The recession of the gums is an insidious and rather unpleasant disease. Timely detection of the cause of pathology, competent treatment of it makes it possible to return a dazzling smile and forget about the problem forever. In this article, we will consider why this disease develops, by 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 gingival surface relative to the tooth. As a result of this process, it is directly exposed. The disease entails not only aesthetic problems, but also the development of various pathologies. These include the increased sensitivity of enamel, wedge-shaped defects, caries and others. At a young age, the disease is diagnosed relatively rarely( approximately 10% of patients).Most often it occurs in people of middle and old age( up to 95%).
Recession of the gums is classified as a disease that negatively affects a person's aesthetics, as well as a person's psychoemotional state. Bared roots of teeth, clearly visible with a smile, significantly underestimate self-esteem, cause difficulties in communication, adversely affect social adaptation. The more pronounced pathology, the stronger the psychological uncertainty of a person.
The main causes of the disease
The reasons for the development of this pathology are diverse. Below are just a few of them.
- Dental stone or plaque. In conditions of a special anatomical structure of the oral mucosa and insufficient width of the gums, the plaque leads to a gradual shift of the epithelium.
- Anatomical specificity of the so-called alveolar process. In some cases, teeth with massive roots have a thin layer of cortical bone. In this kind of situation, the blood supply of the vestibular parts of it is not carried out in the required volume. If the vessels of the periosteum in this area are damaged, then the cortical plate is lost in time. In the place of the attachment of the tooth to the gum, a sagging defect is gradually formed, and with it the recession of the gum develops. Without an operation in this kind of situation is indispensable.
- Wrong / unstable oral care can aggravate the recession. From the mechanical damage of the gums during the excessive active cleaning of the teeth, the condition of the gums deteriorates, which provokes a variety of diseases. Use items to maintain oral hygiene should be very careful.
- Mechanical damage, after which a tooth dislocation occurs or its position is incorrect, also require the elimination of the recession of the gum.
- Orthodontic treatment methods often have a pathological development. The use of pressure to dislodge the teeth during therapy can eventually lead to a thinning of the gums or bone tissue itself. In addition, orthodontic constructs often accumulate plaque, which can also cause inflammation.
- Arsenic leakage to the gums in case of improper location by the dentist can injure the surface and cause disease.
- Inflammatory processes in the gums( gingivitis, periodontitis).
- Incorrect attachment of upper / lower frenum of lips.
How does the disease manifest itself?
There are several types of this pathology, each of which has characteristic clinical manifestations. However, there are common for all forms of the disease symptoms:
- Reduction of the gum level.
- Roughing of the root of the tooth.
- Increased sensitivity to temperature and chemical irritants.
- Formation of carious process.
Classification of gingival recessions
The degree of severity of the disease is divided into light, medium and heavy form. In the first case, the gum drops as much as 3 mm. In severe form, this parameter can exceed the 5 mm mark.
Depending on the degree of coverage of the oral cavity recession is local and generalized. By the way the disease progresses, visible and hidden( diagnosed by sensing) are isolated.
Traumatic recession
Most often develops in patients under 30 years, mainly on the front surface of the teeth. Root extinction reaches 1-2 mm, certainly accompanied by increased sensitivity of soft tissues and cosmetic defects. Symptoms of inflammation are extremely rare.
Symptomatic recession
Develops at any age on the lingual and vestibular surfaces of the teeth. In patients aged up to about 35 years, the pathological process can be observed in the interdental spaces of the gum.
The disease occurs due to poor hygiene of the oral cavity, leading to the appearance of dental deposits and many ailments( gingivitis, periodontitis).The recession of the gum is accompanied by bleeding, swelling, suppuration, loosening of the teeth. In the role of the cause of the disease is often a traumatic treatment of caries.
Physiological Recession
It is diagnosed mainly in elderly patients as a result of physiological aging of periodontium. Obstruction of the roots is noticeable to the naked eye. Teeth retain stability, inflammation of soft tissues is extremely rare.
