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Receding gums

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Receding gums

Receding gums

Gum recession is a term to simply describe a process in which the margin of the gum tissue that surrounds the teeth wears away or pulls back, exposing more of the tooth or tooth root. When gum recession occurs pockets form between the teeth and gum line, making it easier for bacteria to build up. Consequences of recession may include;

  • Tooth sensitivity.
  • Root decay.
  • Poor aesthetics due to uneven gum margins and exposure of the root surface which is typically darker and yellower.


Who it affects

Whilst gum recession can affect anyone from their teenage years, it is most prevalent in adults who are over the age of forty. Like most ailments, the sooner it is caught, the more chance of a successful treatment program minimising any long-term effects. If left untreated, it can, in some cases, lead to tooth loss due to the breakdown of the tissue and bone surrounding the teeth.


What causes
gum recession?

The cause of recession is typically multi-factorial and has to be assessed in detail. Known causes include;

  • Thin gums.
  • Mechanical trauma
  • Tooth position.
  • Orthodontic therapy.
  • Restoration margins which are very close to or beneath the gum.
  • Periodontal disease.


How is gum recession

In the first instance gum recession can be managed through deep cleaning of the affected area and careful control of the causative factors. You will be carefully instructed in oral hygiene techniques which do not traumatise the delicate gum tissue by our hygienists and periodontists.

In some cases recession may not require intervention. Provided the risk factors have been brought under control and you are regularly seeing a professional for maintenance therapy it is possible to prevent progression.

However, there may be instances where a site may be highly susceptible to progressive recession without intervention. The consequences of progressive recession may ultimately lead to increasing sensitivity, pain and in extreme circumstances, tooth-loss.


What type of surgery is used to treat gum recession?

There are a variety of different approaches to managing recession and they will be explained to you in detail during your consultation with a specialist periodontist.

You will be given a detailed report with a full description of the different management options, appointment schedule and financial breakdown.


Epithelialized Free-Gingival Graft

This technique is a well-known means to increasing the thickness of the gum, and in particular the amount of attached tissue which is ‘keratinised’. It is believed that having thick attached keratinised tissue is beneficial to preventing recession It is typically performed in areas which are not readily visible when smiling and where it is unpredictable that we can achieve complete root coverage.

A recipient site is prepared in the region of recession. A donor site of gum is taken from your palate and carefully sutured to the recipient site for a minimum of two weeks. If the graft successfully heals, we can observe an increase the tissue thickness as the site matures over the following year.

In some cases, we may elect to perform a second procedure to ‘advance’ the healed grafted site to achieve root coverage.

De-epithelialized Connective Tissue Graft and Coronally Advanced Flap

This technique is typically used when trying to achieve root coverage for aesthetic purposes and is widely considered to be the gold-standard means of doing so. A recipient bed is prepared onto which a graft from the palate is carefully sutured. The overlying gums are carefully stretched to cover the defect in a passive manner to protect the graft during the healing period. The sutures are typically left for at least two weeks.

Tunneling Procedures

Tunneling is a technique whereby the gums are advanced to provide root coverage without the need for extensive incisions. It is particularly useful when trying to manage a number of adjacent recession defects at the same time. It is typically performed alongside the use of a connective tissue graft or an animal derived equivalent.

Alternative graft sources

Although it is widely accepted that your own tissue (autogenous grafts) are the most successful in improving clinical parameters of recession, as well as improved aesthetics, the harvesting of such a graft does carry a degree of discomfort. This is mainly because there are two surgical sites, one from the palate from where the graft is harvested and the other being the recipient bed to which the graft is placed.

Animal derived alternatives (xenografts) may on occasion be suggested if there is a clear clinical indication and have been shown to be successful when utilised in the correct manner. Such grafts are typically of porcine (pig) origin.

Key points about gum recession

  • Gum recession is not something that simply occurs with old age.
  • The underlying cause of recession needs to be addressed through modification of tooth brushing routines and habits.
  • Gum recession is frequently managed conservatively through preventive measures.
  • More advanced surgical procedures are available and may be necessary to manage recession defects, for both aesthetic and preventive reasons.
For more information regarding periodontal disease please call us on 020 3411 7735 to speak with our friendly team or fill out our contact form.