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Tampa Bay Periodontics and Implant Dentistry
James G. Wilson, DMD
Diplomate, American Board of Periodontology

Gum Grafting Information

In a healthy mouth, teeth roots and bone are surrounded by gingival and mucosal tissues. Gingival (gum) tissue is coral pink, thick, and dense under a microscope. This tissue forms a tight seal around the teeth serving as a barrier against the penetration of bacteria to the underlying supporting bone. The gingiva also helps to withstand trauma from eating and brushing. Dentists refer to this band of tissue as the “attached” or “keratinized” tissue. The second type of tissue, mucosa, is found directly below the gingiva. Mucosal tissue is red, very thin, and appears loose under a microscope. It does not seal tightly around the tooth, nor does it withstand trauma very well. Dentists refer to this zone of tissue as the “alveolar mucosa”.

Reasons for Gingival Grafts

Because the tooth root should be encased within the jawbone, root exposure where gums have receded reveals an area where bone has been lost.  Only following the loss of the bone can the gums move down the root to expose it.  When there is only minor recession, some healthy gingiva often remains and protects the tooth, so there may be no treatment needed other than monitoring for worsening. In this case, Dr. Wilson and/or your dentist may wish to monitor you to determine if the recession is progressing.

When recession reaches the mucosa, the first line of defense against bacterial penetration is lost. At this stage, no matter how meticulously the patient tries to control the bacteria, there is a greater chance of bacteria penetrating and affecting the underlying supporting bone around the tooth. In addition, gum recession often results in root sensitivity to hot and cold foods as well as an unsightly appearance of the gum and tooth. Also, gum recession, when significant, can predispose to worsening recession and expose the root surface, which is softer than enamel, leading to decay on the root surfaces. Your gum may have receded for a variety of reasons, including improper tooth position, aggressive tooth brushing or periodontal disease.  Prior to treatment, Dr. Wilson will help you identify the factors contributing to the problem.  Once these contributing factors are understood, a soft tissue graft procedure is often advised to repair the defect and help to prevent additional recession and bone loss.

Soft tissue grafting is an extremely versatile procedure that has many uses.  Recent developments in dental technology have made soft tissue grafting more predictable and less intrusive.  Here are some of the main benefits associated with soft tissue grafting treatment:

  • Increased comfort – Root exposure can cause substantial pain and discomfort.  Eating hot, cold or even warm foods can cause severe discomfort. Soft tissue grafts can cover the exposed root, decreases sensitivity and restore good health to the gum area.  Loose, movable mucosal tissues at the gumline can be uncomfortable to brush.  Utilizing a soft tissue grafting procedure makes the gum tissues more dense and able to withstand the rigors of brushing.  Better brushing results in less potential for decay on the root surfaces and/or further bone loss.

  • Improved esthetics – Gum recession can cause the smile to look “toothy” or the teeth to appear uneven in size.  Soft tissue grafting can be used as a cosmetic procedure to re-augment the gums, and make the smile appear more symmetrical.

  • Improved gum health – Periodontal disease is a progressive condition that can destroy soft tissue very rapidly.  When used in combination with appropriate home care and recommended periodontal therapy, soft tissue grafting assists in halting tissue and bone loss, and protecting exposed roots from further complications.

Every case of gum recession is slightly different, and therefore many treatments are available. Dr. Wilson will evaluate your situation and advise you of your options for treating your gum recession.

The most common procedure Dr. Wilson performs for root coverage and for thickening/strengthening the attached gingiva is called the subepithelial connective tissue graft. This minor surgery, which is considered the gold standard of the soft tissue grafting procedures, takes about an hour to complete. During the procedure, each affected tooth is cleaned thoroughly and a small recipient pouch is created to receive the graft tissue. Utilizing a Minimally Invasive Surgery, a thin piece of tissue is taken from the roof of the mouth and fitted and secured within the recipient pouch to provide a stable band of firm tissue around the tooth. The gingival graft may be placed in such a way as to cover the exposed portion of the root.  Most patients report only minor discomfort with this procedure, and follow-up visits are scheduled at approximately 2 and 5 weeks.

 If you have any questions about soft tissue grafting, please call for an examination appointment with Dr. Wilson.

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