Many people assume that the phrase “long in the tooth” is simply a reference to aging. For years, it has been a moniker bestowed upon the aged. It began as a reference to the way that horse’s gums recede as they age, however, it is also a legitimate medical issue for a lot of people. It is called gum, or gingival, recession and it is present in up to 12% of adults. Gum recession commonly affects people above the age of 40, although it is not limited to this age group. Younger people can be a victim to this condition as well but it is more common in more matured adults. Shockingly, by the time someone reaches age 65, there is an 88% chance that they have, or have had, receding gums. This happens in older people more often because, unlike most dental conditions, gum recession happens very gradually over a period of many years. Most people will not even notice the issue at all. Contact us at our office near Frisco, Texas if you’ve noticed any gum recession for treatment options available. Here we will go over the causes of gum recession as well as the surgical procedures used in correcting it.
Causes of Gum Recession
Gum recession happens when the soft tissue of the gums is either pulled back or worn away, leaving a greater area of the tooth exposed. In very severe cases, the root of the tooth can become exposed. If left untreated, teeth will become very sensitive and can even begin to fall out entirely. Gum recession is caused by numerous habits and conditions such as: aggressive brushing or flossing, periodontal disease, lack of vitamin C, and hereditary thin gum tissue.
Periodontal disease refers to gum disease which is caused by a buildup of bacteria and plaque. If this condition is ignored, plaque becomes hardened, turning into what is called tartar. This can only be removed by a dentist. The longer plaque and tartar are allowed to remain on teeth, the higher the risk of receding gums and gingivitis becomes. If plaque and tartar are not removed, their condition will advance to a stage where they will make the gums red and inflamed, thus pulling the tissue away from the tooth permanently. Sometimes these issues can be avoided or delayed by a change in habit but, if left untreated or unnoticed, a gum graft may be recommended. Delaying or avoiding these issues can be done by switching to a softer toothbrush, being gentler during brushing and flossing, and breaking habits like smoking cigarettes. With that being said, there are hormonal problems and genetic risk factors that cannot be avoided but it is helpful to be aware of the potential issues. Reducing risk factors is the best way to avoid gum recession and the extensive procedures involved in correcting it.
Receding Gums Treatment
Treatments will typically begin with addressing a patient’s specific cause of gum recession. In a lot of cases, the previously mentioned softer toothbrush and gentle brushing methods will be the first course of action. If those options do work, they will really only slow down the recession so it is important to be aware that you may experience sensitivity and further recession in the future. There are some cases where that is all that is needed however, in some cases patients have poor plaque control so more in-depth care is needed.
Plaque issues can be detected by using a special gel or tablet which is activated in the rough or unclean areas of the tooth. These products provide an important visual aid in assessing the presence of plaque and also showing the maturity of plaque. If plaque is detected, the first step is to physically remove the plaque and bacteria from the teeth, gums, and exposed pockets formed by gingival recession. Deep cleaning is a procedure which is called tooth scaling or root planning because the dentist has to clean underneath the gum line. Some cases will require numbing of the mouth as the dentist will need to clean quite deep with a tool called a scaler. Often, these tools are electric devices, known as ultrasonic scalers, sonic scalers, or power scalers. These tools vibrate at a very high frequency, some will create tiny bubbles that work to clean out plaque and kill bacteria and some will simply agitate the plaque from its position in order to clean it out of the pocket.
Some dentist use handheld scalers which are sharp, flat, hooked tools that they use to maneuver in and visually dislodge plaque. The type of tool used will usually depend on the severity of the patient’s plaque and in many cases, a combination of handheld and electric methods will be used. Following scaling, the majority of bacteria will have been destroyed however, any remaining bacteria or infection must be treated and removed to avoid further deterioration of the patient’s gums. Typically, patients are given antibiotics in the case that any bacteria have survived the intrusive scaling procedure.
Gum Graft Surgery
In the event that a scaling procedure is unsuccessful or deemed to be the wrong course of action, graft surgery may be recommended. The aim of a gum graft is to extend the tissue of the gums to cover the roots, thus restoring their placement within the jaw, preventing further damage, and reducing or eliminating the sensitivity a patient is feeling. In order to perform this surgery, tissue will either be taken from another part of the patient’s mouth, freeze-dried tissue will be used or a synthetic membrane will be placed. When using tissue that is not from the patient, the dentist or surgeon must be very cautious of potential disease transmission, and this risk must be thoroughly discussed with the patient.
