Gum Grafting
Gingival Recession Overview
Gingival or gum recession is a common dental issue that can result in severe damage if left untreated. This condition occurs when the gum tissue surrounding teeth wears down or pulls away to expose too much tooth or tooth root.
If you are uncertain whether you have gingival recession, schedule an evaluation with your periodontist to make sure things are stable. The condition usually develops gradually, and you may not realize your gums are receding. Tooth sensitivity, or changes in the appearance of your teeth and gums are signs to watch for when looking for gingival recession.
Causes for Gingival Recession
Some common causes for gum recession include:
- Periodontal disease
- Lack of Home Care
- Genetics
- Teeth grinding or clenching
- Crooked teeth or misaligned bite
- Tobacco use
- Piercings
Treatment for Gum Recession
The most common solution for gum recession is soft tissue grafting. There are a few different types of gum grafts, but each is aimed at restoring health and stability.
A connective tissue graft is done to increase gum thickness and reverse as much of the damage from the gum recession as possible. Due to factors outside of our control, covering 100% of the exposed root surfaces is not always possible. However, the grafting procedure can typically make significant improvements for most patients. These grafts have been historically taken from the roof of the mouth, but nowadays many grafting procedures can be done using donor tissue.
The Pinhole Surgical Technique (PST) is a minimally invasive alternative for the treatment of gum recession. Rather than using incisions, small pinholes are made into the soft tissue. A specific set of instruments are then used to loosen the gum tissue and place it in a more suitable position around the teeth. In other words, the soft tissue is brought down to cover the exposed parts of the teeth roots. Benefits of this technique are decreased healing time and post-operative discomfort. Unfortunately, not everyone is a candidate for this procedure. Patients that smoke, are diabetic, or have a history of traditional periodontal disease / gingival inflammation typically do not see optimal results. Talk with your periodontist about whether or not you would be a good candidate for this technique.
There are two types of soft tissue in the mouth – one that is tough and strong, and one that is stretchy and movable. We want the tough tissue to surround our teeth – it is much easier to clean and is more resistant to gum recession. In situations where there is a lack of the tough tissue, a free gingival graft is performed. The purpose of this graft is to replace the strong tissue around the teeth. While this stabilizes and strengthens the support of the teeth, it does not typically cover the exposed parts of the roots. This type of graft does need to be “borrowed” from the roof of the mouth.
If a soft tissue graft is taken from the roof of the mouth, discomfort is common during recovery. Duration and intensity varies from patient to patient. Proper medications will be prescribed, and we advise eating soft, cold foods to avoid irritating the graft location.
Complications from palatal grafts are uncommon, but can occur. Problems may include bleeding, tooth sensitivity, and infection.