Periodontal plastic surgery

One of the most frequent reasons for consultation regarding the aesthetics of the smile is receding gums, that is, when the gum tissue lifts (upper teeth) or lowers (lower teeth) its position on the teeth. Periodontal plastic surgery is the solution to these problems.

The effect makes the teeth appear longer, or at least longer than the adjacent teeth. The recession can also be accompanied by sensitivity to cold or heat, inflammation in the area, and pain during mastication and brushing.

Cause

The most common reason of gum recession is brought about by an inappropriate brushing, either due to excessive or too intense brushing, or due to fault, leading to bacterial inflammation and eventually to receding gums.

Treatment

The treatment aims to identify and eliminate the cause of the recession, as well as covering it. The microsurgical technique, named subepithelial connective tissue graft, is simple and painless.

The success of treatment is directly related to the originating cause and the technique used to cover the recession. Once again, the success largely depends on the surgeon’s surgical expertise too.

Periodontal plastic surgery treatments are performed by Dr. David González, Periodontics Specialist.

How is periodontitis diagnosed?

The final diagnosis is based on the medical history, the x-ray study and the teeth and gum examination. An exploration is vital in order to check whether bone tissue surrounding every tooth has been lost.

These measures are recorded in a periodontal chart which helps us to draw a “map” of the bone and supporting tissue of each tooth.

What causes periodontitis or pyorrhea?

This illness is caused by bacteria living in the mouth, around the teeth. If they are not eliminated, they invade the groove between the gum and the teeth (the gingival sulcus), and their reproduction leads to swelling and tissue destruction.

Bacteria on their own are not capable of causing these illnesses. They need a vulnerable individual (genetic predisposition). Also tobacco, stress, old age, malnutrition or excessive alcohol consumption are major risk factors which lead to bacteria colonization. The genetic factor is very important.

Some individuals are more likely to accumulate plaque (dirt), but their supporting tissues withstand this attack. Nevertheless, in other individuals the disease progresses quickly and aggressively. That is why it is extremely important to know if there is prior family history of this type of diseases.

What are the symptoms of periodontitis?

Neither gingivitis nor periodontitis (in their first stages) hurt, and that is why sometimes their progress goes unnoticed. The clearest symptom of gingivitis is spontaneous bleeding or when brushing your teeth. Smokers might not notice this due to the tobacco’s vasoconstrictor effects.

Patients with periodontitis suffer from symptoms such as receding gums (longer teeth), appearance of spaces between teeth, teeth mobility, increased sensitivity to cold, gumboils and, sometimes, burning sensation.

They usually have red or swollen gums, feeling of bad taste in their mouths, or they report having bad breath and spontaneous gum bleeding during brushing or meals. Periodontitis might hurt but generally this is not the case, and that is why it usually goes unnoticed by the patients.

Also, smokers must take into account that they have decreased blood flow and therefore their gums bleed less. This contributes to the disguising of the periodontitis.