Gum recession is an insidious and rather unpleasant disease. Timely detection of the cause of the pathology, its competent treatment makes it possible to return a dazzling smile and forget about the problem forever. In this article we will consider why this disease develops, according to what principles it is classified by specialists, the methods of surgical intervention used today and their effectiveness in practice.
general information
Recession is a pathological change in the level of the surface of the gums relative to the tooth. As a result of this process, its direct exposure occurs. The disease entails not only aesthetic problems, but also the development of various kinds of pathologies. These include increased sensitivity of enamel, wedge-shaped defects, caries, and others. At a young age, the disease is diagnosed relatively rarely (in approximately 10% of patients). Most often, it manifests itself in people of middle and old age (up to 95%).
Gingival recession is classified as a disease that negatively affects the aesthetics of the face, as well as the psychoemotional state of a person. The bare roots of the teeth, clearly visible with a smile, significantly underestimate self-esteem, cause difficulties in communication, negatively affect social adaptation. The more pronounced the pathology, the stronger the psychological insecurity of a person.
The main causes of the disease
The reasons for the development of this pathology are diverse. We list only a few of them below.
- Tartar or plaque. In conditions of a special anatomical structure of the oral mucosa and insufficient gum width, plaque leads to a gradual displacement of the epithelium.
- The anatomical specificity of the so-called alveolar bone. In some cases, teeth with massive roots have a thin layer of cortical bone. In this kind of situation, blood supply to its vestibular parts is not carried out to the required extent. If the vessels of the periosteum in this area are damaged, then the cortical plate is lost over time. In the place of attachment of the tooth to the gum, a slit-like defect is gradually formed, and with it the gum recession develops. One cannot do without an operation in this kind of situation.
- Improper / intermittent oral care can exacerbate a recession. Due to mechanical damage to the gums during excessive brushing, the condition of the gums worsens, which provokes various kinds of diseases. Use items to maintain oral hygiene with special care.
- Mechanical damage, after which the tooth is dislocated or its position is incorrect, also requires the elimination of the gum recession.
- Orthodontic treatment methods often lead to the development of pathology. Applying pressure to dislodge teeth during therapy can lead to thinning of the gums or the bone itself after some time. In addition, plaque often accumulates under orthodontic structures, which can also cause an inflammatory process.
- Arsenic leaking onto the gums if the dentist doesn’t position it correctly can injure the surface and cause illness.
- Inflammatory processes in the gums (gingivitis, periodontitis).
- Incorrect attachment of the upper / lower frenulum of the lips.
How is the disease manifested?
There are several types of this pathology, each of which has characteristic clinical manifestations. However, there are symptoms common to all forms of the disease:
- Decreased gum levels.
- Exposure of the root of the tooth.
- Increased sensitivity to temperature and chemical irritants.
- The formation of the carious process.
Classification of Gingival Recessions
The severity of the disease is divided into mild, moderate and severe. In the first case, the gum drops to a maximum of 3 mm. In severe form, this parameter may exceed the mark of 5 mm.
Depending on the degree of coverage of the oral cavity, the recession is local and generalized. By the method of the course of the disease, the visible and hidden (diagnosed by sensing) option are isolated.
Traumatic recession
Most often develops in patients under 30 years of age, mainly on the front surface of the teeth. Exposure of the root reaches 1-2 mm, is certainly accompanied by increased sensitivity of soft tissues and cosmetic defects. Signs of inflammation are extremely rare.
Symptomatic Recession
It develops at any age on the lingual and vestibular surfaces of the teeth. In patients under the age of approximately 35 years, the pathological process can be observed in the interdental spaces of the gums.
The disease occurs due to poor oral hygiene, leading to the appearance of dental deposits and many ailments (gingivitis, periodontitis). Gingival recession is accompanied by bleeding, swelling, suppuration, loosening of the teeth. The role of the cause of the disease is often the traumatic treatment of caries.
Physiological recession
It is diagnosed mainly in elderly patients as a result of the physiological aging of periodontal disease. The exposure of the roots is noticeable with the naked eye. The teeth remain stable, inflammation of the soft tissues is extremely rare.
Indications for resolving a recession
- The desire of the patient.
- Excessive enamel sensitivity.
- Preparation for orthopedic therapy.