Indications for eliminating the recession
- The desire of the patient.
- Excessive sensitivity of the enamel.
- Preparation for orthopedic therapy.
- High probability of carious process development.
- Progressive recession of the gum.
Necessary treatment
Therapy of this disease is necessary, as the recession can progress and cause very unpleasant complications.
Treatment, as a rule, implies surgical intervention. It allows you to restore the contour of the gum and close the exposed root. According to the Miller classification of the disease, widespread today, not every case is subject to a surgical treatment option. In the recession of classes I and II, the probability of complete closure of the root surface is very high. With disease of grade III, it is not possible to close the root surface 100%.The recession of the gum on Miller IV class is not subject to surgical manipulation.
Operative intervention
In order to cope with this disease and eliminate visible cosmetic defects, specialists 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 options are actively used in practice:
- Method of lateral flap. The flap on the leg is taken in the "donor" zones adjacent to the affected area. Plastic gum recession in this way is carried out if the soft tissue next to the tooth has the necessary amount of material. During the operation, the doctor takes a flap from the gums or from the hard palate. This method of treatment is relevant for a localized and generalized type of disease. The operation is performed using a local anesthetic option. Initially, the specialist removes existing inflammations and removes dental deposits. Then the process of forming the flap is underway. At the final stage, it is sewn up. The main advantage of the lateral flap method is the effective maintenance of the recovery period due to the 100% coincidence of the soft tissues of the oral cavity. The only drawback of the procedure, according to experts, is a manifestation of a small discomfort in the area with which the donor site was taken. It is possible that the flap is not correctly engrafted on the surface.
- Non-resorbable membranes are a classic operation. The gum recession is eliminated without serious complications. The operation consists of two stages. Initially, the doctor installs the membrane. Due to their high rigidity, they rule out the likelihood of a repeat procedure. After a certain period of time, they must be removed. According to statistical data, this kind of operation is not very efficient. Restoration of damaged tissues is not observed in full-fledged size( up to 73% of inflamed areas).Doctors do not recommend resorting to this option of therapy for patients with a diagnosis of gum recession.
- Treatment with the help of regeneration potentials of certain 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 an element of amelogenin are used. These substances contribute to the formation of healthy enamel gums and restore the structure of the roots of the teeth. The use of the enamel matrix is aimed at the formation of solid structures on the surface of the affected gingiva.
Non-surgical methods
Treatment of gingival recession with collagen is a conservative treatment for the disease. This approach to treatment is recommended only in the early stages of development of pathology, when the roots are not much stripped. Moreover, collagen gives an excellent result in the event that the recession is a consequence of inflammatory processes. With 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 measures
Do not disregard such a disease as a gum recession. Treatment should appoint a doctor based on the cause of the pathology and its form of development. To prevent her appearance, experts recommend using simple enough advice on prevention.
In the first place, it is necessary to treat caries in a timely manner, since it is he who acts as the main cause of this ailment. Equally important are regular visits to the dentist's office with a preventive purpose. The earlier a doctor diagnoses a problem, the easier it is to eliminate it with minimal health consequences.
Do not allow injuries and bleeding gums. Possible abnormalities of the occlusion are recommended to be corrected with the most gentle methods, periodically strengthen the enamel by remineralizing therapy. Particular attention should be given to the quality of oral hygiene: it is correct to brush your teeth, do not use a too rigid brush.
Conclusion
This article provides detailed information on such a common disease as a gum recession. Reviews about the treatment methods presented here are very diverse. Some patients report positive results after conservative therapy. Others talk about the rapid recovery of the affected area after treatment through surgical intervention. In any case, a specific variant of therapy can be offered exclusively by the doctor after examination of the patient, revealing the nature of the disease and its form.
The closure of the gum recession in the early stages is much quicker and easier, rather than in neglected cases. If you do not seek help from a specialist in time, the treatment will be lengthy 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!