Research is currently being done on creating and growing new tissue from a patient’s stem cells, however, this is still in experimental stages so it will probably not be a common treatment as of right now. Stem cell research has been met with backlash and resistance in the past so if a patient is not comfortable with this option there are many other grafts which can be done. At this point it should be noted that gum grafting is seen as a cosmetic procedure, and can be performed simply to improve the look of the teeth and boost the confidence of the patient, rather than to fix a serious dental issue.
During the gum graft procedure, typically patients are not even required to be put under anesthesia. Tissue from the surrounding area is manipulated and shaped to cover the tooth exposed by the receding gum. This usually requires the area to be numbed to avoid discomfort but the recovery time is much quicker than alternative procedures. This option is great for individuals who are in the early stages of gum recession as it will correct the problem before it becomes painful while also giving the patient a more attractive smile.
Connective Tissue Gum Graft
The most common procedure that is done for more medical purposes is called a connective-tissue graft. During this procedure, a piece of skin is removed from the roof of the patient’s mouth by creating a small flap and removing the tissue underneath it. That tissue is then stitched around the exposed tooth root, finishing the graft process. Once the graft is completed, the flap on the roof of the mouth is stitched back together.
The connective-tissue graft is the same method that is used when grafting from medically donated skin. The advantage to this version of the procedure is that there will not be a second incision made in the patient’s mouth. There is a great deal of research currently being done on different methods and materials for this version of the procedure however, this method is currently the most popular option for professionals. Some dentists and surgeons prefer this method as it is less invasive however, some see this as simply intensifying the risk of rejection or infection. It will completely depend upon the surgeon conducting the procedure as to what they recommend. This option will typically be discussed before scheduling the procedure so it is important to know the differences between on-site grafting and donor grafting.
Pedicle Gum Graft
Another procedure in grafting is called a pedicle graft. In this situation, tissue is not removed from the soft palette and reattached for surgery. Instead, the surrounding gum is used for the repair. The dentist or surgeon will assess the state of the surrounding gum and pull tissue from the side with more tissue. Typically, an incision is made and the gum is then pulled into place and stitched down. Occasionally, incisions do not have to be made and the tissue can simply be pushed over and stitched into place but this is rare. This procedure is only possible when patients have a decent amount of gum tissue in the surrounding areas. It is up to the dentist or surgeon to choose which method best suits each individual patient. It must be stated that this procedure will absolutely not be an option if the patient has extensive damage or thin gum tissue.
Free Gingival Gum Graft
An alternative to the pedicle graft is the free gingival graft. This procedure requires a portion of skin to be removed from the roof of the mouth directly, without making a small flap. This larger piece is once again stitched to the area around the exposed tooth root. The reason for this alteration in surgical technique is specific to people with thin gums who are in need of the additional protection. Following this surgery, patients have reported different levels of discomfort based on the severity of their condition. It is important to discuss the proper aftercare instructions with the dentist or surgeon before the procedure as this will help to reduce the amount of pain experienced. One thing that is generally agreed upon is that the incision on the roof of the mouth feels like a burn one might get from hot food and it is very important to avoid agitating the stitches.
Gum Grafting Frisco, TX
Something to keep in mind is that one procedure may not be enough for some patients. If damage is extensive or if the gum recession continues, multiple procedures may be required. It is important to discuss the extent of the damage and the best course of action with the surgeon or dentist in order to attain the best result and reduce the pain or stress that comes with the surgical procedure. If only one operation is needed, it is important to be diligent in sticking to the aftercare instructions. After the gum graft surgery, it is important to avoid harshly brushing the area, stick to eating foods that are soft and cool, and use medicated mouthwash rinse (if provided by the dentist or surgeon). Also, if patients are given antibiotics, they must be sure to maintain that course of treatment until it is gone.
Gum graft procedures will not only improve the overall look of someone’s smile, they are also important to the reduction of tooth sensitivity. There is extensive research conducted on an ongoing basis to reduce the pain and invasiveness of grafting procedures. It is important to talk with a dentist about receding gums before it becomes a bigger problem. If you have receding gums, give us a call today at our office near Frisco, TX to discuss the treatment options that may be available to you.