There are no nationally representative epidemiological studies available reporting on the different recession types according to the 2018 classification system or focusing on the aesthetic zone. The aims of this cross‐sectional study were (a) to provide estimates on the prevalence, severity and extent of mid‐buccal GRs according to the 2018 classification and (b) to identify their risk indicators in the adult U.S. population from the NHANES database.

Data from 10,676 subjects, representative of 143.8 millions of adults, were retrieved from the NHANES 2009–2014 database. GR prevalence was defined as the presence of at least one mid‐buccal GR ≥1 mm. GRs were categorized following the 2018 World Workshop classification system (RT1, RT2, RT3) and according to different severity cut‐offs. An analysis for GR risk indicators was also performed, selecting subjects without periodontitis.

The patient‐level prevalence of mid‐buccal GRs (all types) was 91.6%, while it decreased to 70.7% when considering only the aesthetic zone. When focusing on RT1 GRs, the patient‐level prevalence (whole mouth) was 12.4%, while it was 5.8% considering only the aesthetic zone. The majority of RT1 GRs were considered as mild (1–2 mm). The whole‐mouth patient‐level prevalence of RT2 and RT3 GRs was 88.8% and 55.0%, respectively. Age (35–49 years), gender (female), ethnicity (non–Hispanic Whites), last dental visit (>6 months before), tooth type (incisors) and the arch (mandible) resulted as risk indicators associated with the presence of RT1 GR.

Mid‐buccal GRs affect almost the entire US population. Age, gender, ethnicity, dental care exposure, tooth type and arch were identified as risk indicators for RT1 GRs.