Gingival Recession Treatment Options


Gingival recession is a common dental problem that can affect people of all ages. It happens when the gum tissue pulls away from the tooth, exposing the root. The following article will discuss various treatments for receding gums and tips on how to slow or stop its progression.


The gums are pink in a healthy mouth, and the gum line is similar around all of the teeth. Gum recession causes the gums to become irritated. Around some teeth, the gum line appears to be lower than around others. Gum tissue deteriorates, exposing more of a tooth. Gum recession can begin gradually, therefore it's crucial to check your gums and teeth every day. If your gums are receding and you haven't seen the dentist in a while, schedule an appointment right away.


Gum recession treatment is a type of periodontal surgery that is used to correct, prevent, or eliminate disease related problems in the gingiva or alveolar-mucosa that are caused by anatomical, developmental, traumatic, or plaque-induced factors. According to the study, gingival recession can be addressed with a range of periodontal surgical treatments. In all these procedures, the patient's tissues are often altered to enhance the soft gum tissues and hide the exposed-root surface.

Gingival Recession Causes

Gingival recession can happen for a variety of reasons. Sometimes the gum tissue recedes because people do not take good care of their teeth, such as brushing and flossing daily. Other causes include nicotine use or certain medications like lithium which could cause damage to the gums around your tooth roots. If you notice that your gums are starting to pull away from your teeth then it is important to see a dentist right away before more serious problems occur.

Gingival Recession Classification


Gingival recession has been classified in a variety of ways, the most generally used of which is Miller's classification system. Many instances seen in regular clinical practice are ineligible for classification using the current categorization systems' criteria.


Kumar and Masa Matti's classification methodology provides a full picture of recession defects that can be utilized to classify cases that don't fit into existing categories. Palatal recessions (PR) have been given their own classification system. The position of the interdental papilla and buccal/lingual/palatal recessions are used to classify recession in a new complete classification scheme. Kumar and Masa Matti's classification scheme attempts to address Miller's shortcomings.


The most complete reference I have found for a complete classification of gingival recession is Rolfing's Classification of Gingival Recession and Its Relation to Self-Leveling Disease. This classification is based on the extent of the affected area and the associated problem areas of paronychia, paroxysmal thickening, and parainfluenza.

Gingival recession can also be classified by the severity of gum recession.

- Mild: The tissue that covers the tooth has not been exposed and there are no signs or symptoms of gingivitis.


- Moderate to Severe: Gum recession exposes part or all of the root surface, which can reduce your ability to brush away plaque in areas where it used to be covered with healthy gum tissues. You may also experience bleeding when brushing teeth as well as redness, swelling and soreness around the area of recessed gums.


Classification of Gingival Recession is important because it helps manage the problem better in the acute periods between relapses by identifying high risk periodontal pockets. It also helps identify good periodontal treatment in terms of managing the attachment level to the teeth. In this way, if periodontal disease is not detected and treated early, then it can escalate into a more distressing condition and be difficult to treat.

 
Gingival Recession can be reversed if detected and diagnosed early, it can be cured and the patient can go back to an active and healthy life. If you recognize the actual signs and symptoms of Gingival Recession, then it is easy to manage the disease by the help of appropriate treatment options.

Treatment of the Exposed Root Surface


Treatment for an exposed root depends on the severity of the Gingival recession. If it is a mild gingival recession, then surgical treatment may not be necessary. However if the root surface has been exposed for an extended period of time and there are signs or symptoms that show up from gum disease, then surgery will be needed to cover the tooth with healthy tissue again.


Root exposure can be caused by the tooth moving, gingival recession or even gum disease. If the root is exposed due to a movement of teeth then it might require orthodontics treatment before any other procedure.


If Gingival Recession resulted in an exposed root surface and there are no signs of inflammation around this area, then one way to cover up the nerve would be with sutures that attach tissue from either side of the wound on top of each other. This process is called "surgical closure." Sutures will need to stay for about three weeks while they heal over time.


If Gingival Recession has led to bone loss so deep that you cannot see your tooth roots anymore, then surgery may be needed if we want to save the tooth. The bone may be reshaped and fitted with a dental implant or covered by grafts taken from other parts of your body like your palate, chin or lower jawbone.

Coronally Positioned Flap

This procedure is often done for Gingival Recession in the front of your mouth. Here a flap that has been cut back from above and below will be moved up to cover any open space where teeth are missing. The reason this treatment is called "coronally positioned" is because it comes down at an angle like you're looking at somebody's crowning jewels!


