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What are receding gums are and how they are treated

What are receding gums are and how they are treated

This is not a subject specific to orthodontia, but several people have written to me asking about receding gums in orthodontia and what can be done to fix them if there is an existing gum problem.

This problem, and all gum diseases, falls within the scope of periodontics. This is the branch of dentistry that deals with the gums and the alveolar bone, the bone into which the teeth are inserted.

In orthodontia, we work closely with specialists in several branches of dentistry, but especially with specialists in periodontics. Multidisciplinary treatments involve several branches of dentistry such as periodontics, orthodontia, prostheses and aesthetics.

Before orthodontic treatment, it must be verified that the gums are not inflamed and that there are no signs of active inflammation or gum disease. If there is gum disease, treatment is postponed until this disease is resolved. If it is not resolved prior to orthodontic treatment, the teeth may never recover their fixation in the bone and may even fall out.

What to do if the gums are receding

What can be done if one or more teeth have receding gums (“shrinking” gums) before or after treatment.

In April, I published this case in which the gingival biotype was so thin that it was decided to remove a lower incisor. It can be seen that the state of the periodontium (gums) improved after treatment.

It must be emphasised that the gingival biotype or thickness and type vary depending on the person and that, obviously, a person with more delicate, thinner gums with a thin biotype could have more problems than a person with thicker, stronger gums.

In 1985, Miller proposed a classification taking into account the different forms of receding gums. This classification has a therapeutic objective and is currently the most commonly used classification. It divides receding gums into 4 classes according to their severity (Miller PD. A classification of marginal tissue recession. Int J Periodontics Restorative Dent 1985;(2):8-13).

The treatment for receding gums that are treatable tends to be a surgical procedure in which gums are taken from another location in the mouth and placed where they are needed (gum graft).

Some very nice cases by Dr Augusto Quinteros in Barcelona are shown here (photos before and after).

Gum graft (adding gums)

antes y despues de Injerto de encía

Gum graft (adding gums)

Injerto de encías

Gum graft (adding gums)

It can be seen, after lifting the gums, that the bone defect is higher than what is seen in the mouth.

Injerto de encía tratamiento

Gingivectomy

(removal of a part of the gums) to even out the gum lines

Gingivectomía en margenes gingivales

Regardless of the type of braces — incognito invisible lingual bracesInvisalign or any other type — the gums have to be in their best state of health.

For further information please contact us by telephone (+34) 93 832 72 81.

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