
Dr. Yola Kovalenko
تُعد د. يولا كوفالينكا من الكفاءات الطبية المتميزة في مجال طب الأسنان. تخرجت من جامعة لوغانسك الطبية الحكومية عام 2007، وكانت ضمن أوائل خمسة طلاب على دفعتها، وه…
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Gum recession is the migration of the gum margin away from its normal position so that part of the tooth root becomes exposed. The tooth looks longer, a darker band appears at the gum line, and the exposed root often turns sensitive to cold air, cold drinks and brushing. Treating gum recession is not one operation: it is a plan that begins by removing the cause and only then considers surgical root coverage where there is a clear indication for it. The causes seen most often in practice are aggressive horizontal brushing or a hard-bristled brush, long-standing plaque and calculus with chronic gum inflammation that erodes the thin bone plate in front of the root, a genetically thin gum biotype, a root sitting outside the bony arch because of crowding or rapid orthodontic movement, night-time clenching, filling or crown margins that encroach on the gum, a tight mucosal frenum that pulls the gum margin whenever the lip moves, and lip or tongue piercings. Non-surgical care comes first: correcting brushing technique and switching to a soft brush, removing calculus and smoothing the root surfaces, desensitising the exposed root with in-office agents or a dedicated toothpaste, reshaping an offending restoration, providing a night guard for grinding, and charting every recession site so the dentist can tell whether it is stable or progressing. Many shallow, stable recessions need nothing beyond monitoring and a change of habit. Surgery is considered when the recession is progressing, when sensitivity or root wear persists, or when the aesthetic impact is genuinely troubling. Options include a connective tissue graft harvested from the palate, tunnel and coronally advanced flap techniques, and processed graft substitutes. The choice depends on tissue thickness, defect depth and the condition of the papillae between the teeth. The limits matter as much as the technique. Root coverage does not rebuild bone that has already been lost, it cannot recreate an interdental papilla that has disappeared, and it treats neither decay nor staining. It also will not prevent recurrence while the original cause continues. Not every site is a candidate: where bone between the teeth is significantly reduced, expected coverage is lower. Suitability is decided by clinical examination, pocket measurements and tissue assessment, never from reading an article or from a phone photograph.
The dentist measures the amount of recession at each tooth, pocket depths and tissue thickness, takes radiographs, and asks about brushing technique, clenching, nearby restorations and previous orthodontics, to establish whether the recession is stable or progressing and what is driving it.
Calculus removal and root smoothing, hands-on coaching in gentle brushing with a soft brush, correction of any offending filling or crown margin, and a night guard if grinding is present. The site is then reassessed after some weeks, and in mild stable cases the plan ends here.
Under local anaesthesia the exposed root surface is cleaned and conditioned to receive tissue, and the incision or tunnel is designed to disturb the interdental papillae as little as possible, since preserving them underpins the final appearance.
A thin connective tissue graft is harvested from the palate, or a processed substitute is used when a second surgical site is best avoided. The graft is secured over the root, the gum is advanced or tunnelled over it, and fine sutures are placed. The palate is protected with a dressing or a plate to reduce discomfort.
Reviews in the first and second week to check healing and remove sutures, then re-measurement of coverage and tissue thickness after some months, alongside a maintenance schedule and a permanent change in brushing habit, because recession returns if the cause persists no matter how well the surgery was done.
Tell your dentist about every medication you take, especially anticoagulants, antiplatelet drugs, bone-density medicines and steroids, and do not stop any of them on your own. Mention chronic conditions such as diabetes, high blood pressure or any immune disorder, and any previous drug allergy. Complete the scaling appointments prescribed before surgery and keep brushing gently and flossing until the day of the procedure, because clean gums improve graft attachment. If you smoke, stopping before surgery and through the healing weeks improves blood supply to the graft. Eat a light meal beforehand if only local anaesthesia is planned, and arrange a driver if you will be sedated. Stock soft cold foods and ice packs at home, and set aside two days of relative rest.
Apply cold packs to the outside of the face at intervals during the first hours, and sleep with your head raised on the first night. Do not brush or floss the surgical site until your dentist allows it, keep the rest of your teeth clean as usual, and use the prescribed rinse exactly as demonstrated. Avoid drinking through a straw, strong water jets, and hard, spicy or very hot food, and do not lift your lip to inspect the site in a mirror or with your fingers, because that breaks the early attachment. Avoid smoking for at least the first healing week. Mild swelling and discomfort at the palate are expected and settle gradually. **Seek care immediately if bleeding does not stop after twenty minutes of continuous pressure with clean gauze, if swelling increases after the third day with fever or pus, if pain increases instead of easing, if you have difficulty swallowing, breathing or opening your mouth, if a wide white area becomes exposed at the graft site or the sutures come away early, or if numbness persists.**
Usually 45 to 90 minutes per surgical session depending on how many teeth are treated, performed under local anaesthesia.

تُعد د. يولا كوفالينكا من الكفاءات الطبية المتميزة في مجال طب الأسنان. تخرجت من جامعة لوغانسك الطبية الحكومية عام 2007، وكانت ضمن أوائل خمسة طلاب على دفعتها، وه…

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