Gingival Recession

Gum recession is the condition in which the gingival separates from the tooth surface over time and retracts, exposing the tooth roots. This condition, which occurs due to periodontal diseases, can be difficult to recognize in the early stages due to its progression and can lead to tooth loss.

What are the Causes of the Gingival Recession?

Periodontal Diseases

Periodontal diseases are among the most common causes of gingival recession. These diseases, especially gingivitis, and periodontitis, are infections and inflammations that damage the gingival, teeth, and supporting bone structure.

Wrong Brushing Technique

Brushing too hard or incorrect brushing technique can damage the gingival and lead to recession.

Genetic Predisposition

Some individuals are genetically more susceptible to periodontal diseases and, consequently, gum recession.

Smoking

Smoking and tobacco use can compromise gum health and lead to gum recession.

Hormonal Changes

In women, hormonal changes during puberty, pregnancy, and menopause can make the gingival more sensitive and increase the risk of gum recession.

Poor Oral Hygiene

Irregular brushing and deficiencies in interdental care can create conditions conducive to the development of periodontal diseases.

Teeth Grinding and Clenching

Bruxism, or grinding and clenching teeth, can be a factor that accelerates the progression of existing periodontal diseases.

Faulty Dental Restorations and Orthodontic Treatments

Incorrectly placed fillings, crowns, or orthodontic treatments can pave the way for the development of periodontal diseases and, consequently, gum recession.

Trauma

Direct trauma to the teeth or gingival can cause recession of the gingival.

What are the Symptoms of Gingival Recession?

Tooth Sensitivity

When the gingival recedes, the root of the tooth can be exposed, which might lead to sensitivity to hot, cold, sweet, or sour foods and beverages.

Tooth Appearing Longer

As the gingival recedes, teeth may start to appear longer because more of the tooth surface becomes exposed.

Gingival Bleeding

Bleeding from the gingival may occur during brushing or flossing.

Red or Swollen Gingival

Redness and swelling can be indicative of inflammation and infection.

Bad Breath

Persistent and unexplained bad breath or an unpleasant taste may be a sign of gum disease.

Tooth Mobility

In advanced cases of gum recession, teeth may become loose or movable because the supporting tissues have been damaged.

Difficulty Eating

Due to the weakness caused by gum recession, teeth may cause pain when they come into contact with food, leading to discomfort or difficulties while eating.

Gap Formation Between Teeth

Gingival recession may result in the development of gaps between teeth, a condition known as pathological diastema.

Potential Consequences of the Gingival Recession?

Aesthetic Concerns

Gingival recession can cause the teeth to appear longer and deteriorate the aesthetic appearance of the smile.

Tooth Loss

Progressive gum recession can damage the bone and connective tissues supporting the teeth, potentially leading to tooth loss.

Increased Risk of Cavities

Exposed tooth roots are not as protected as the enamel covering the outer part of the tooth, making them more susceptible to decay.

What Happens When Gingival Recession Is Left Untreated?

Advanced Gingival Disease

If gum recession continues, advanced gum disease such as periodontitis can develop, which can lead to the loss of bone and other tissues that support the teeth.

Tooth Loss

As gum recession progresses, teeth can lose adequate support and eventually fall out.

General Health Problems

Gingival disease and oral infections can be linked to heart disease, diabetes, and other systemic health problems.

Expensive and Complicated Treatments

As gum recession progresses, treatment becomes more complex and expensive; grafts, surgical procedures, and even dental implants may be required.

How to Prevent the Gingival Recession?

Regular and Correct Tooth Brushing

It is important to brush your teeth at least twice a day using the correct brushing technique. For individuals with delicate gum structures, brushing too hard may be considered a risk factor for gum recession. Consulting with a dentist for the selection of the most suitable toothbrush for gum structure is crucial.

Use of Dental Floss

Dental floss helps to clean plaque that accumulates between teeth and below the gumline. Regular use of dental floss every day is effective in preventing gum recession.

Regular Dental Check-ups

Regular visits to dentists allow for early diagnosis and treatment of potential issues. Professional cleaning significantly contributes to preventing gum recession by reducing plaque and tartar buildup.

Healthy Nutrition

Since gum tissues are physiologically and metabolically active, maintaining a healthy eating habit contributes positively not only to overall health but also to gum health.

Avoiding Smoking and Tobacco Products

Smoking and tobacco use is one of the biggest risk factors for gum disease. Quitting these habits helps improve gum health.

Reducing Stress

Stress can lead to behaviors such as clenching or grinding, which can contribute to gum recession. Stress management techniques and relaxation exercises can help control these habits.

Treatment of Gingival Recession: How Is It Done?

The treatment methods applied for gum recession can vary depending on the severity of the condition and its underlying causes. However, within the framework of general periodontal treatments, the primary goal is to eliminate the factors causing gum recession.