One of the most commonly used root covering treatments is the coronally positioned flap paired with a sub epithelial connective tissue transplant. This study shows four separate examples of where this technique has worked well. Periodontal plastic surgery is used to treat four different conditions:

 

  • Isolated Miller class II recession defect with frenum pull,
  •  Multiple adjacent Miller class I defects in the aesthetic zone,
  •  Isolated Miller class I defect with dentin hypersensitivity,
  •  Isolated Miller class II defect on a retained deciduous tooth.

Several techniques were used to create the coronally positioned flap. The therapy resulted in complete root covering, alleviation from hypersensitivity, and satisfaction of the patients' cosmetic concerns. When treating gingival recession, an effective and predictable therapeutic approach, such as a coronally positioned flap combined with a sub epithelial connective tissue transplant, should be considered.


If Gingival Recession results in exposed nerve endings, then the nerves may need to be removed or covered by grafts taken from either side of the wound on top of each other which would resemble sutures (discussed earlier). A piece of tissue might also have to be surgically placed under your gum line onto the tooth root surface if bone loss has gone too deep and has exposed the root.

Lateral Position Graft

Lateral Position Grafts are another way to effectively treat gingival recession. A lateral pedicle graft (LPG) is a procedure in which a graft is lifted from a donor site and transferred to a neighboring location in an isolated denuded root while remaining linked at its base for feeding. Grupe and Warren were the first to deploy a laterally shifted flap to cover up areas along with limited recession. The exposed root surface was covered by reflecting a full-thickness-flap in a donor-location next to the defect and then lateral-displacement of the flap. This approach was chosen because of its benefits, which include a single surgical region, preservation of the flap's blood supply, and a postoperative hue that blends well with the surrounding tissue.

Sub-epithelial Connective Tissue Grafts

A sub epithelial connective tissue graft is a flap of living tissue that replaces the lost gum. This procedure can be done in one visit to your dentist's office and typically takes less than an hour. In a sub epithelial connective tissue grafting for root coverage the connective tissue is used beneath a pedicle flap; resulting in an average of 90% exposed root coverage, which is higher than earlier soft tissue grafting approaches. The plate of sub epithelial connective tissue is used to harvest donor tissue, which necessitates a thorough understanding of the palate's architecture. The best connective-tissue is closest to the teeth, not the plate’s midline.


The first step involves removing any infected or dead gum near the tooth roots, then slitting the gums with long incisions made parallel to each other on either side of the exposed area. Then, healthy gum from another part of your mouth is cut away and used as a substitute for what you've just removed. These pieces are placed under the receding edge of teeth where they're secured by sutures or surgical staples so that it heals into place over time. A denture hole may also need to be created around some teeth to provide more room for the new gum tissue.


A coronally positioned flap with vertical or horizontal incisions is used to generate a totally covered connective tissue transplant. Similar to the coronally positioned flap, vertical incisions are produced. Vertical incisions allow for more flap creation, however they can restrict blood flow and cause mucosal scarring. When a thin or average connective tissue graft can be placed under the coronally positioned flap to enhance the soft tissue complex, the therapy is appropriate for class I recession defects. At the recipient site of class I defects, there is a band of keratinized tissue. Covering the grafted tissue fully with a coronally positioned flap generally results in 100% root coverage, but with a nonkeratinized mucosal margin at the CEJ in more advanced recession with defects where little or no keratinized tissue exists.

Acellular Of Dermal Matrix Allografts

If autogenous connective tissue cannot be used, acellular dermal matrix allografts can be used instead. The donor allograft tissue must be recovered by a tissue bank that has been approved. The American Dental Association of Tissue Banks' and the US Food and Drug Administration's requirements for donor tissue should be followed in the United States.


Acellular dermal allograft treatments have seen an increase in success thanks to novel methods of processing allografts. The matrix is maintained by inhibiting metalloproteinases after the dermal cells have been removed. The tissue is freeze dried to preserve the components necessary for revascularization and repopulation by normal cells in the recipient.


Although this procedure removes cellular components from the dermal matrix, it leaves blood vessel channels, collagen, elastin, and proteoglycans intact. By providing a biologic scaffold for natural tissue remodeling, this enables for a more structured and fast healing response.

 
Many folks desire to graft but don't want to deal with the palatal issues. When it comes to covering exposed roots, autogenous connective grafts and acellular dermal matrix allografts are nearly identical. Acellular dermal matrix grafts heal 2 to 3 weeks faster and produce more keratinized soft tissue than connective tissue grafts. Completely covering a connective tissue transplant has two advantages: it allows for a smaller graft and improved esthetics. It's possible that a thin graft that isn't entirely covered will die.

