Gingival recession (receding gums) refers to the progressive loss of gum tissue resulting in tooth root exposure which could lead to tooth loss if left untreated. Gum recession is most common in adults over the age of 40, but the process can begin in the teenage years.
Gum recession can be difficult to self-diagnose in its earlier stages because the changes often occur asymptomatically and gradually. Regular dental check ups will help to prevent gum recession and assess risk factors.
The following symptoms may be indicative of gum recession:
Sensitive teeth – When the gums recede enough to expose the cementum protecting the tooth root, the dentin tubules beneath will become more susceptible to external stimuli, especially cold and sweets.
Visible roots – This is one of the main characteristics of a more severe case of gum recession.
Longer-looking teeth – Individuals experiencing gingival recession often have a “toothy” smile. The length of the teeth is perfectly normal, but the gum tissue has been lost, making the teeth appear longer.
Halitosis, inflammation and bleeding – These symptoms are characteristic of gingivitis or periodontal disease. A bacterial infection causes the gums to recede from the teeth and may cause tooth loss if not treated promptly.
Causes of Gum Recession
Gum recession is an incredibly widespread problem that periodontists diagnose and treat on a daily basis. It is important to thoroughly examine the affected areas and make an accurate diagnosis of the actual underlying problem. Once the cause of the gum recession has been determined, surgical and non surgical procedures can be performed to halt the progress of the recession, and prevent it from occurring in the future.
The most common causes of gingival recession are:
Overaggressive brushing – Over brushing can almost be as dangerous to the gums as too little. Brushing too hard or brushing with a hard-bristled toothbrush can erode the tooth enamel at the gum line, and irritate or inflame gum tissue.
Poor oral hygiene – When brushing and flossing are performed improperly or not at all, a plaque build up can begin to affect the teeth. The plaque contains various bacterial toxins which can promote infection and erode the underlying jawbone leading to recession of the gum tissue.
Chewing tobacco – Any kind of tobacco use has devastating effects on the entire oral cavity. Chewing tobacco in particular, aggravates the gingival lining of the mouth and causes gum recession if used continuously.
Poor tooth position- Teeth that are not properly positioned often have thin, fragile gum tissue that is likely to recede even with good home care and regular dental care.
Treatment of Gum Recession
Every case of gum recession is slightly different, and therefore many treatments are available. The nature of the problem which caused the recession to begin with needs to be addressed first.
If overly aggressive brushing techniques are eroding the gums, a softer toothbrush and a gentler brushing technique should be used. If poor oral hygiene is a problem, prophylaxis (professional dental cleaning) may be recommended to rid the gum pockets of debris and bacteria. In the case of a severe calculus (tartar) build up, scaling and root planing will be performed to heal the gingival inflammation and clean the teeth. If bruxism is a factor a night guard will be recommended.
Once the cause of the gingival recession has been addressed, surgery of a more cosmetic or restorative nature may be recommended. Gum grafting is an excellent way to restore natural symmetry to the gums and make the smile look more aesthetically pleasing along with strengthening the tooth for long term retention and health.
A gum graft (also known as a gingival graft or periodontal plastic surgery), is a collective name for surgical periodontal procedures that aim to strengthen the gum tissue and cover an exposed tooth root surface with grafted oral tissue.
Here are some of the most common types of gum grafting:
Free gingival graft – This procedure is often used to thicken gum tissue. A layer of tissue is removed from the palate and relocated to the area affected by gum recession. Both sites will quickly heal without permanent damage.
Subepithelial connective tissue graft – This procedure is commonly used to cover exposed roots. Tissue is removed fairly painlessly from the inner layer of the palate and relocated to the site of gum recession.
Acellular dermal matrix allograft – This procedure uses medically processed, donated human tissue as a tissue source for the graft. The advantage of this is procedure is that there is no need for a donor site from the patient’s palate (and thus, less pain).
Reasons for gum grafting
Gum grafting is a common periodontal procedure. Though the name might sound frightening, the procedure is commonly performed with excellent results.
Here are some of the major benefits associated with gum grafting:
Reduced sensitivity – When the tooth root becomes exposed, eating or drinking hot or cold foods can cause extreme sensitivity to the teeth. Gum grafting surgery permanently covers the exposed root, helps reduce discomfort, and restores the good health of the gums.
Improved appearance – Periodontal disease is characterized by gum recession and inflammation. Gum recession and root exposure can make the teeth look longer than normal and the smile to appear “toothy.” Gum grafting can make the teeth look shorter, more symmetrical and generally more pleasing to look at. In addition, adjacent tissue can be enhanced and augmented during the procedure for aesthetic purposes.
Improved gum health – Periodontal disease can progress and destroy gum tissue very rapidly. If left untreated, a large amount of gum tissue can be lost in a short period of time. Gum grafting can help halt tissue and bone loss; preventing further problems and protecting exposed roots from further decay.
What does gum grafting treatment involve?
The gum grafting procedure is usually performed under local anesthetic in the office. The exact procedure will depend much on whether tissue is coming from the patient’s palate or a tissue bank.
First, the teeth must be thoroughly cleaned above and below the gumline to remove calculus (tartar) and bacteria. Then small incisions will be made at the recipient site to create a small space between the tooth and receding gum to accommodate the graft. The graft tissue is typically taken from beneath a small incision on the palate and is inserted into the space created between the tooth and receding gum. The graft is usually slightly larger than the recession area, so some excess will be apparent.
Sutures are placed to stabilize the graft and to prevent any shifting from the designated site. Surgical material is used to protect the surgical area during the first week of healing. Uniformity and healing of the gums will be achieved in approximately six weeks.
If you have any questions about gum grafting, please ask Dr. McNamara.