Gum Recession & Grafts

Gum grafts are one of the most predictable and delicate procedures performed in dentistry today. Gum grafts can help reduce gum recession and bone loss. Aside from a better smile, you may also notice reduced tooth sensitivity and improved dental health after a successful gum graft.

In your mouth, there are two types of gum tissues that surround a tooth. The part of the gum that is around the neck of the tooth called the gingiva and this is firmly attached to the tooth and underlying bone.

This attached gingiva is immovable and tough, and is resistant to normal trauma from eating, tooth brushing, etc. When your teeth have a properly attached gumline, no gum grafts are needed.

Right below the attached gingiva is a looser gum tissue called alveolar mucosa. This tissue is loose to allow the movement of the lip and the cheeks but is not tough enough to withstand the normal trauma from eating and tooth brushing.

A soft tissue graft can reduce further recession and bone loss. In some cases, it can cover exposed roots to protect them from decay. This may reduce tooth sensitivity and improve the esthetics of your smile. Whether you have a graft to improve function or esthetics, patients often receive the benefits of both: a beautiful new smile and improved periodontal health – your keys to smiling, eating and speaking with comfort and confidence

When Gum Grafts Might Be Needed

Genetically, we all have different widths and thicknesses of attached gingiva. Some people are born with thin or insufficient attached gingiva. In these cases the gum slowly continues to recede over time, even though the patient may be very dedicated to oral health. This situation is not an infection, as seen with periodontal disease, but it still needs to be treated as such.

Unfortunately, when gums recede, bone recession is occurring at the same time. This is caused because the bone, which is just under the gum, will not allow itself to become exposed to the oral cavity. As a result, it moves down with the gum.

A lack of attached gingiva is sometimes associated with a high frenum attachment, which exaggerates the pull on the gum margin. A frenum is a naturally occurring muscle attachment, normally seen between the front teeth (either upper or lower). It is normal to have a frenum, but it should not pull on the gum margin or recession will occur. If pulling is seen, the frenum is surgically released from the gum with a frenectomy. Often a new band of hard gum is also added to re-establish an adequate amount of attached gingiva.

With the wear and tear of time, even normal attached gum can be worn away, generally from vigorous brushing. This often happens in people with naturally thin tissues, or when the tissues have been stretched during orthodontics. If there is still adequate attached gum to act as a barrier to the muscle, the treatment for gum recession is to ensure further damage isn’t done when brushing.

However, if the attached gum is worn to the point where it cannot resist the constant pull of the mucosa, gum recession will continue unless a new hard band of gum is placed. Unchecked, the gum recession can cause tooth loss as the bone recedes with the tissue and tooth support weakens.

Gingival Grafting

The replacement of missing attached gum is called gingival grafting. The muscle that is pulling down on the edge of the gum is first surgically resected and repositioned away from the gum margin. Then a small piece of attached gingiva is taken from the roof of the mouth, just adjacent to the back teeth, and transplanted to the site in question.

The new tissue reattaches and reforms a new layer of attached gum, which should last a lifetime with proper care. The roof of the mouth heals quickly, just like a skinned knee would. With this procedure the root is not covered, and the tissue stays at the same level as before, except with attached gingiva at the margin. Gingival grafting procedures are very easy on the patient, and rarely require more than over-the-counter pain pills post-operatively (ibuprofen).

Gum Grafts to Correct Exposed Tooth Roots

Exposed tooth roots are the result of gum recession. Perhaps you wish to enhance your smile by covering one or more of these roots that make your teeth appear too long. Or, maybe you’re not bothered by the appearance of these areas, but you cringe because the exposed roots are sensitive to hot or cold foods and liquids.

Your gums may have receded for a variety of reasons, including aggressive tooth brushing or periodontal disease. You may not be in control of what caused the recession, but prior to treatment we can help you identify the factors contributing to the problem. Once these contributing factors are controlled, a soft tissue graft procedure will repair the defect and help to prevent additional recession and bone loss.