Approaches aimed at eliminating the inflammatory factor are followed in the treatment of periodontal diseases such as gingivitis and periodontitis.

What does gingivitis treatment involve?

For gingivitis, which can be considered the initial stage of gum inflammation, establishing good oral hygiene habits including professional dental cleaning along with regular brushing and flossing may suffice.

What does periodontitis treatment involve?

Treatment for periodontitis is more complex and comprehensive than gingivitis due to damage to the bone and other supporting tissues. In cases resembling the advanced stage of gum disease, known as periodontitis, treatment planning involves addressing the inflammation beneath the gingival based on the degree of bone loss and severity of existing inflammation:

Deep Cleaning (Root Planing and Scaling)

This procedure aims to remove the inflammatory tissues beneath the gingival while cleaning the surface of the tooth roots to reduce bacterial buildup by smoothing rough areas.

Antibiotic Treatments

Local or systemic antibiotics may be used to control bacterial infection and reduce inflammation.

Surgical Interventions

In severe cases, surgical procedures such as cleaning of periodontal pockets or surgeries involving bone and gum grafts may be necessary.

Regenerative Procedures

These treatments aim to stimulate the regeneration of lost bone and tissue. Methods such as bone grafts, materials containing tissue-stimulating proteins, and similar approaches can be utilized.

Regular Follow-up and Care

Given that periodontitis is a chronic condition, it requires regular monitoring and professional care.

Gingival Tissue Grafts

Gingival tissue graft applications (such as Free Gingival Graft and Connective Tissue Graft operations) are among the most used methods in treatments aimed at covering gum recession. In gum tissue graft operations, gingival tissue is taken from another part of the patient’s mouth, typically the palate, and transplanted to the area where the gingival has receded. This procedure covers the receded area, providing a healthier and more aesthetic appearance. Gingival tissue grafts also help prevent further gum recession and preserve the roots of the teeth.

What are the differences between Free Gingival Graft and Connective Tissue Graft Operations?

Free Gingival Graft

Purpose of Use: Free gingival grafts are preferred in patients with thin gum tissue, especially in areas experiencing gum recession. This method is used to thicken the gingival and reduce the risk of further recession.

Location of Graft Harvest: The graft is usually taken from the palate region of the mouth. The gum tissue obtained from this area is transplanted over the receded gingival.

Esthetic Results: Free gingival grafts may sometimes provide less aesthetic results, particularly when used in the front teeth, as achieving perfect color and texture matching may be challenging.

Healing Process: This procedure generally involves a more painful healing process because the palate area from where the graft is taken needs to heal.

Connective Tissue Graft

Purpose of Use: Connective tissue grafts are particularly preferred in cases where aesthetic concerns are significant. This method is used to cover receded gingival and improve the gum line.

Location of Graft Harvest: The graft is usually taken from deeper layers of the palate, namely from the connective tissue. In this method, the top layer of the palate is left in place, which makes the healing process less painful.

Esthetic Results: Connective tissue grafts generally yield better esthetic results compared to free gingival grafts because better color and texture matching can be achieved.

Healing Process: The healing process for connective tissue grafts is typically faster and less painful compared to free gingival grafts as there is less trauma to the palate area.

Both procedures are effective methods for treating gum recession; however, the method suitable for the patient’s needs and aesthetic expectations should be chosen. A dentist can determine the most appropriate treatment method based on the patient’s condition and expectations.

Surgical Procedure

Preparation: Before surgery, the dentist evaluates the patient’s mouth and gingival. Necessary medical history and X-rays are reviewed.

Local Anesthesia: During the procedure, local anesthesia is applied to the area being treated to prevent pain and discomfort.

Surgical Procedure: A gum tissue graft or a similar procedure is performed. Depending on the type of procedure, gum tissue can be taken from another area or repositioned.

Healing Process: After the surgery, a healing period is necessary. During this period, mild pain, swelling, and discomfort might be experienced, but these are generally manageable.

Healing and Care

Recovery: The healing process varies depending on the surgical procedure and the individual’s health. Generally, normal activities can be resumed within a few days.

Pain Management: Any discomfort can usually be managed with prescribed or over-the-counter pain relievers.

Diet and Oral Hygiene: During the recovery phase, consuming soft foods and practicing careful oral hygiene to avoid damaging the surgical area are recommended.

Regular Check-ups: Regular dental visits after surgery are important to monitor the healing process and prevent any complications

Patient’s Role

Compliance with Follow-up Instructions: It is important for the patient to follow the instructions given by the dentist and maintain the recommended oral care routine.

Managing Expectations: Post-surgery expectations may vary depending on the type of procedure and the individual’s specific situation.

In conclusion, gum recession surgery is generally not a difficult procedure, but the patient’s experience can vary based on personal factors. Regular dental visits before and after surgery can enhance the patient’s comfort and the success of the healing process.