Periodontal Disease: Soft Tissue Grafts Rebuild Receding Gumlines

Erosion of the gums at the gumline is relatively common, both as a result of chronic inflammation associated with chronic gum disease and in young adults with aggressive tooth brushing habits. Generally, teeth will develop gum recession when a root is prominent in the bone compared to other teeth. Patients who grind their teeth also stress the sockets in which the teeth reside. When this stress is delivered to sockets with thin bone, loss of bone and gum may occur, which leads to thermal sensitivity of the tooth and may be unsightly.

Dentists are concerned about receding gumlines when the amount of gum tissue deteriorates. Research has shown that when the amount of attached gum tissue diminishes below one millimeter, these teeth are more vulnerable to developing further recession.

The solution: when these teeth are treated with gum grafts, the recession will stabilize and help to prevent the further loss of tooth support.

Soft Tissue Grafts are procedures that rebuild the protective gum tissue around the tooth or teeth.

The procedure is as follows:

1. Patient receives a local anesthetic.
2. The tissue below the receded gum is cut away, exposing underlying tissues.
3. Gum tissue is taken from the roof of the mouth. This is usually a 1-2mm paper-thin graft that can easily be positioned around the problem tooth. The roof of the mouth is essentially an eternal reservoir of gum tissue. The site where gum tissue was taken from will be slightly tender but heals quickly and returns to normal after a few days.
4. The graft tissue is then sewn into place over the exposed underlying tissues. Sutures are enough to secure the graft and allow proper healing. The graft will turn white first and then often red as it bonds to the surrounding tissue. Ultimately, grafts will turn to more normal color.

New variations of grafts have emerged over the past several years. Tissue bank skin graft material is available for those patients who would prefer not to use tissue from the roof of the mouth. These grafts tend to have more shrinkage but will provide more natural color matching to the surrounding gums.

Root coverage is now a very popular option for teeth with receding gum lines. Subepithelial Connective Tissue Grafts uses internal tissue from the roof of the mouth and places it under a flap of gum in the area of recession. The nutrition from the gum under and over the graft keeps the graft alive over the previously exposed root surface. The result is both an increase in the amount of protective gum tissue as well as improved esthetics. These grafts also provide the best color match with the surrounding gums.