When recession of the gingival occurs, the body loses a natural defense against both bacterial penetration and trauma. As gum tissue recedes due to inadequate hard gum tissue around the teeth, bone that was under the gum tissue and enclosing the bone is also lost.
When there is only minor recession, some healthy gingiva often remains and protects the teeth, so that no treatment other than modifying home care is necessary. The first line of defense against penetration is the keratinized hard tissue around teeth. However, when there is not enough tissue (usually 2 to 3 mm are needed for health), recession will continue because the remaining mucosa is not strong enough to prevent further recession and bone loss even with careful brushing and chewing.
In addition, gum recession often results in root sensitivity to hot and cold foods as well as unsightly appearance of the gum and tooth. Exposure of the root surface, which is softer than enamel, can lead to root caries and abrasion of the root from normal tooth brushing.

before and after gum grafting
A gingival graft is designed to solve these problems. A thin piece of tissue is taken from the roof of the mouth or gently moved over from adjacent areas to provide a stable band of attached gingival around the tooth. The gingival graft may be placed in such a way as to cover the exposed portion of the root.
The gingival graft procedure is highly predictable and results in a stable healthy band of attached tissue around the tooth. However, if recession is allowed to continue, complete coverage of the root may not be possible because of the bone loss caused by gum recession.
Factors that predispose people to recession of their gum tissue include genetics (people with fair and delicate skin are more prone to gum recession), use of medium or hard toothbrushes, clenching and bruxing of the teeth, excessive force when brushing teeth and a history of orthodontics.
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