WILMINGTON--MDTVSelect.org--Periodontal problems can present themselves in many different ways. So patients may have significant inflammation and infections while others present with areas of root exposure. Both are different signs of a similar disease process. Some patients will also present with exposed roots that are unrelated to disease activity. Gingival recession can cause esthetic as well as functional problems such as sensitivity to cold or sweet foods, increased risk of cavity formation and possibly loss of teeth.
Gingival recession is defined as a localized area of bone and gum loss that leaves the root of the tooth exposed to the oral cavity. Once exposed, the root of the tooth becomes prone to root decay. Also, the exposed root surface is no longer insulated and can conduct temperature to the tooth resulting in sensitivity. The sensitivity can sometimes be treated with various materials. Because of the loss of gum, these teeth are now in jeopardy of increasing and progressive recession which can then lead to the loss of teeth. The reason this occurs is based on the different types of gum tissue we have.
There are two types of gum tissue in our mouth. The first is called gingiva and is a dense orange peel like tissue. This tissue is called attached because it is attached to the underlying bone. It is a very tough tissue that is resistant to the forces of everyday life. The other type of tissue is called mucosa. This is a lining type of tissue that is red and movable. It is primarily made of elastic fibers and will run away from an irritant. Ideally our teeth are surrounded by gingival. Unfortunately, the type of tissue we loose with recession is the gingival and this leaves the tooth surrounded by mucosa.
There are multiple procedures aimed at correcting recession. The two most common are the gingival graft and the connective tissue graft. The gingival graft uses tissue harvested from the roof of the mouth and replaces the gingiva which has been lost. The goal is to increase the zone of gingiva and create a barrier to prevent further recession. The connective tissue graft uses an internal type of tissue from the roof of the mouth and is used primarily for root coverage procedures. Both grafting procedures utilize growth factors harvested prior to the surgery to accelerate the soft tissue healing. These procedures are relatively quick and are usually done with local anesthesia.
The consultation for grafting allows the doctor to determine the cause of recession and to select the appropriate treatment. Things to be evaluated are
1) Periodontal health
2) Tooth position
3) Occlusal relationship (Bite Analysis)
4) Source of donor tissue
With the technology available today, we can successfully treat recession and rebuild the lost soft tissue in the mouth. The cosmetic benefit is tremendous. The use of growth factors has also greatly enhanced the treatment outcome. The key to successful treatment lies in the diagnosis. There are often many treatment options but only 1 true diagnosis.
