Two main concerns of dentists and patients are related to gingival contours. The first is recession, which is shrinkage of the gum that exposes the root surface. When the root is exposed it can be unsightly, sensitive, and is more susceptible to decay. Gum grafting procedures may be employed to not only prevent further recession, but in some cases may also cover some or the entire exposed root.

The second is inadequate crown exposure. Crown lengthening techniques can lower the gum level to expose more tooth structure to create a natural smile line.

Gum Grafting Procedures

When recession of the gingiva occurs, the body loses a natural defense against both bacterial penetration and trauma. When gum recession is a problem gum reconstruction using grafting techniques is an option.

When there is only minor recession, some healthy gingiva often remains and protects the tooth, so that no treatment other than modifying home care practices is necessary. However, when recession reaches the mucosa, the first line of defense against bacterial penetration is lost.

In addition, gum recession often results in root sensitivity to hot and cold foods as well as an unsightly appearance to the gum and tooth. Also, gum recession, when significant, can predispose to worsening recession and expose the root surface, which is softer than enamel, leading to root caries and root gouging.

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 gingiva 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 predictable and results in a stable healthy band of attached tissue around the tooth.

Crown Lengthening

When decay occurs below the gumline, it may be necessary to remove a small amount of bone and gum tissue. Your dentist may ask for this procedure before he or she makes a new crown for your tooth.	Reshaping The Gum and Supporting Tissues: This will allow your general dentist adequate room to place a quality final restoration.	Final Restoration: another indication for crown lengthening is when the front teeth are too short or of uneven length.

Ridge Preservation/ Prosthetic Facilitation
Over a period of time, the jawbone associated with missing teeth atrophies or is reabsorbed. This often leaves a condition in which there is poor quality and quantity of bone suitable for placement of dental implants or proper design of fixed bridgework.

We now have the ability to grow bone where needed. This gives us the opportunity to place implants of proper length and width, and it also gives us a chance to more effectively restore esthetic appearance and functionality.

Careful management of extraction sockets at the time of tooth extraction prevents unsightly bone loss and a better cosmetic outcome of tooth replacement.