When recession of the gingiva occurs, the body loses a natural defense against both bacterial penetration and trauma. This can happen around both teeth and dental implants. When gum recession is a problem, gum reconstruction using grafting techniques is an option, which can repair the defect and prevent additional recession, bone loss, and tooth loss.
When there is only minor recession, some healthy gingiva often remains and protects the tooth, so that no treatment other than modifying home care practices is necessary. However, when recession reaches the mucosa, the first line of defense against bacterial penetration is lost and intervention is necessary to restore health.
Causes and Risk Factors of Gum Recession
- Periodontal (gum) disease
- Genetics- some people are born with gums that are thin, fragile, or insufficient predisposing them to recession
- Overaggressive brushing – 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.
- Improper flossing which may cut into the gums
- Orthodontics/Tooth Position – Teeth that are more “prominent” in the dental arch are more susceptible to gum recession. This position results in thin bone on the facial surface, which may result in gum recession. This tooth will also be more exposed to aggressive toothbrushing.
- Trauma to gum tissues, such as sports injuries or facial/tongue piercings
- High muscle attachments that can pull at the gumline
- Partial dentures that don’t fit right
- 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.
Gum recession often results in root sensitivity to hot and cold foods as well as an unsightly appearance to the gum and tooth. When gum recession is significant, it can predispose you to worsening recession and expose the root surface, which is softer than enamel. This uneven gum line can lead to root gouging and the accumulation of bacterial plaque which can cause root caries and tooth loss.
A soft tissue graft, or gum graft, is designed to solve these problems and prevent additional recession from occurring. A thin piece of tissue is taken from the roof of the mouth, or gently moved over from adjacent areas, to provide a stable band of attached gingiva around the tooth. In some cases, sterile donor tissue may be used thereby avoiding a second surgical site on the roof of the mouth. This procedure can be done for a single tooth or multiple teeth.
Benefits of Soft Tissue grafting
Gingival graft procedures are highly predictable and results in a stable healthy band of attached tissue around the tooth. A few benefits include:
- Improved Cosmetics- Gum recession can cause the teeth to look longer than normal and teeth may appear uneven in size. After gum grafting, the smile appears more symmetrical and healthy.
- Improved Periodontal Health- Periodontal disease is a progressive condition that can destroy soft tissue very rapidly. Soft tissue grafting can cease tissue and bone loss and protect exposed roots from further complications.
- Increased Comfort- Root exposure can cause substantial pain and discomfort because the root of the tooth is used to being protected by the gums and bone. Eating hot, cold or acidic foods can cause severe discomfort. Soft tissue grafts cover the exposed root and decreases sensitivity.