Why do your gums leave you and how can you bring them back home?
Quite often, very young girls, 20-25 years old, come to see us, whose teeth are quite straight and everything is fine with them in general. The chewing teeth look almost perfect. And the front group of teeth, from canine to canine, are worn down very badly, as if their owners were already in their sixth decade. Of course, this should not be the case, and this is a warning sign that you need to act urgently. Namely, remove the recessions and deal with the bite.
Compare the canine tooth and the adjacent tooth, for example
Does it hurt?
In general, it doesn't hurt. The operation is superficial, there is no need to drill the bone or get somewhere deep, we only anesthetize the soft tissues. So everything is tolerated quite easily.
True, there are two unpleasant moments.
Firstly, it takes a long time: if there are several teeth, the transplant can take two to three hours.
Secondly, the recovery period after such an operation is quite unpleasant. Anyone who has ever burned their palate with hot tea can imagine how disgusting it is to live for several days without a piece of mucous membrane at all. To make life easier for the patient, mouth guards were invented that can be put on after the operation and worn until everything heals. And also composite protective plates that are placed on the palate after the transplant is taken. Such life hacks allow you to reduce postoperative pain and suffering to a minimum.
And sometimes patients send me video reports in which they look like victims of domestic violence who also ended up in an apiary – with hematomas, swelling and dark circles under the eyes – and they say that everything is fine, nothing hurts. Of course, we warn about bruises and swelling. They do not appear in everyone, but they do happen.
Not all recessions are the same
They can be wide or narrow, and are generally divided into four classes:
1 – recession within the free gum, without atrophy of the gingival papillae and bone septa, it can be cured completely.
2 – recession within the attached gum, it is also 100% treatable.
3 – recession with damage to periodontal tissues and contact surfaces, and here it will no longer be possible to completely close the root.
4 – circular atrophy of the gum and bone, when the gum recedes not only from the front, but also from the sides, the gingival papillae also “dissolve” and transplants have to be planted from all sides at once. Here, the gum is generally very difficult to restore, and this is not always possible.
Sometimes at stage four we restore only the thickness of the gum and adjust the volume by height. But this is more of a stabilization of the condition than a full-fledged treatment.
That is, it is necessary to cover the teeth with mucous membrane patches literally from all sides
And still it is not possible to completely restore the gums
In general, the smaller the recession, the simpler the treatment, the more predictable the result and the smaller the amount on the check. And the cheapest thing is prevention.
By the way, about the cost. I always warn my patients that if they are not planning to have surgery right now, they need to monitor the recession very carefully and run for treatment as soon as it starts to increase (if it starts, of course). Because a simple operation costs about 30-35 thousand for one tooth, and for a complex one you will have to pay about 60 thousand.
By the way, it is not always possible to operate on one tooth
Just a couple of days ago I had a consultation with a girl whom I will soon operate on. And her story is quite sad. She has already had gum transplants to her central lower incisors twice and they have never been successful.
Initially, she asked to operate on only one tooth. But her situation is such that it is absolutely impossible to operate on one tooth. The lower incisors are generally very difficult from a surgical point of view, because the gums in this area are thin, the roots are narrow, and the teeth themselves are close to each other. It is technically impossible to operate on one tooth: to close this single recession, you need to do four at once. And to do this, take a longer transplant and place it behind the teeth that are on the sides, so that it can feed on them and survive. Not because the doctor wants a lot of money, but because a small flap simply will not take root. Which, in fact, happened to her twice in a row.
And a couple of stories for last
I remember with great warmth the stories from the series “the eyes are afraid, but the hands are doing”, when I did not know at all which side to approach the patient from, but in the end it turned out well. For example, right now I am in the midst of treating a person who lives in two countries – Russia and Turkey. It so happened that I stitched up his recession here, and another doctor had to remove his stitches there. We spent a long time looking for a good clinic for him with a doctor who speaks Russian. In the end, we found one, and this Russian-speaking doctor then admired our surgery for a long time and said that it was a shame to remove such stitches, no one does them in Turkey. He did not even see the threads with which the stitch was made.
And a separate question is what to do with those who first put in beautiful crowns, inlays or veneers, and then discovered a recession on the gum. Veneers do not have an expiration date, and it is simply a pity to pick at them if there are no chips or cracks, the hygiene is good and the color is acceptable. Another question is that there are stories like my patient, who put in an expensive inlay in Switzerland, and a month later came to us for an examination, and I saw in the photo that it had already cracked. But if everything is fine with the veneers, then I have only good news. Because you can deal with the recession without removing the restorations.
I had a patient who had ten restorations on her upper teeth, from the fifth to the fifth, about seven years ago. The veneers turned out to be very beautiful, high-quality, and durable. And about three months ago, she discovered recession on two front teeth. The girl is a doctor herself, she knows very well what recession is, so she did not put anything off and came for treatment right away. I operated on her, the gums healed, the veneers were not damaged.
In general, to sum it up, gum recession can happen to anyone, there is no need to be afraid of it, but I also do not advise delaying treatment.
