Why is gum grafting sometimes required pre orthodontic treatment?
Studies over the past 4 decades have examined the correlation between gum grafting and orthodontic treatment. These studies mainly focus on the severity and type of gum recession and thickness of the tissue pre and post orthodontic treatment. The authors have shown that orthodontic treatment before gum grafting will increase the severity of gum recession when a patient presents with a mucogingival defect. Multiple factors contribute to the reason why patients have recession. The current patient, shown below, demonstrates lower left recession due to a combination of thin biotype “gum tissue”, tooth mal-position, and mechanical trauma (smokeless tobacco). A Free Gingival Graft was utilized to gain root coverage and increase the thickness and amount of keratinized gingiva. After 4 weeks of healing the surgical site was re-evaluated. Surgical outcome included both root coverage and increase in the amount of keratinized tissue. However, I noted slight inflammation due to the patient’s lack of home care and bacterial plaque removal. Therefore, I reinforced the importance of hyigene to the patient. Based on professional experience and supported by countless studies, if the current patient had started orthodontic treatment a increase in the amount recession would be unavoidable and even tooth loss. If you have sensitive teeth and gum recession, schedule a exam before it gets worse.