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.
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
Alternative graft sources
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.