- High likelihood of a carious process.
- Progressive gum recession.
Necessary treatment
Therapy for this disease is necessary, since a recession can progress and cause very unpleasant complications.
Treatment usually involves surgery. It allows you to restore the contour of the gums and close the bare root. According to Miller’s current classification of the disease, not every case is subject to the surgical treatment option. In a recession of I and II class, the probability of complete closure of the root surface is very high. With class III disease, it is not possible to close the root surface 100%. The recession of the gum according to Miller, class IV, is not subject to surgical manipulation.
Surgical intervention
To cope with this disease and eliminate visible cosmetic defects, experts strongly recommend that you seek qualified help in a timely manner. Surgical methods allow you to restore the contours of the gums and close the exposed roots of the teeth. Currently, the following surgical intervention options are actively used in practice:
- The method of lateral flap. The flap on the leg is taken in the "donor" zones adjacent to the affected area. Plastic surgery of the gingival recession by this method is performed if the necessary amount of material is available in the soft tissues near the tooth. During the operation, the doctor takes the flap from the gum itself or from a hard palate. This treatment method is relevant for a localized and generalized type of disease. The operation is performed using a local version of anesthesia. Initially, a specialist removes existing inflammations and removes dental deposits. Then comes the process of forming the flap itself. At the final stage it is sutured. The main advantage of the lateral flap method is the effective provision of the recovery period due to 100% coincidence of the soft tissues of the oral cavity. The only drawback of the procedure, according to experts, is the manifestation of a little discomfort in the area from which the donor site was taken. Incorrect engraftment of the flap on the surface is not excluded.
- Non-resorbable membranes are a classic operation. Gingival recession is eliminated without serious complications. The operation consists of two stages. Initially, the doctor installs the membrane. Due to their high rigidity, they exclude the possibility of a second procedure. After a certain period of time, they must be removed. According to statistics, this kind of operation is not very effective. Recovery of damaged tissues is not observed in full size (up to 73% of inflamed areas). Doctors do not recommend resorting to this treatment option for patients with a diagnosis of gum recession.
- Treatment with the help of regeneration potentials of some biological elements. The components of these funds are certain sets of elements that contribute to the rapid formation of new healthy tissues. As a rule, protein enzymes and the amelogenin element are used. These substances contribute to the formation of healthy gum enamel and restore the structure of tooth roots. The use of enamel matrix is aimed at the formation of solid structures on the surface of the affected gum.
Non-surgical methods
Collagen treatment for gum recession is a conservative treatment option for the disease. This approach to treatment is recommended only in the early stages of the development of pathology, when the roots are not yet very bare. Moreover, collagen gives an excellent result if the recession is a consequence of inflammatory processes. With the help of this substance introduced into the gum tissue, it is possible to achieve an aesthetic improvement in the appearance of the affected area, to close the exposed part of the tooth in order to avoid negative effects.
Preventive actions
A disease such as gum recession should not be ignored. Treatment should be prescribed by a doctor based on the cause of the pathology and its form of development. To prevent its occurrence, experts recommend using fairly simple prevention tips.
First of all, it is necessary to treat caries in a timely manner, since it is he who acts as the main cause of this ailment. Regular visits to the dentist’s office for preventive purposes are equally important. The sooner the doctor diagnoses the problem, the easier it is to eliminate it with minimal health consequences.
Injury and bleeding of the gums should not be allowed . Possible occlusion anomalies are recommended to be corrected with the most gentle methods, periodically strengthen the enamel through remineralizing therapy. Particular attention should be paid to good oral hygiene: brush your teeth correctly, do not use too hard a brush.
Conclusion
This article provides detailed information about a common condition such as gum recession. Reviews of the treatment methods presented here are very diverse. Some patients report positive results after conservative therapy. Others talk about the quick recovery of the affected area after treatment through surgery. In any case, a specific treatment option can only be offered by a doctor after examining the patient, identifying the nature of the disease and its form.
Closing the gum recession in the early stages is much faster and easier than in advanced cases. If you do not seek the help of a specialist in a timely manner, the treatment will be long and very painful. That is why when the first signs appear, it is so important not to postpone the visit to the doctor.
We hope that all the information presented in this article will be really useful for you. Be healthy!