Teeth are defined as healthy when the underlying bone and overlying gum tissue completely envelope the root of the tooth allowing only the crown, or the enamel, of the tooth to show in the mouth. Gingival recession, or when the root surface of the tooth becomes exposed to the oral cavity, is a defect that can be caused from a variety of factors and leaves the tooth susceptible to problems. The root surface of the tooth is much softer than the enamel surface of the tooth so as bacteria collect on the teeth and along the gums, cavities can start to develop on the root surfaces of the teeth. Also, abrasion or erosion of the root surfaces can occur leaving a “gouged” look to the root surface.
Due to recession, teeth can become more sensitive because the root surfaces of the teeth have microscopic channels full of fluid that communicate to the inside, or nerve of the tooth. Changes in temperature due to cold or hot fluids and sweet foods, alters the fluid flow, giving the sensation of sensitivity and discomfort.
The solution to the symptoms, defects, and unesthetic appearance of gingival recession is gum grafting. There are three options when it comes to grafting the gums, Soft Tissue Grafts, Free Gingival Grafts or Donor (AllodermTM) Grafts. Drs. Thomas, Combs & Thomas perform Gum Grafting in Kansas City at all 4 locations.
Connective Tissue Grafts, also known as Soft Tissue Grafts, are the gold standard for grafting the gums because the graft comes from the patient. It is the most successful, heals optimally, and has the best longevity of any graft material. A measurement is made of how deep and wide the recession is and that measurement is translated to the roof of the mouth, or the palate. One “paper cut” is made on the palate and from underneath it a piece of tissue is removed. That piece of tissue is taken to the tooth or teeth with recession, and the gums around those teeth is loosened like an envelope. The piece of tissue, or graft, is placed in the envelope and secured with sutures, which typically remain in place for 2 weeks and are removed. At which point, the patient can return to normal function, including brushing, flossing and eating.
In circumstances where full coverage of the root surface of the tooth cannot be achieved and more healthy tissue is needed to surround the tooth, one option is Free Gingival Grafting. A “patch” of tissue is harvested from the palate (roof of the mouth) and placed on top of the existing gum tissue around a specific tooth or teeth in order to gain a thicker band of tissue.
The advantage of using donor tissue for gingival grafting is that a second site to obtain the graft is not needed and more tissue can be available depending on how big the defect is. Donor tissue tends to heal slower, although, so more care is needed during the healing process. Measurements are made around the tooth or teeth with recession, and corresponding graft is obtained. The gums around the teeth are loosened like an envelope and the donor graft is placed in the enveloped and secured with sutures. Suture removal is done in 2-3 weeks when patients can return to normal oral hygiene activities.
Please call to have one of our Kansas City Periodontists evaluate which treatment option is best for you.