Question:

I found out I have significant gum recession (I never noticed it as I did not have symptoms and it does not show when I smile) up to 5mm on 4 lower teeth. I was advised I definitely need connective tissue grafting as I have no attached gingiva. I do not have “gum disease” as my pockets are normal.

If I practice extremely meticulous oral hygiene from here on out, is grafting absolutely necessary? Does recession always get worse or as I have read, can it often be self limiting? The price tag for all 4 grafts by the periodontist is $5,000. I am a 49 year old female in good health but my anxiety about this procedure is mounting and I have heard that grafts often don’t work or last past a few years.

Thank you.

Answer:

There are a couple of things that we need to clarify:

1. Periodontal disease does not always present itself with pockets. Sometimes, you have shallow pockets but severe root exposures that go together with severe bone loss around teeth, which is periodontal disease.

2. Soft tissue grafting is mainly recommended for three reasons:

a. Sensitivity: So bad that you cannot touch the area and you cannot clean.

b. Increasing type of recession: Again due to not being able to clean the area.

c. Esthetics: You do not like the way it looks.

3. Soft tissue grafts have been in practice for longtime with very predictable outcome. It all depends on right indication and right surgical technique. 

For more information:

Go to the Gum Diseases health topic.