Treatment of gingival recession

Both preventing gingival recession from getting worse and carrying out any surgical treatment that may be indicated require certain changes in behaviour. On the one hand, the oral hygiene technique should be conscientiously optimised and, if necessary, even corrected. Only then can the treatment results achieved be successfully maintained.

Users of snus and smokers must also stop using tobacco, as otherwise no surgical measures to cover the exposed root surfaces can be carried out.

Changing behaviour takes time. Regular visits to the dental hygienist or prophylaxis assistant make it possible to address unhealthy contributing factors and to plan successfully how to change them.

During professional teeth cleaning, the dentist, dental hygienist or prophylaxis assistant systematically cleans all tooth surfaces. In gingival recession, cleaning and smoothing the exposed root surfaces colonised by bacteria is particularly important.

Professional teeth cleaning also removes all obstacles that can make optimal oral hygiene at home more difficult. These include in particular tartar deposits above the gum margin and overhanging crown or filling margins.

Carrying out optimal oral hygiene at home regularly is a great challenge. Cleaning between the teeth conscientiously also takes a little more time. Furthermore, the special cleaning of areas with gingival recession is not always easy. There are special oral hygiene aids for these areas, so-called single-tuft brushes. These are selected individually for each situation in the mouth, and the dentist, dental hygienist or prophylaxis assistant gives instruction in their correct use.

For further information on oral hygiene instruction, see also https://www.oralhygiene-instruction.com.

A few weeks after professional teeth cleaning, the overall situation is reviewed again. At this follow-up, the main point checked is whether patients can clean their teeth well with their oral hygiene at home.

In the course of gum treatment, patients learn an oral hygiene technique adapted to their situation. Good cooperation with optimal oral hygiene at home determines the success of the entire treatment.

To correct gingival recession successfully and cover the exposed root surface, a surgical procedure is required. In this treatment under local anaesthetic, the patient's own gum is moved back to its original position using suitable incisions and suturing techniques. A tissue graft from the patient's own palate can help to increase the thickness of the gum and thereby improve the stability of the tissue.

The sutures must be left in place for a few weeks to allow healing and must be checked regularly. During this time, the wound area must not be cleaned mechanically with oral hygiene aids. Rinsing with a suitable chlorhexidine mouthwash twice a day can bridge this period well.

Once the new gum margin has healed completely, the teeth there must first be cleaned carefully and then with the correct oral hygiene technique.

Where gingival recession is not perceived as aesthetically disturbing but the affected teeth are hypersensitive, treatment with fillings at the tooth neck may be indicated. The teeth concerned will then still look the same length. However, sensitivity to cold temperatures is significantly reduced and the missing tooth substance is replaced.

If there is decay on the exposed root surface, the decay is removed and the root is then covered with filling material.

After gum treatment, long-term success over several years is only ensured if patients practise optimal oral hygiene at home and thereby successfully prevent their gums from developing gingival recession.

For optimal long-term success, it is also important to maintain continuous professional long-term care in the dental practice, so that any recurring problems can be detected and dealt with in good time.

Dentists will have had theoretical and practical training and testing in the examination and treatment of gingival recession during their study of dentistry. With this training, they can treat cases that are not too advanced on their own. In advanced training courses and other events offered by universities, national periodontal societies and other institutions, this basic knowledge can be deepened.

The treatment of difficult cases, which include in particular more advanced gingival recession in adolescents and adults, requires specialist knowledge and an infrastructure that guarantees seamless long-term periodontal care. The general dentist (family dentist) can refer such patients to a periodontist.