Gum recession occurs when the gum tissue surrounding the teeth pulls back, exposing the tooth root beneath. This loss of protective tissue can lead to increased tooth sensitivity, root decay, and an unappealing aesthetic appearance. While receding gum tissue cannot naturally grow back, effective treatments are available to stop its progression and restore the gum line. Treatment options range from addressing the underlying causes through non-surgical procedures to advanced soft tissue grafting techniques for more complete coverage.
Identifying the Causes of Recession and Stopping Progression
Effective treatment for gum recession must begin by identifying and eliminating the factors causing the tissue loss. One common cause is overly aggressive brushing, where excessive force or the use of a hard-bristled toothbrush physically wears away the delicate gum tissue. Switching to a soft-bristled brush and adopting a gentler, circular brushing technique is the necessary first step to stop this damage.
Periodontal disease, which includes gingivitis and periodontitis, is another primary driver of recession. This bacterial infection destroys the underlying bone and supporting gum tissue, creating pockets around the teeth and causing the gum margin to recede. Treating the infection through professional cleanings and improved oral hygiene halts the destructive process and prevents further tissue loss. Other contributing factors include a genetic predisposition to thin gum tissue, a misaligned bite that places undue pressure on certain teeth, and trauma from habits like grinding or using tobacco products. Addressing these mechanical and genetic components, often through orthodontic treatment or a nightguard, is fundamental to stabilizing the gum line.
Managing Inflammation and Protecting Exposed Root Surfaces
For cases where recession is primarily driven by inflammation or involves only minor tissue loss, non-surgical therapies are the initial approach. The most common non-surgical intervention is Scaling and Root Planing (SRP), often referred to as a deep cleaning. This procedure involves two main steps: scaling, which removes hardened plaque and tartar from above and below the gum line, and root planing, which smooths the exposed tooth root surfaces. This deep cleaning eliminates bacteria and toxins that contribute to inflammation, allowing the gum tissue to become healthier and potentially reattach slightly to the cleaned root surfaces.
Managing the heightened sensitivity that results from root exposure is a separate but related goal. The tooth root lacks the protective enamel layer of the crown, making it highly sensitive to temperature changes. Dentists can apply desensitizing agents, varnishes, or specialized bonding agents directly to the exposed root to block the microscopic tubules that lead to the nerve. For minor recession areas, dental bonding using tooth-colored composite resin can cover the exposed root surface for both aesthetic improvement and physical protection. These techniques control disease and relieve symptoms, but they do not fully restore the lost gum tissue.
Surgical Gum Grafting Procedures
When the recession is moderate to severe, or when non-surgical methods fail to provide adequate coverage, surgical gum grafting is necessary to physically replace the lost tissue and cover the exposed roots. The goal of these procedures is to cover the root, reduce sensitivity, and improve the appearance of the gum line.
The most frequently performed technique is the Connective Tissue Graft (CTG), which is considered the standard for root coverage. This procedure involves creating a small flap on the roof of the mouth to remove the underlying connective tissue, which is then placed under the gum tissue at the recession site. CTGs offer a high success rate for achieving significant root coverage and are often preferred for aesthetic areas.
The Free Gingival Graft (FGG) uses a small piece of tissue taken directly from the outer layer of the palate and attaches it to the recession site. FGGs are highly effective for thickening thin gum tissue and establishing a durable band of tissue resistant to further recession. However, they may result in a slight color mismatch with the surrounding gum tissue, making them a less ideal choice for highly visible areas.
The Pedicle Graft uses tissue adjacent to the recession site, partially cutting and rotating it over the exposed root while keeping one edge attached to maintain its blood supply. This method promotes faster healing due to the retained blood flow, but it is limited to localized recession where sufficient, healthy gum tissue is immediately next to the exposed root.
Post-Treatment Care and Long-Term Maintenance
Healing from a gum grafting procedure requires careful attention to the surgical sites to ensure the graft successfully integrates and blood flow is established. Patients are advised to avoid any strenuous activity for the first 48 to 72 hours to prevent excessive bleeding or disruption of the healing blood clot. Pain and swelling are managed with prescribed medications and the application of ice packs to the outside of the face in short intervals.
A soft, non-chewy diet is required for one to two weeks, and patients must be cautious to chew on the side of the mouth opposite the surgical area. It is specifically advised to avoid hard, crunchy, or sticky foods that could dislodge the graft. Proper oral hygiene is modified immediately post-surgery by avoiding brushing or flossing the surgical area for up to two weeks, though the rest of the mouth should be cleaned gently. Smoking is strictly prohibited during the entire healing phase, as it significantly compromises blood flow and the graft’s ability to heal successfully.
Long-term success depends on adopting new habits to prevent the recurrence of recession. Switching to a soft-bristled or electric toothbrush and receiving instruction on a proper, non-aggressive brushing technique are crucial changes. Regular professional cleaning appointments monitor the health of the gum tissue and ensure no new plaque or tartar buildup is contributing to inflammation. Follow-up appointments with the periodontist allow for monitoring of the graft and guidance on when to slowly resume cleaning the surgical site.