Gum Recession Treatment San Diego

What is gum recession?

Research shows that 88% of individuals over the age of 65 have receding gums in at least one tooth. Receding gums, also known as gingival recession, is the process by which gum tissue wears away and pulls back from the tooth root, thereby exposing the roots of the teeth. These exposed roots create gaps or spaces between the tooth and the gum line, inviting bacteria and plaque to collect and buildup. This can result in sensitivity and root decay. If there is not enough strong attached gum tissue surrounding the tooth, this can lead to a gum abscess or infection. Cosmetically, gum recession makes teeth appear longer. If gum recession presents with bone loss around teeth, the appearance of black triangles can form.

What causes gum recession?

Gum recession can be caused by many individual factors or a combination of factors. The most common reason is aggressive toothbrushing. Vigorous toothbrushing combined with the use of a medium or hard bristled toothbrush may physically wear down the gums and cause recession. Even the improper use of an electric toothbrush can cause recession. If gum recession is common in the family, genetics can play a role as to whether you are more prone to receding gums to start with. Not having adequate strong and attached gum tissue around your teeth can also contribute to gum recession. Trauma or any constant tooth movements, such as from constant clenching or grinding of your teeth, can cause recession. Even orthodontics can cause recession if the tooth is moved out of the bony tooth housing or combined with any of these factors. The same is true if your teeth are misaligned or if your tooth is situated out of the bony housing. Gum disease can cause the surrounding bone to wear away, resulting in gum recession. Other factors include lip and tongue piercings, smoking, and the use of any tobacco products.

What are the available treatments for gum recession?

The typical treatment for gum recession is soft tissue grafts. Soft tissue grafts, or gum grafts, is a long-term way to treat gum recession. Typically the goal of gum grafts is primarily to increase the amount of strong, attached gum tissue present surrounding your teeth, and secondarily if possible, to cover over the entire exposed root.

Different techniques exist to regenerate lost gum tissue. Some techniques use your own gum tissue (autograft) and other techniques may involve using a donor tissue, either originating from a cadaver source (allograft) or animal source (xenograft). Each technique has its own advantages and disadvantages; it just depends on your individual case and what you and the periodontist are trying to achieve.

Autografts (From Self)

Typically in areas of gum recession, we have exposed roots combined with weak and/or unattached gum tissue. This weaker gum tissue invites more plaque and bacterial accumulation, causing the gums to be constantly inflamed and thereby, contributes to future recession. When doing soft tissue grafts, we are looking to use strong, keratinized gum tissue to cover over the exposed root, and where we usually have the highest quantity of strong gum tissue is typically found in the roof of your mouth.

Our gums are typically composed of two layers: an outer “epithelial” layer and an inner “connective tissue” layer.

Free Gingival Graft

In a free gingival graft, a small piece of tissue is taken from the roof of the mouth and attached to the recession site to encourage natural growth. This involves the removal of both the outer AND inner layer of gum tissue to be removed. This technique is used if there is a recession area that needs to be reinforced or thickened with strong gum tissue. Typically a second procedure may be necessary to move the gum tissue up to cover the roots. Color matching of the gum tissue is not ideal and there may be more postoperative discomfort on the roof of the mouth.

Connective Tissue Graft

The connective tissue graft is the more common type soft tissue autograft. A small inner layer of connective tissue is removed, typically from the roof of the mouth, and is then placed onto the recession area to attach and cover the exposed tooth roots. The gums are then typically lifted to cover over the graft and exposed root and are held with stitches. This method is more esthetic as he graft (which only takes the inner gum layer) blends to the surrounding gum tissue and is less invasive than the free gingival graft. It can help resolve areas of sensitivity caused by recession as the exposed root is covered.

Allograft or Xenograft (from donor or animal source)

Instead of using your own gum tissue, the alternative method of gum grafting involves using a donor source. The advantage of using an allograft or xenograft is that you don’t have to get gum tissue from your own mouth. Allografts also do not limit how many recession areas can be treated at one time compared to an autograft. meaning a whole arch or a whole mouth can be treated in one visit. However we must note that this does not work in all cases.

Some techniques that use this type of graft are the Pat Allen Tunneling Technique, the Chao Pinhole Gum Rejuvenation Technique, and the VISTA technique. All of these techniques are minimally invasive as they utilize minimal incisions to access and peel the gum tissue from the underlying bone, compared to the larger traditional flap access. Because it is less invasive, there is also less postoperative discomfort.

Pat Allen Tunneling Technique

This minimally invasive surgical grafting technique involves the creation of small pouches around involved teeth that eventually connect together to create a tunnel space, allowing for the passing of donor tissue underneath the gums. The gums are advanced towards the neck of the tooth to cover over the recession sites and a special suturing technique is used to hold the gums and the graft together in place.

The Chao Pinhole Surgical Technique®

Another minimally invasive procedure, the Chao pinhole technique is a different treatment modality for receding gums and involves no blades or sutures. The periodontist creates pinhole incisions in the gum and uses specialized instruments to loosen the gum away from the tooth, gently repositioning it to restore the gum line and cover the exposed tooth root. Donor collagen strips are inserted into the pinhole incisions to hold the gums in place.

How Do I Prevent Receding Gums?

Whether you currently have receding gums or if you want to prevent gum recession, here are a few tips to prevent or even slow down the rate of recession:

Removing plaque buildup with proper and excellent oral hygiene
Use a soft bristle manual toothbrush or a sensitive toothbrush head for an electric toothbrush
Avoid brushing your teeth too hard or applying too much pressure when brushing
Review with your dentist or hygienist the proper techniques of brushing
Changing your toothbrush regularly
For thin or weak gums, consider gum grafting which can help increase the amount of stronger gum tissue
Consult with your dentist about getting a nightguard, which can minimize the effects of clenching and grinding