Gingival recession, commonly known as receding gums, occurs when the gum tissue margin pulls back, exposing more of the tooth structure, including the root surface. This exposure is a significant concern because the root is not protected by enamel, making it highly susceptible to decay, abrasion, and heightened sensitivity. Recession results in teeth appearing “longer” and creates small gaps or “pockets” where disease-causing bacteria accumulate. Factors contributing to this issue include aggressive tooth brushing, periodontal diseases, and genetic predisposition to thin gum tissue.
Setting Expectations: Can Gum Tissue Regrow Naturally?
The direct answer is that gum tissue cannot naturally grow back once it has receded. Unlike some other tissues, the gingival tissue lost due to recession does not spontaneously return to its original position. This lack of natural regeneration means that any noticeable “rebuilding” of the gum line requires professional, interventional treatment. Improved oral hygiene can cause inflamed tissue to heal and tighten, which may give the appearance of healthier gums. However, this healing only stabilizes the existing tissue and prevents further loss; it cannot restore the physical volume of tissue already lost. Therefore, professional intervention is necessary to either physically replace or reposition the lost tissue.
Addressing the Root Cause: Non-Surgical Treatments
Before physical restoration of the gum line can be successfully performed, the underlying cause of the recession must be controlled, especially if periodontal disease is a factor. The primary non-surgical intervention for halting the progression of gum disease is a deep cleaning procedure called Scaling and Root Planing (SRP). This two-part process removes the destructive elements that cause tissue and bone loss.
Scaling involves meticulously removing plaque, calculus (hardened tartar), and bacteria from the tooth surfaces both above and below the gum line, extending into the periodontal pockets. Following scaling, root planing smooths the rough surfaces of the exposed tooth roots. This smoothing action removes bacterial toxins and makes it harder for new plaque and tartar to adhere, promoting the reattachment of the gums to the cleaned root surfaces. In some instances, the periodontist may also apply topical antimicrobial medications or prescribe a short course of oral antibiotics to manage infection and reduce inflammation.
Restoring Lost Tissue: Surgical Procedures
Surgical procedures are the definitive method for physically restoring lost gum tissue and covering exposed tooth roots. These treatments effectively “rebuild” the gum line by transplanting or repositioning soft tissue. Traditional gum grafting involves using tissue harvested from the patient’s own mouth.
Traditional Grafting Techniques
- Connective-Tissue Graft: This is the most frequently performed procedure. Tissue from the subepithelial connective layer beneath a flap created on the palate is removed and stitched over the exposed root. This technique is often preferred because it achieves excellent, natural-looking results.
- Free Gingival Graft: A small, full-thickness piece of tissue is taken directly from the palate and secured to the recipient site.
- Pedicle Graft: This uses tissue immediately adjacent to the recessed tooth. The tissue is partially cut and then stretched laterally or coronally to cover the exposed root, maintaining its blood supply at one edge.
Pinhole Surgical Technique (PST)
An alternative, less invasive technique is the Pinhole Surgical Technique (PST). This involves making a tiny pinhole in the gum and using specialized instruments to gently loosen and reposition the existing gum tissue over the recession. Collagen strips are then placed to stabilize the repositioned tissue and encourage healing, offering a suture-free option for suitable candidates with mild to moderate recession.
Long-Term Maintenance and Prevention
Sustaining the results of both non-surgical and surgical treatments requires a rigorous commitment to long-term maintenance and preventative care. The most significant component of this ongoing care is refining daily oral hygiene habits. Patients must switch to a soft-bristled toothbrush and adopt a gentle, correct brushing technique, avoiding the aggressive horizontal scrubbing that often contributed to the recession.
Daily flossing remains necessary to disrupt plaque in areas a toothbrush cannot reach. Regular professional cleanings and check-ups, often on a three- or four-month periodontal maintenance schedule, are crucial for monitoring the health of the gums and preventing the reoccurrence of disease. Additionally, addressing lifestyle factors, such as quitting tobacco use (which constricts blood flow and hinders healing) and using a nightguard if teeth grinding is an issue, will protect the treated areas and stabilize the overall oral environment.