.

Outside of work, Jane loves to travel, and enjoys spending time in her home in Spain. She also loves interior design and property renovation, and has recently finished renovating a property in Spain. Her other interests include painting, gardening and keeping fit.

Diane Telot

Diane Telot

Dental Nurse

GDC: 133903

Diane is a dedicated Dental Nurse with many years of experience working in dental practices. She gained her SAAD Conscious Sedation qualification in 1996 at St Bartholomew’s Hospital.

Diane’s favourite part of her role is interacting with patients and continually learning new aspects of the job, ensuring every patient feels comfortable and well cared for. She brings a wealth of experience to the team, having spent over 11 years across her previous two practices before joining us.

Outside of work, Diane enjoys cooking, interior design, and walking, which help her relax and stay inspired.

Samaneh Sadri

Samaneh Sadri

Trainee Dental Nurse

Samaneh Sadri is an enthusiastic Trainee Dental Nurse. Originally studying IT in Iran and graduating in 1999, she is now dedicated to pursuing her new career path in dental care. As a trainee, she is working diligently to gain the experience necessary for her professional registration.

Samaneh’s favourite part of her role is learning new clinical skills and helping patients, ensuring everyone who visits the practice feels supported and well-cared for. She is passionate about expanding her clinical knowledge and providing high-quality assistance to the rest of the dental team.

Outside of work, Samaneh enjoys baking, reading, and meditation . She also enjoys regular exercise, which helps her stay balanced and active.

Martin Goodson

Martin Goodson

Practice Manager

Martin holds a degree in Philosophy and has completed CIPD Training Skills and Counselling Skills with Westminster Pastoral Foundation. He has been part of the practice team since 2011.

Martin loves interacting with patients, offering support for those who are feeling anxious or needing a bit more help. He is a large part of the day-to-day running of the practice, and is always on hand to answer questions or help in any way he can.

Outside of dentistry, Martin teaches meditation and mindfulness as well as Buddhist philosophy at a temple in London. He also supplies articles and podcasts to The Zen Gateway, a website he co-founded on meditation, mindfulness and philosophy.

Martin enjoys reading, listening to podcasts, walking, going to the cinema, and weight training.

Louise Scott-Hoffmann

Louise Scott-Hoffmann

Finance Manager

Louise joined the practice as Finance Manager in 2013. She loves working with numbers and is an integral part of the day-to-day running of the practice. She also enjoys being part of a great team.

Outside of work, Louise enjoys reading and watching rugby. She also has fun raising her teenage daughters!

Pamela Wilson

Pamela Wilson

Receptionist

Pamela joined the practice team in May 2023 and is the cheerful face on reception, welcoming our patients to the clinic with a smile. She loves working as part of a friendly and professional team to ensure the smooth running of the practice, and enjoys seeing the other side of dentistry, having previously only experienced it as a patient.

Outside of work, Pamela loves anything to do with the arts, particularly theatre and opera. She is a long term practitioner of iyengar yoga and a keen walker, both in the town and countryside.