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Gum recession, or gingival recession, is a condition where one’s gums gradually pull back from the teeth, exposing more of the tooth and the roots. When this happens, gaps form between the gums and the teeth. Bacteria can gather in these gaps, causing periodontal disease and wear away at the teeth. In advanced cases, the infection can break down the bone underneath, resulting in tooth loss.
As gum recession tends to be a slow process, it can go unnoticed for many years. After a prolonged process, the following symptoms get worse and cause discomfort:
Your dentist can diagnose gum disease during a routine examination. They use a periodontal probe to measure the depth of the sulcus (the space between the tooth and the gums). A healthy sulcus is typically 3mm or less, while a depth of more than 3mm may be a sign of gum disease.
However, as the depth alone is not always conclusive, your dentist will also check for other signs like bleeding, inflammation, tooth mobility, bad breath, and gum recession. In some cases, x-rays may be taken to assess bone loss, which can be affected by advanced gum disease.
Aggressive brushing or flossing: Overly forceful brushing or flossing can irritate and damage gum tissue, increasing the risk of recession over time.
Dental plaque or tartar build-up: These directly contribute to periodontal diseases like gingivitis and periodontitis, which trigger inflammation and damage gum tissue.
Poor oral hygiene: Consistent neglect of proper brushing and flossing allows plaque and tartar to build up, leading to periodontal diseases and ultimately gum recession.
Genetic predisposition to thin gum tissue: Some individuals naturally have thinner gum tissue, making them more vulnerable to recession even with good oral hygiene.
Smoking: Smoking reduces blood flow to the gums, weakens gum tissue, and contributes to periodontal disease, all of which increase the risk of recession.
Bruxism: Grinding and clenching teeth put significant pressure on the gums, potentially causing them to recede over time.
Diabetes: Elevated blood sugar levels can lead to plaque build-up and weaken the immune system, all increasing the risk of gum disease and ultimately, gum recession.
Hormonal changes in women: During pregnancy, menopause, and other hormonal fluctuations, women may experience gum tissue changes that make them more susceptible to recession.
Lip and tongue piercings or ill-fitting dental appliances: These can directly irritate and injure gum tissue, leading to recession in the affected areas.
Gum grafting is a surgical dental procedure that involves taking tissue from one area of the mouth and placing it over the exposed tooth roots to thicken and strengthen the gums to help reduce further gum recession, as well as protect the vulnerable roots from decay. Gum grafting surgery will repair the defect to your gum line and may also reduce sensitivity.
During a gum grafting procedure, your periodontist will first use a suitable form of sedation. Next, they will make incisions in your gums and carefully separate them from your teeth. Then, a small amount of donor tissue will be taken from another area of your mouth and transplanted to the treatment site. Finally, the incisions will be closed with sutures and a dressing may be placed over the grafted area.
There are three common types of gum grafting techniques:
The connective tissue graft involves taking a small piece of tissue from the roof of the mouth (palate) and placing it under the existing gum. This technique allows the new tissue to blend in well with the surrounding gums, as it goes under the gum line.
The free gingival graft procedure also involves using tissue from the palate. However, instead of creating a flap and taking out tissue below the top layer, a small amount of tissue is directly removed from the roof of the mouth. This extracted tissue is then attached to the targeted gum area.
The pedicle graft involves carefully repositioning a portion of gum tissue adjacent to an exposed root surface. The advantage of this technique is that the relocated tissue retains its blood supply. This treatment is most effective when there is sufficient gum tissue surrounding the affected area.
Strengthened Gum Attachment
By adding a protective layer of gum tissue, grafting halts the progression of recession, shielding the vulnerable tooth root and the underlying bone from exposure. This preserves both the structural integrity and health of your teeth and jaw.
Reduced Risk of Root Decay
Exposed tooth roots lack the enamel layer's natural defence against decay-causing bacteria. Grafting covers these sensitive roots, significantly lowering the risk of painful cavities and subsequent root canal procedures.
Reduced Tooth Sensitivity
Exposed dentin (the layer beneath enamel) is sensitive to temperature and pressure changes, causing discomfort. Grafting covers the dentin, creating a barrier that insulates against these triggers and eases tooth sensitivity.
Improved Cosmetic Appearance
Receding gums often lead to a "long tooth" appearance, impacting your smile's aesthetics. Grafting restores a natural gum line, enhancing the beauty and confidence in your smile.
Successful gum grafting relies on proper care and maintenance. Here are some general rules to follow:
Prescription
Your dental specialist will provide you with a prescription for antibiotics, painkillers, and antiseptic mouthwash. These medications facilitate the healing process by addressing mild pain, bleeding, and swelling.
Activity
You can typically resume work or normal activities the day after surgery. However, it is advisable to avoid vigorous exercise and stimulants like caffeine on the day of the procedure to prioritise rest and aid in the recovery process.
Oral care
During the healing period, it is crucial to avoid direct brushing or flossing in the surgical area to prevent the unintentional removal of stitches at the grafting site. Instead, gently brush your other teeth as usual. Use the prescribed mouthwash to rinse your mouth gently.
Diet
To minimise bleeding and discomfort after surgery, approach your diet with caution in the initial days. Shift to a soft diet and chew on the unoperated side. Avoid hot, spicy, or acidic foods and small, hard items like nuts and seeds.
Gum grafting is a safe and effective procedure with a high success rate. However, it is essential to be aware of the potential risks and complications, including:
Infection is a common complication of gum grafting that can occur at the donor site, recipient site, or both.
Bleeding is a common complication of gum grafting. It may occur during the procedure or healing process.
Pain after gum grafting is expected, but most patients report only mild to moderate discomfort.
Swelling is a common side effect of gum grafting that typically peaks 2 to 3 days after the procedure and then slowly subsides over 7 to 10 days.
The amount of pain experienced after a gum graft surgery depends on the type of procedure performed. If no tissue is extracted from the palate, there should be minimal discomfort. Nonetheless, pain medications are usually prescribed for a few days after the procedure to relieve the discomfort.
After your surgery, you will need to visit your periodontist or dentist within the first two weeks for a review. During this visit, your stitches will also be removed. You may be asked to come back for further follow-up checks to ensure you are healing properly.
Not everyone is a good candidate for gum grafts. To ensure the success of a gum graft, healthy gum tissue is required around it. The health of the teeth surrounding the graft is also important. Additionally, people with diabetes or those taking blood thinners may not be optimal candidates for a gum graft. Speak to our dentist for personalised advice.
At PKWY Dental Specialist Practice, our gum grafting treatments aim to treat severely recessed gums, which is crucial to treat before complications arise. Gum grafts may sound frightening, but in the hands of an experienced dental specialist like a periodontist, patients can rest assured to receive safe, effective, and lasting treatment.
Our team of dental specialists include a periodontist, who will be able to utilise advanced surgical tools and techniques to perform the grafting procedure seamlessly with minimal downtime.
For more information on gum grafting, please reach out to our clinic today.
