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. In this article we will discuss different options for gingival recession treatment.

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. Explore our comprehensive guide on herbal solutions for receding gums and take the first step toward a healthier smile today.

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 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 or various antibiotics 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.

Signs and symptoms of Gingival recession

The following can be signs that you are suffering from gum recession:

  • Bleeding in the mouth.
  • Pain while chewing or brushing teeth, especially on the receded side of your tooth. Sometimes this pain is alleviated when using a cold compress to ice the area for about 20 minutes after eating or drinking hot liquids.
  • Difficulty cleaning around and under your fingernails - this could indicate that gingival recession has progressed down below the level of your nail bed.
  • Pus coming out from between teeth and gums (pus pockets) as well as ulcers on either side of one's lower jaw bone. Gingival recession also has been found to cause an increase in plaque buildup at root surfaces because it exposes them which may contribute to the increase in bacterial buildup at root surfaces because it exposes them which may contribute to tooth decay.
  • Decreased ability of teeth from holding dental restorations like crowns, bridges and fillings, receding gums around crown.
  • Aesthetic concerns: gum tissue can cause sagging cheeks or make one's smile look less attractive than before; unattractive appearance when smiling with more gum showing around the lips than what was there originally (gum lines). Gingival recession also causes an increased amount of oral bacteria as well as poor oral care routine.

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 crown 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 Gum 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. Various antimicrobial medications are also recommended for gingival recession. 

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 For Gingival Recession

There are several treatment options for gingival recession. 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.

Final Thought

Gingival recession is a common dental condition that requires prompt attention and appropriate treatment to prevent further complications. The article discussed the causes and symptoms of gum recession, emphasizing the importance of regular dental check-ups for early detection. Various treatment options for gingival recession were explored, with a focus on periodontal surgical procedures that aim to correct and prevent the progression of the condition. These treatments involve altering the patient's tissues to enhance gum health and conceal exposed roots.

It is essential for individuals experiencing gum recession to seek professional dental care and follow the recommended treatment plan. By addressing the underlying causes and choosing the most suitable treatment option, it is possible to restore gum health, protect tooth roots, and improve overall oral hygiene. Remember to maintain good oral hygiene practices, such as proper brushing and flossing techniques, to prevent gum disease and promote healthy gums.

Through a combination of timely intervention, effective treatment, and consistent oral care, individuals can achieve optimal gum health, alleviate discomfort, and maintain a confident smile.

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