Gum Grafts

Correction of Recessions and Deficiencies

Dr Yvan Gaudex

Over time, or due to certain oral conditions, the gums may recede, gradually exposing the roots of the teeth. This is known as gingival recession. Beyond its sometimes bothersome aesthetic aspect, this condition can cause daily discomfort, increased sensitivity, and weaken the affected tooth.

Fortunately, solutions exist: gum grafting is a precise and well-established surgical procedure that restores gingival tissues and helps preserve long-term oral health.

What Is Gingival Recession?

Gingival recession is characterized by the withdrawal of gum tissue around one or more teeth. It may result in teeth appearing longer, exposed roots, sensitivity to hot, cold, or brushing, and sometimes the appearance of dark spaces between teeth (“black triangles”) caused by the loss of gingival papillae.

The causes of recession are varied:

Anatomical (naturally thin gum tissue)
Traumatic (overly vigorous or improper brushing)
Infectious (as in periodontitis)
Orthodontic (tooth movement in areas of thin bone)

In most cases, it is the result of multiple factors.

When infection extends to the bone surrounding the teeth, as in advanced stages of periodontitis, gingival recession may be accompanied by bone loss between teeth, complicating the potential for complete regeneration of these structures.

Why Consider a Gum Graft?

Gum grafting corrects the undesirable consequences of recession—functionally, aesthetically, and preventively.

The procedure aims to:

Cover exposed roots, thereby reducing sensitivity to thermal or mechanical stimuli
Strengthen thin or fragile gum tissue that can no longer withstand effective brushing without bleeding or further recession
Reestablish a healthy gum line, particularly in the smile zone where appearance is important

It is worth noting that not all recessions require grafting. A personalized evaluation is essential to determine whether treatment is indicated and which technique is most appropriate.

Types of Gum Graft Techniques

Gum grafting is a minimally invasive surgical procedure performed under local anesthesia. Two main techniques exist, selected according to the location of the defect, the thickness of the remaining gum tissue, and the desired outcome.

A small piece of gum, usually taken from the top of the mouth (palate), including both surface mucosa and underlying tissue, is transplanted to the recession site at the tooth base.
This technique provides significant reinforcement of the gum, especially in posterior or less visible areas. However, the esthetic outcome may be less natural in the smile zone, limiting its use in these cases. The palate regenerates surprisingly quickly and the same area may be harvested multiple times.

Here, only the inner connective portion of the graft—rich in collagen fibers—is harvested (from the palate or behind the second molars). It is slipped beneath the existing gum without external visibility and secured with fine sutures.
This approach is particularly suitable for anterior recessions or multiple adjacent recessions. These are considered coverage grafts.

Around Dental Implants

Gum grafts are not limited to natural teeth. They can also be indicated around dental implants when gum thickness is insufficient to ensure long-term protection of the implant crown base.

In some cases, grafting may even cover exposed metallic surfaces or reinforce gingival tissue around implants, contributing both to the long-term success of implant therapy and to improved esthetics.

Factors Influencing Success

Although this procedure is safe and well-mastered, several factors are critical to achieving optimal results:

Proper case selection, with an appropriate grafting technique for each patient
Use of specialized equipment (fine instruments, dedicated surgical setting)
Most importantly, the patient’s cooperation in following hygiene recommendations and postoperative instructions

Smoking is a major risk factor. It impairs blood supply to tissues and significantly reduces the chances of success. It is therefore strongly recommended to stop smoking at least one month before and after the procedure.

CONCLUSION

Gum grafting is today a reliable, long-lasting, and esthetic solution for treating gingival recessions and gum deficiencies. It restores the natural protection of the teeth, reduces bothersome sensitivity, and reestablishes a balanced smile.

If you notice gum recession, discomfort while brushing, or changes in the appearance of your teeth, do not hesitate to consult Dr. Gaudex. A precise diagnosis will determine whether gum grafting is indicated, helping to protect your oral health and enhance the beauty of your smile.