Repairing Gum Recession

The Problem

Gum recession is common in people of all ages and is the result of your teeth losing part of their bony foundation. Since bone is essentially a scaffold that holds the gums in place, this absence of bone can lead to gum recession. Also, there are two types of gum tissue, one strong and one weak. Recession is more likely in the absence of strong gum tissue called attached gingiva (gingiva means "gum"). This type has fibers that form a strong attachment to the tooth and underlying bone. The weak type lacks that attachment strength and is more prone to recession. When you have both bone loss and the weak gum type, recession is often simply the result of normal, daily activities such as tooth brushing and eating. The use of a medium or hard bristle manual brush with abrasive toothpaste and mechanical toothbrushes can speed up the recession in areas of the weak gum type.

A Great Solution

Some cases of gum recession are self limiting, but many are not. For example, recession that results from overzealous brushing or the use of abrasive, whitening toothpaste can be stopped with a change in cleaning habits such as the use of a soft bristle brush and toothpaste lower in whitening additives. Some gums continue to recede in spite of those behavior changes, which is where therapy to increase the quantity of strong gingiva comes in. This usually involves the grafting of gum tissue from one part of the mouth to a site in which gum recession has occurred.

Advances in tissue engineering have increased the probability of generating new bone and speeding healingat the same time soft tissue grafts are placed. One such approach involves the use of the enamel matrix proteins.

Enamel Matrix Derivatives (Emdogain®)

Enamel matrix derivatives (EMD's) are naturally occurring proteins found in all humans that help regulate the formation of our teeth. Like a multitude of proteins throughout our bodies, EM derivatives are building blocks within the body cells. Similar proteins are found around the developing teeth of all mammals. First isolated in the 1980s, EMD's have also been found to generate new bone around teeth and a new periodontal ligament that attaches the bone to the teeth. They have been found to clinically speed up the healing of gum tissue. Those regenerative properties have made EMD's quite valuable in the restoration of gum lost as a result of recession.

The proteins used in periodontal treatment have a porcine origin. They are isolated, processed, and prepared for "on-time" delivery during the therapy itself. Their use for treating periodontitis (bone loss from gum disease) and gum recession has been approved by the U.S. Food and Drug Administration.

Before EMD's can be applied, the affected teeth are given a through cleansing to remove tartar and bacterial plaque. Then the proteins are placed. These proteins quickly form an interactive yet invisible layer on the teeth which, in our experience, has significantly enhanced healing following treatment of gum recession.

When should I check into repairing areas of gum recession?

1. If the recession continues.
2. If the area is of esthetic concern (appearance).
3. If the root of the tooth is sensitive to hot or cold fluids.
4. If orthodontic therapy (braces) will move the affected teeth into prominence.
5. If restorations (fillings, caps, etc.) touch or go below the gum in an area of recession.
   

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