Tooth brush abrasion is commonly blamed for gingival recession. In reality, the cause is usually multi-factorial. Proper diagnosis of the etiology for gingival recession is beneficial to providing a successful treatment.
Gum Recession Before Treatment
Pre-treatment photograph of tooth #24 shows gingival recession of 6mm. It is interesting to analyze the etiologic factors. Our hypothesis is as follows: The presence of a high frenum (yellow arrow) prevented the patient from thoroughly keeping the area clean. The patient had learned that bumping her frenum with a toothbrush was painful. As a result, she shied away from cleaning the area. This led to plaque accumulation at the gingival margin. Because the gingival attachment was weak (due to their being no attached tissue) the gingiva receded. The condition is further complicated by the buccal positioning of the tooth and occlusal interferences. Without treatment periodontal deterioration will likely continue leading to tooth loss.
Gum Recession After Treatment
Post-treatment photograph shows considerable improvement in the periodontal health. Gingival grafting along with a frenectomy has achieved 1) Complete root coverage and 2) An increase in protective keratinized attached tissue. This new attache d tissue if firmly bound down to the underlying tooth and alveolar bone. Having a level gingival margin will also assist more effective
home care efforts. The prognosis for tooth retention has improved greatly.
Waiting Too Long For Treatment
IF GINGIVAL RECESSION PROGRESSES, IT CAN REACH A POINT WHERE REPARATIVE EFFORTS ARE NOT AS PREDICTABLE. A FEW EXAMPLES OF THIS ARE SEEN BELOW: