Gum Grafts

There is a thickening of the gum around all of our teeth (called keratinized tissue). This tissue is thicker so that it can resist being worn away by the normal wear and tear that occurs in the mouth. Tooth brushing, food rubbing against the gums and bacteria are all things which can contribute to the loss of the gums that surround the teeth. Just like there is a thickening of the skin on the palms of our hands; gum tissue around the teeth has developed to protect against possibly harmful forces.

When the thicker tissue around teeth is absent, the gums are susceptible to recession, or being worn away. When this happens we end up with the roots showing which can be unsightly or sensitive to hot or cold. They may also be more prone to cavities. Without this thick tissue, teeth are more prone to infection and bone loss.

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Possible Causes of Recession

1. Improper brushing
Brushing too hard, in the wrong direction or with a hard – bristled toothbrush can all wear gum tissue away.

2. Position of teeth/ Orthodontic treatment
When teeth are pushed through the bone that holds them in place the gum can thin out. This may be caused either by crowding of teeth or braces.

3. Plaque and Tartar
Periodontal disease can result in a loss of tissue.

4. Local anatomy
Sometimes there are certain muscle or soft tissue fibers (a frenum) which may pull on the gums.

5. Orthodontic treatment
Although orthodontic treatment may be necessary to improve the alignment of the teeth or jaws, in certain cases, a graft might be needed to thicken the gums before the teeth are moved. Similarly, after having had orthodontic treatment, the gums may be thinner and may require a gum graft.

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Prevention of Recession
The most important thing we can do prevent receding gums is to brush and floss properly using a soft toothbrush. The wrong technique or brushing too vigorously can quickly wear gums away.

It is also important to visit your dentist regularly so that they can see if any areas have begun to recede.

Treatment of recession
Not all receding gums need to be treated. A careful exam and a history of the recession are important. When it is felt that treatment is needed then a gingival (gum) graft is performed. Basically there are two different types of gum grafts.



1. Free gingival graft
For a free gingival graft, donor tissue is taken (usually from the palate) and placed at the area with recession. The procedure is fairly quick and is painless with local anesthetic (freezing) with or without intravenous sedation. The band of thicker tissue is widened and this will serve to prevent further receding of gums and allow you to keep the area cleaner and free of inflammation. With a free gingival graft the root is not covered and the recession remains. The free gingival graft is a very reliable procedure with benefits lasting throughout a patient’s life.



2. Connective tissue graft for root coverage.
Sometimes for reasons of cosmetics or because of increased sensitivity, there may be a desire to cover the root and regain the natural appearance of the tooth. In these situations, a connective tissue graft for root coverage is performed. When this treatment is performed, the recession is covered with gum tissue. Not all roots can be fully covered and sometimes a second procedure is required to gain additional root coverage or touch up the area.

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