Gum or Gingiva Recession

The gums or gingiva consist of tissue surrounding the roots of teeth, underlying bone, and covering the jawbone. Healthy gums appear naturally transparent, and red in color (Because blood is flowing through them). Gingiva ranges in width from one to nine millimeters. It s composed of mucosa that is immovable, tough and resistant to normal trauma, from eating and brushing. Below the gingiva is a looser gum called alveolar mucosa. This tissue is loose enough to allow movement of the lip, and checks, but not resistant enough from normal trauma when eating or tooth brushing. It does not seal tightly around any tooth. Gingiva or gum recession (disease) occurs, for one or more reasons, exposing the root of a tooth or teeth (Pathological movement of the gum margin away from the tooth). Exposed root surface causes pain upon contact to cold and hot liquids, sweet, and salty substances. Furthermore, any exposed root, is likely prone to develop bacteria penetration and decay. Also, pain will occur, when brushing upon contact. Gingval recession is UN-aesthetic, especially seen in the front of the mouth, when a person speaks or smiles. Also, upon appearance having an uneven gum line, which may distract from a beautiful smile. Gum recession can be treated by a Periodontist and at home oral care, which can reverse this problem. An alternative solution may require having root canal surgery by an endodontist. When gum recession is diagnosed reaching the mucosa, periodontal care is necessary, and likely a soft tissue graft is required. A study conducted at State University of New York, school of dental medicine ascertained 88 percent of people 65 years and older, and 50 percent of those 18 to 64 years old, have one or more areas of gum recession.

Reasons for gingiva or gum recession related to genetics, some people born with insufficient attached gingiva. Brushing abrasively with a hard toothbrush rather than a soft toothbrush can lead to scaring and contraction of gum tissue or recession. Inadequately, not removing plaque accumulation (A yellowish film that builds up on the teeth. These microorganisms can form calculus or tarter, which is a bacteria growth harming the health of gums, besides staining the teeth.) from teeth (hygienist can professional remove plaque) by carefully brushing or using a dental cleaning device, can result in inflammation on the gums. This leads to epithelium a periodontal disease (Bacteria in the plaque causes the gums to become inflamed.) which is the out layer of tissue, proliferate and outgrow its blood supply, thus causing the gum tissue to die and move away from the tooth (gum recession). Frequently using abrasive toothpaste attributes to gum recession. Also, poor dieting or poor nutrition contributes to gum recession. A study reported in an issue of the Journal of Periodontology, evaluated men and women, that had taken less than 500 milligrams of calcium (Half of the recommended dietary allowance), twice likely to have periodontal diseases, including gum recession. Chewing tobacco can lead to gum recession, which causes the surrounding tooth to loose stability and sometimes premature loss. Recommend, better to sip hot tea, coffee or soup, than continually in – taking hot liquid, which attributes to gum recession. Crowded teeth may leave certain teeth to far out with less bone and gum, available for that tooth. Also, Diabetes can lead to gum recession.

Periodontal plastic surgeons have learned techniques to correct gum recession. A surgical (soft tissue graft) procedure, involves transplanting a section of tissue from the inner surface of the roof of the mouth (palate), which is applied to cover the exposed root surface. A connective tissue graft is more advanced surgical procedure compared to soft tissue graft and requires advance surgical skills. During the past twenty years, tissue graft techniques have evolved surgical innovations. The soft tissue graft can reduce further recession and bone loss. Also, offer a beautiful new smile, and improved periodontal health. During the procedure, stitches are necessary, which will be removed approximately one week after surgery. The surgical procedure takes between 60 – 90 minutes under local anesthesia. The surgical procedure has a high percentage rate of success, because the grafted tissue obtains blood supply from two areas, the bone and adjacent tissue. Patients can expect to experience some soreness to mild discomfort for one week, which is controlled with over the counter and prescription medication. Soft tissue grafting primarily performed on permanent teeth.

I had experienced gum recession, on a tooth, and had severe pain. A periodontist recommend I have a soft tissue graft. A few days later, the pain intensified, and I went to an endodontist (root can specialist), that my dentist recommended. The endodontist examined the area, and recommended I have a root canal surgery adjacent to the gum recession. (In my situation, the gum recession was localized in one small area next to a tooth). I decided to have this procedure, which resolved my pain and discomfort. I was informed, there is a percentage of times, having soft tissue graft surgery may not work, (In some patients, soft tissue grafts don’t have good results.) and certainly a more painful or discomforting procedure, than undergoing a root canal. Besides, soft tissue surgery has a length of time for recovery, and after root canal surgery, the pain is gone, except for some feeling of bruising (I had felt inside my mouth for about day). In most cases, after root canal surgery, no follow-up examination is necessary for at least a few months. Besides, no stitches have to be removed (necessary during soft tissue graft), a week after surgery. A few years earlier, I had root canal surgery, so I was familiar with the procedure and outcome. Fortunately, in my situation, going to an endodontist proved to be the correct choose, rather than going to a periodontist, which would be more painful and long recovery time. My suggestion: Always get second opinion, before any surgery.

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