Do you have tooth sensitivity—when eating something very cold or very hot makes you feel a sharp pain in the tooth? Does the gum and tooth where the recession is progressing have an unsightly appearance? Do you also feel a notch near the gum line?
The medical term for this condition is gum, or gingival, recession (to describe the gums pulling back or receding). Gingival recession may develop subtly and gradually, usually without your knowledge. In fact, if it doesn’t progress too far before your dentist catches it, you’d still have some healthy gingiva. This is a minor recession and significant treatment may not be necessary.
What Is Gum Grafting?
In medical terms, a graft is a piece of living tissue transplanted surgically. Thus, gum grafting is the surgical process whereby healthy gum tissue is transplanted to an area where it is needed. The graft (gum tissue) is used to cover the exposed, damaged area. As gums recede, gaps or “pockets” begin to form between the teeth and gum line. This creates a perfect abode for disease-causing bacteria to gain a foothold and multiply.
In addition, the loss of critical gum protection makes your tooth root (as well as other supporting tissue and bone structures of the teeth) susceptible to damage. This destruction may become so severe that it could lead to decay, bone degeneration, and ultimately tooth loss.
Causes of gingival recession
- Gum (periodontal) disease. It is the primary cause of gum recession.
- Genetics. According to some studies, up to 30% of the population may have increased predisposition to gum disease, regardless of how committed they are to oral hygiene.
- Rough or aggressive brushing and flossing. Go gentle. Don’t scrub. And if a toothbrush is not labeled as “soft,” pass on it.
- Poor oral hygiene. On the flip side, not brushing, flossing, or using antibacterial mouthwash as often as you need to may worsen gum recession. Inadequate dental care helps plaque become tartar (calculus), which is hard to remove and can cause gum recession.
- Smoking and use of tobacco products. It encourages buildup of sticky plaque that is difficult to get off and can lead to gum recession. Compared to nonsmokers, smokers are four times more likely to develop periodontal disease.
- Bruxism—teeth grinding or clenching
- Hormonal changes. Especially in women, hormonal fluctuations that occur during puberty, pregnancy, and menopause may increase the sensitivity of gums and make them vulnerable to gingival recession.
Treatment of Gum Recession
Mild gum recession may be treated by a process called tooth scaling and root planing, and colloquially referred to as deep cleaning. This process involves Carefully removing plaque and tartar that builds up on the teeth and root surfaces below the gum line in the affected area. Smoothing the exposed root area to make it hard for pathogenic bacteria to attach to it.
Deep cleaning may also be supplemented by administering antibiotics to take care of any remaining harmful bacteria.
However, if the gum recession is extensive and is characterized by overly deep pockets and excessive bone loss, deep cleaning would not cut it. You’d need to have gum graft surgery to repair the damage caused by the gingival recession, halt its progress, and prevent additional infection.
Types of Gum Grafts
- Subepithelial connective-tissue grafts, often just called a connective tissue graft, is the most common type of gum graft. It gets its name from the actual type of tissue used for the graft. The procedure involves cutting a flap of skin (palatal flap) at the roof of your mouth (palate). Then tissue underneath the flap, called subepithelial connective tissue, is removed to be used as the graft. The subepithelial tissue graft is then stitched to the gum surrounding the exposed root. This method has the benefit of excellent predictability of root coverage.
- For Free gingival grafts the roof of your mouth (palate) is also the donor site. However, instead of going underneath the skin to get the graft, a small amount of the free-lying tissue at the palate is cut out directly to serve as the graft. This method is often used in people who have thin gums.
Gum Graft Recovery and Follow-Up Care
Swelling, Pain, and Inflammation
Aside bleeding, swelling is another fairly normal sign after gum graft surgery. To keep it down, apply ice on your face for 15 consecutive minutes on and allow for a span of 15 minutes before applying it again. You can use an “ice pack,” ice cubes in a plastic bag, or a bag of frozen veggies for the first 48 hours.
Pain and Inflammation
A certain degree of pain is likely after gingival surgery (more on this in the next section). But it’s nothing a safe dose of over-the-counter pain medication such ibuprofen or acetaminophen can’t relieve.
Healing Time and Recovery
It would take between 1 to 8 weeks for your mouth to heal fully. However, you should be able to continue with your normal activity or return to work the day after your operation.
The duration of healing time depends on several factors. Which is why it varies from one individual to another. The factors include:
- Your general health
- Extent of tissue graft
- Commitment to follow post-operative instructions
Healing starts with shrinking of the soft tissue and reduced swelling. The graft would bind to the root surface and surrounding bone surface. It’d then begin to mature as vascularization (formation of new vessels that ensure stable blood supply) occurs.
Diet and Oral Hygiene
You have to stick to a soft, cold diet for a few days, sometimes up to two weeks, after surgery. You don’t want to bite into hard food as that could impede the healing process and undermine the surgery’s success. Typical soft foods include:
- Ice cream
- Cottage cheese
- Soft-cooked veggies
You want to follow specific recommendations given to you as to when to resume your normal diet. Sometimes, although quite rare, the duration to stay on soft foods may be extended.
Maintaining excellent oral hygiene offers two benefits. It helps reduce the risk of developing an infection during the healing period. And post-healing, it helps prevent a recurrence. Preventing gum recession is a lot less costly, painful, and complicated than a gum graft.
For the first couple of days after surgery, you shouldn’t brush or floss the operated area until you’re given the thumbs up. However, you’d have to use antimicrobial mouthwash to forestall infections, buildup of plaque, or issues with the graft. And that’s it. Also, endeavor to keep your dental appointments.
Other recovery tips
- If you grind your teeth at night, you’d want to ask for a mouth guard
- If you’ve misaligned teeth, you’d want to discuss tooth-straightening options
- Do not exercise or perform any strenuous activity until you get an okay to do so. The ban on performing strenuous activities usually lasts for the first three days.
Gum grafting helps restore the evenness and symmetry of your gum line, making the teeth look shorter, restoring your smile, and making the teeth and gum structure pleasing to look at. Come into our office today at North Texas Dental surgery to start the journey to a better smile.