Gum recession is a common dental problem where the gum tissue pulls away from the tooth surface, exposing the root underneath. This exposure can lead to increased sensitivity, root decay, and an unappealing “long-toothed” appearance. Gum tissue, once lost from the tooth margin, does not naturally regenerate or “grow back” on its own. Effective treatments either stop the progression of the loss or involve specialized surgical procedures to physically restore the lost tissue.
The Biological Reality of Gum Regeneration
The gingiva, or gum tissue, is composed of an outer epithelial layer and an underlying connective tissue layer. When recession occurs, the specialized fibers that form the attachment apparatus between the gum and the tooth root are destroyed. This loss of attachment is not easily reversed because the adult gingiva lacks the necessary progenitor cells for full tissue regeneration.
The body’s natural healing response is geared toward repair, not regeneration. It will not spontaneously restore the complex, high-level attachment lost in recession. Rebuilding the original gum line requires advanced medical intervention.
Identifying and Stopping the Drivers of Recession
Treating gum recession must begin by eliminating the factors actively causing the tissue loss, as no intervention can succeed if the underlying cause persists. The most widespread driver is periodontal disease, a bacterial infection that causes chronic inflammation and destruction of the gum and supporting bone structure. Controlling this infection through meticulous oral hygiene is the foundational step in halting recession.
Mechanical trauma from overzealous brushing is another frequent cause of tissue wear. Patients should switch to a soft-bristled toothbrush and adopt a gentle, controlled technique, such as the modified Bass method, which uses short, circular strokes aimed at the gumline. Using excessive force or a hard-bristled brush can physically abrade the delicate gingival margin.
Other habits and conditions also contribute to tissue loss. Tobacco use reduces blood flow to the gums, impairing healing and making tissue more susceptible to recession. Oral piercings that rub against the gum tissue cause chronic irritation. Furthermore, misaligned teeth or the habit of grinding and clenching can place undue pressure on the periodontal tissues, accelerating the recession process.
Non-Surgical Treatments for Management
Once the causes of recession are addressed, non-surgical treatments focus on managing the existing condition and preventing further damage. A common professional procedure is scaling and root planing, often referred to as a deep cleaning. This procedure removes hardened plaque and tartar from below the gum line and smooths the root surfaces, eliminating the bacteria and toxins that perpetuate inflammation.
Recession frequently exposes the softer cementum and dentin of the tooth root, leading to increased sensitivity to hot, cold, or sweet stimuli. Desensitizing toothpastes containing compounds like potassium nitrate or strontium chloride can help block the nerve signals on the root surface. Dentists can also apply in-office desensitizing varnishes or sealants to provide a protective layer over the exposed root surface.
Regular professional monitoring by a periodontist is an important part of non-surgical management. These visits allow the clinician to measure the recession depth and track the rate of loss over time. This consistent assessment ensures the condition is stabilized and helps determine the ideal timing for any restorative procedures.
Surgical Procedures to Restore the Gum Line
The only way to physically restore lost gum tissue and cover the exposed tooth root is through a surgical grafting procedure. These techniques involve transplanting healthy tissue to the area of recession, effectively recreating the lost gum line. The goal of these procedures is to cover the exposed root, reduce sensitivity, and improve the tooth’s appearance.
Autograft Procedures
- The Connective Tissue Graft is widely regarded as the most successful method for root coverage. This procedure involves harvesting a layer of connective tissue from beneath the surface of the patient’s palate and placing it over the exposed root, creating a thicker, more stable band of gingiva.
- A Free Gingival Graft may be used when the primary need is to increase the thickness of the gum tissue to resist future recession. This technique involves taking a small piece of tissue directly from the outer layer of the palate and stitching it to the recession site.
- A Pedicle Graft uses gum tissue adjacent to the recession site and repositions it without fully detaching its blood supply.
Alternative Materials and Techniques
Alternatives to using the patient’s own tissue include allograft materials (sterilized human donor tissues) or xenograft materials (derived from animal sources). These materials serve as a scaffold that encourages the patient’s own cells to populate and form new tissue.
A less invasive option for certain cases is the Pinhole Surgical Technique, which involves creating a small hole in the gum and maneuvering the existing tissue to cover the exposed root without large incisions or stitches.