Recession refers to the process by which the roots of the teeth become exposed.  There are many reasons this can occur, including trauma, aggressive brushing and periodontal disease.  Significant problems, such as caries, sensitivity and eventual tooth loss may result from such exposure.  Gum (gingival) grafting refers to a group of periodontal plastic surgical procedures that aim to cover the affected roots. 

Here are some of the most common types of gum grafting:

• Free gingival graft – Although this procedure does little to cover exposed root surfaces, it is highly effective at strengthening the gum tissue ADJACENT TO the affected tooth.  Donor tissue is removed from the surface of the posterior palate and relocated to the recipient site.  Post operative discomfort and the development of more advanced techniques render this type of grafting somewhat obsolete.  However, it is occasionally indicated.   
  
  
• Subepithelial connective tissue graft – This procedure is commonly used to cover exposed roots.  Deeper layers of palatal tissue are used as the donor material.  Significant root coverage is usually achieved.  Superior esthetics and patient comfort make this technique very popular. 
  
  
• Acellular dermal matrix allograft – This procedure uses medically processed, donated human tissue as a source for the graft.  The advantage of this is procedure is that there is no need to harvest donor tissue from the patient's palate. 

Reasons for gum grafting

Here are some of the major benefits associated with gum grafting:

• Reduced sensitivity – When a tooth root becomes exposed, severe temperature and tactile sensitivity often develops.  Covering the exposed root helps reduce this discomfort .
  
  
• Improved appearance – Gum recession and root exposure make the teeth look longer than normal.  Gum grafting restores the symmetry and natural contours of your smile. 
  
  
• Improved tooth and gum health – Root surfaces exposed by recession are more vulnerable to decay.  Covering these roots not only reduces the risk of caries, but also strengthens the tooth by increasing its support.

What does gum grafting treatment involve?

As with other surgical procedures, gum grafting is performed with local anesthesia.  The exposed roots are thoroughly cleaned, smoothed and conditioned.  The donor tissue (whether from the palate or an FDA approved tissue bank) is secured to the root and adjacent jawbone, covered with a layer of adjacent gums and sutured.  A waterproof dressing protects the graft site during the initial stages of healing.  Once the sutures are removed, the patient is given extensive oral hygiene instruction, ensuring the long term health and stability of the graft and  minimizing the risk of recession in other areas. 

If you have any questions about gum grafting, please ask your periodontist or dentist.