Dr Boota Singh Ubhi discusses the causes and treatments for gingival recession
There are many possible causes for gingival recession, including build-up of calculus leading to disease and inflammation , history of and current ‘hard’ tooth brushing , and misaligned teeth . Lifestyle habits like smoking  and features such as lip piercings  have also been shown to promote the development of gingival recession.
A major impact of the condition is what it does to the smile aesthetics – this is often the main complaint from the patient. It can also lead to plaque retention, gingival bleeding and inflammation, loose teeth and pain or discomfort . Recession can also cause dentine hypersensitivity  and lead to continued discomfort for the patient that could affect their quality of life.
Where minor recession has occurred and it is detected early, there are some fairly simple treatment options available. Revision of home care routines and a review of any existing restorations or tooth alignment can help stop the condition from progressing any further. Where infection is identified, the appropriate topical antibiotics, antiseptics or antimicrobials can be applied. Alternatively, orthodontic treatment may be considered.
In cases of advanced recession, more complex intervention may be required, such as periodontal plastic surgery. This encompasses a wide range of surgical procedures that involve improving the soft tissue aesthetics by restoring the position of the gingiva.
The main surgical procedures employed for root coverage can generally be placed into one of two categories :
1. Pedicle soft tissue graft procedures
These grafts allow soft tissue to be repositioned over the defect, but as they remain attached they retain their own blood supply. This type of graft includes coronally advanced flaps and laterally positioned flaps.
2. Free soft tissue graft procedures
Where there is insufficient soft tissue close to the defect or tissue thickness needs to be increased, these procedures involve placing a grafted material from elsewhere – usually the palate. These include free gingival grafts and connective tissue grafts.
A connective tissue graft covered with an overlying flap is widely considered to be the gold standard treatment for gingival recession defects in the profession. It is believed that the two blood supplies afforded by this technique provide an optimal aesthetic outcome .
Treatment for gingival recession should always begin with less invasive procedures when possible, but more complex intervention may be required for advanced cases. Referral to a colleague with the appropriate skills and experience may be in the best interests of your patient and working with my specialist team at BPI Dental could offer a solution. Accepting referrals for an array of periodontal plastic surgery procedures – including connective tissue grafts, as well as crown lengthening and ridge augmentation – the team can offer an extension to your services and ensure your patients receive the highest quality care.
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