Non-surgical treatment options


If you don't obtain treatment for an exposed tooth root, it won't get any better. Consult your dentist about the best treatment choices if you believe one of your roots has become exposed. They can also spot signs of gum disease, which could be the cause of the exposed root, and assist prevent it from getting worse. Here are a few tips to help you avoid getting exposed roots:

- Keep your teeth as clean and healthy as possible. Brush at least twice a day with fluoride toothpaste or mouthwash to kill plaque bacteria that can lead to gum disease. 

Floss daily, using either regular flossing threaders or dental tape for better access under bridges and braces.

-Tobacco should be avoided. Untreated gum disease affects more than 40% of smokers between the ages of 20 and 64. This figure is twice as high in smokers as it is in non-smokers. Quitting smoking can be challenging, but a healthcare expert can assist you in developing a strategy that is right for you.

Have regular dental checkups with x-rays of the lower jaw area every one to two years; this will help detect early signs of gingival recession before it becomes serious. If you have a dry mouth from medicines, medications, or medical conditions such as diabetes type II (diabetes mellitus), talk with your dentist about what steps you should take.

Brushing too hard can damage your teeth. Brushing your teeth violently or with a hard toothbrush can harm your gums and expose the roots of your teeth.

Avoid clenching or grinding your teeth. Gum recession can be caused by the pressure from grinding your teeth. If you grind your teeth while sleeping, a mouth guard may be beneficial.

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Questions To Answer


Can massaging my gums help in gum recession?


Yes, massaging your gums is a highly effective and simple way to cure receding gums; however, you should never put your bare fingers in your mouth because they carry a lot of germs that can cause caries and other oral issues.


Use the circular brushing approach for greater outcomes; it will aid in the treatment of other dental issues as well as the maintenance of oral hygiene.

What are the signs and symptoms of gum recession?


Symptoms include bleeding gums, sharp tooth sensitivity in certain areas, a sense that something is "off" or not fitting right with your teeth. Severe receding gums may lead to loose teeth due to the root exposure left behind by this dental issue.


Gum recession can be painful if the pain continues without being treated early on; it's best to get an evaluation from our team as soon as possible so we can help you prevent further damage and alleviate any discomfort you're experiencing.

What are some nonsurgical ways to reverse a gum recession?


Root planning and scaling, in addition to brushing and flossing, are the most effective ways to remove plaque below the gum line. This non-surgical treatment reduces gum pockets by closing gaps between your teeth and gums, where germs thrive and cause the most harm to your smile.

How can I treat my receding gums at home, or how can I stop it in lockdown?


The importance of maintaining good dental health cannot be overstated. Negligence in oral hygiene causes deterioration in the state of the gums, such as recession. You may certainly slow down the process by doing the following steps:

  • To maintain adequate oral hygiene and avoid germs developing in that area, brush the area between your gums and teeth with a soft toothbrush.
  • Cleaning the interdental gaps with dental floss is a good idea.
  • To keep microbial activity at bay, use warm saline rinses. You may also do the same thing with mouthwash.
  • To improve blood circulation in the area, gently massage your gums with a clean finger.
  • Remember to seek expert assistance once the lockdown is over.

Should I Be Worried About Receding Gums?


Yes, you should be worried and schedule an appointment with your dentist as soon as possible, as receding gums can cause a variety of issues, including discomfort and tooth loosening. It's because your gums are receding from the natural gum line. Experiencing sensitivity to chemical and thermal changes due to the cervical part of your roots being exposed. If left untreated, periodontal ligaments and other tooth structures will be destroyed, resulting in tooth and bone loss.

What Can I Do About It?


There are various treatments for receding gums and you may choose from any one of them depending on what suits your requirements best: surgical treatment where grafts will be placed around the tooth; orthodontic surgery which involves moving teeth in order to relieve pressure on weakened areas; crown lengthening where excess tissue at the bottom of a tooth is removed using laser technology, some cases need more than one session before all tissues have been lowered. Your dentist will recommend whichever method he thinks would work best for you.

Does Gingival Recession Require Surgical Treatment?


Gingivitis is most commonly treated at home by the patient. Periodontitis/periodontal disease is a more serious gum infection that necessitates treatment from your dentist and hygienist.

How Do You Fix Receding Gums Without Surgery?


If your gum recession is due to gum disease it is possible to stop and fix gum recession by following good oral hygiene routine. There are a few simple steps that can help slow and stop the progression of gingival recession: brushing your teeth with Natural toothpaste to regrow gums twice daily, flossing at least once a day, visiting your dentist regularly for professional cleanings and dental checkups; using mouthwash after every meal or snack to manage plaque build up on your teeth; avoiding chewing tobacco as it only worsens gum recession. You may also want to consider wearing custom-made night guards if you grind your teeth during sleep.


In addition, make sure you visit us for any emergencies that come around such as bleeding from the gums which could be due to inflammation caused by bacteria buildup.

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