Like Mother Like Daughter?
Question:
Many years ago I went to my dentist for a checkup. During my exam, he told me I had recession. I know that, because I could see it and I also had hot and cold sensitivity on my roots. He said that I had notching of my roots, which he showed me was right near my gums. He said I needed fillings in those notches and that it would not only fill the teeth, but take away the sensitivity. He did it and it worked. The fillings covered my roots and the gums stayed generally at where the fillings ended. It was straight forward and I thought nothing of it. I’ve had them replaced over time, but it has been a good answer. We now have a new dentist, who is taking care of my children. A month or so ago this dentist sent us to the periodontist (gum specialist), because my daughter has recession. The periodontist said my daughter needed several gum grafts to cover her roots. When I told him of my experience he said I was lucky no further recession had occurred. He did point out that my daughter had notches in her teeth and when I asked about filling them, he said the notches would get smoothed and covered with the graft. I went away with more questions than before the appointment. Why should I do expensive surgery and subject my daughter to pain? Why can’t we just do what I had done? I’m really confused.
Answer:
It’s difficult to give you a direct answer. The reason for that is because I would have to know what kind of gum-tissue your daughter has around each tooth and in what quantities. Gingiva (gum-tissue) is of two types. The first is the kind that is bound tightly to bone. A good example of this is the gum that covers the palate. It is immovable and is called attached gingiva. It serves many purposes, but one, most important to your daughter, is to protect and stabilize the bone covering the roots of her teeth. A good analogy of attached gingiva would be lawn grass planted in top soil. Once the grass is mature the top soil will not erode away. If your daughter doesn’t have adequate attached gingiva and she’s got significant recession, she should have the type of gum graft that covers the root because the notches (if they’re not deep and can be shallowed out) will be covered by new attached gingiva created by the gum grafting. This is a plastic surgery technique called a “connective tissue graft”. If the notches are deep and the attached gingiva is inadequate, you might have to have fillings placed and a different grafting procedure done, because the connective tissue graft won’t attach itself to white filling material.
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Based on actual patient cases.