Gum Grafting

When recession of the gums occurs, the body loses a natural defense against both bacterial penetration and trauma. When gum recession is a problem, gum reconstruction using grafting techniques is an option.

First, a simple distinction between attached  and non-attached gum tissue needs to be made.  The band of tissue directly around the teeth, typically pink/orange and stippled and 2-6mm wide, is called attached gum  because its attached or fixed to the bone underneath. Beyond the attached tissue, typically red/purple and moveable, is non-attached gum,  as it slides freely over the bone underneath. If you lose your zone of attached gum to the point where non-attached tissue is bordering the teeth, the “seal” of the gum tissue is lost. Food debris enters, sets up inflammation and infection, and causes loss of the thin plate of bone underneath. If enough of the bone is resorbed the tooth will be lost.

A critical note: When bone is lost around a tooth due to recession, its lost forever. Currently there are no techniques for replacing a plate of lost bone. This is why early interception of a receding gum is important.

When there is only minor recession, and some healthy attached gum remains, no treatment other than modifying home care practice, i.e., a soft tooth brush used carefully with light pressure, is necessary. However, when recession reaches the non-attached tissue, the first line of defense against bacterial penetration is lost.  A graft is necessary to stabilize the gum level and prevent loss of the underlying bone.

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. Exposed root surfaces are softer than enamel and much more prone to root decay and gouging.

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A gingival graft is designed to solve these problems. A thin piece of tissue is taken from the roof of the mouth and grafted to recession zone to provide a stable band of attached gingiva around the tooth. The procedure is performed under normal local anesthesia (“novocaine”) and  is highly predictable with only minor post-op pain. Patients can resume normal activities immmediately, and the chance of complications is remote.