Gum recession occurs when the gum tissue surrounding the teeth pulls back, causing a portion of the tooth root to become exposed. This process affects the appearance of the smile and increases the risk of tooth sensitivity, decay, and loss of supporting bone structure. A periodontist is a dental specialist with additional training focused on the prevention, diagnosis, and treatment of diseases affecting the gums and underlying bone structure. They are best equipped to manage gum recession, aiming to halt further tissue loss and restore the gumline to a healthier position.
The Periodontist’s Diagnostic Process
Managing receding gums begins with a thorough diagnostic evaluation to determine the extent of damage and identify the underlying cause. A periodontist reviews the patient’s medical and dental history, looking for contributing factors such as aggressive brushing, genetic predisposition, or periodontal disease. This assessment is important because treatment must address the root cause to prevent recurrence.
The periodontist uses a specialized periodontal probe to perform detailed charting of the mouth. They precisely measure the distance from the gum margin to the cementoenamel junction, which indicates the level of recession on each tooth. They also measure the depth of the gum pockets; healthy pockets typically measure between one and three millimeters, while five millimeters or more often suggest active periodontal disease.
Dental X-rays are utilized to evaluate the condition of the supporting bone. Since bone loss frequently accompanies gum recession, X-rays help determine the extent of damage below the gumline. This full picture—combining the visual exam, recession measurements, pocket depths, and bone level—allows the periodontist to create a tailored treatment plan that targets both the cause and the consequence of recession.
Non-Surgical Approaches to Halt Recession
When gum recession is primarily driven by inflammation, plaque, or tartar buildup, non-surgical therapy is often the first course of action. The primary non-surgical procedure is Scaling and Root Planing (SRP), commonly referred to as a deep cleaning. This treatment involves meticulously removing hardened plaque and tartar deposits from the tooth surfaces above and below the gumline.
The scaling portion removes the bacterial irritants that cause inflammation and tissue destruction. The root planing step involves smoothing the root surfaces to eliminate bacterial toxins and rough spots. This smoothing makes it more difficult for bacteria to reattach and encourages the gum tissue to reattach firmly to the cleaned root.
In conjunction with SRP, the periodontist may recommend antibiotics to control bacterial infection. These can be administered as oral medication or applied directly into the gum pockets using gels or slow-release chips. This targeted approach helps manage persistent bacterial growth and promotes tissue healing following the deep cleaning.
A significant component of non-surgical management is patient education focused on preventing further mechanical wear. The periodontist instructs the patient on proper brushing techniques, emphasizing the use of a soft-bristled toothbrush and gentle, circular motions instead of aggressive scrubbing. Correcting harmful hygiene habits is fundamental to stopping recession caused by trauma.
Surgical Options for Tissue Restoration
When non-surgical methods cannot stop the progression or when the exposed root surface requires coverage, the periodontist turns to surgical options. Gum grafting is the traditional and most predictable surgical method for covering exposed roots, reducing sensitivity, and protecting the root from decay. This procedure involves transplanting healthy gum tissue to the area of recession.
The connective tissue graft is a common method, where tissue is harvested from beneath a flap on the roof of the mouth and stitched over the exposed root surface. The free gingival graft is similar, using a small piece of tissue taken directly from the palate. These grafts cover the exposed area and thicken the existing gum tissue, making it more resistant to future recession.
Alternatively, a pedicle graft involves partially cutting a flap of gum tissue adjacent to the recession site and rotating it to cover the exposed root, keeping one edge attached to maintain a blood supply. For patients with mild to moderate recession, some periodontists offer the Pinhole Surgical Technique (PST). This technique involves making a small pinhole in the gum, then using specialized instruments to gently reposition the existing gum tissue over the exposed root without the need for large incisions or stitches.
Regardless of the technique chosen, the goal of surgical intervention is to physically restore the lost gum tissue, providing a healthier and more aesthetically pleasing gumline. The periodontist selects the specific grafting method based on the amount of recession, the thickness of the surrounding gum tissue, and the patient’s overall health. Surgical restoration protects vulnerable root surfaces from external factors and supports long-term tooth health.