Hi there,
I wore braces for several years when I was in high school and when they came off, I was in fifth year of high school.
Since at that time I neither knew nor had they explained to me what hygiene was like with orthodontic treatment, when they removed the braces, I had many cavities. I don’t remember how many I had, but for me there were a lot and since the dentist I had at that time was very abrupt, the process of fixing the cavities was traumatic.
From there, I started brushing my teeth super hard. At my next annual checkup, the dentist told me that I was brushing too hard and was wearing down my gums.
I was 17 years old.
Years later, when I went to live in Spain and began to do my annual cleanings at the Covadonga Balaguer Orthodontics, they told me that I had a bit of gum recession in some of the lower teeth.
In the summer of 2022, the doctor told me again that I had a bit of gum recession, but since it was not her specialty, I should see a periodontist.
She recommended a clinic in Valencia, and I really liked the doctor’s attention. This doctor wrote down all the teeth in which I had recession to follow up and suggested that I do a gum graft on 7 teeth.
The graft would be done in 3 phases since it was not possible to extract all the gum from the palate at one time. So, they would do the graft on three teeth, we would wait 4 months for the palate to heal, then 3 more teeth, another 4 months for the palate to heal and the last tooth.
In addition, he told me that I would have to rest for a week after each surgery.
Total price: around 1600 euros
The consultation was in July, and I only had August available. Since everyone in Spain goes on vacation for the entire month of August, I left it for when we settled in Porto.
While in Porto, I went to a clinic called João Desport Dentistas since the insurance broker had told me that his brother-in-law worked there, and he was very good.
I went to the consultation and the doctor told me that the problem came from the fact that my orthodontics was not correct and that I was clenching my teeth a lot. He told me that I would have to get orthodontics again.
This doctor proposed to give me a gum graft on 10 teeth. Supposedly he was going to do all the teeth in the same session and when I asked him again if he would have enough donor for all 10 teeth, he already told me that we would see on the day of surgery if it was enough or not.
Graft price: 1200 euros. In addition. The consultation was almost 150 euros, the most expensive I had ever paid in my life.
Something that left me traumatized is that he told me that I could even lose some teeth if I didn’t have the surgery.
So, I kept that idea in my head since October 2022. I made an appointment for the surgery, but later I canceled it because I preferred to seek another opinion.
Then I went to the Luso Espanhola Clinic. I was attended by the dentist who did the x-ray and the photos to later consult with the periodontist and give me the budget. I waited 3 months, and they were not able to send me the budget. I mean, I lost the 55 euros of the consultation.
Then I was recommended the Ruy García Clinic. The consultation was free.
I was treated by a Brazilian dentist who had crooked teeth and he himself had gum recession in a couple of teeth. He also told me that my gum recession was caused by clenching my teeth a lot and he suggested the following:
- Gum graft on a single tooth: 800 euros
- Occlusal adjustment: 500 euros
- Retainer for bruxism: 300 euros.
An orthodontist also saw me and said that my orthodontics “wasn’t so bad”, but that, if I wanted 100% perfect teeth, she charged 4,100 euros for the invisalign treatment.
That night I was traumatized because each person told me a different thing.
I know that my gum recession comes from brushing too hard and I think that recession hasn’t increased (or hasn’t increased much) since I was 17 years old. But none of the dentists who had treated me had considered this as a cause.
Also, if I had bruxism, my teeth would be worn down and I would have already broken the retainers.
I decided to ask Sandra, a friend from school who is a dentist and lives in Australia. I also sent her a picture of my teeth.
The first thing she told me is that in the photos you could see that the recession was due to brushing. If it were to clench the teeth too much, the recession would be in the molars.
In addition, she told me that in Australia gum graft surgery was not performed for something as minor as my case.
Another very important thing that she told me and that no one had explained to me so far is that gum grafts are unpredictable, so it can go wrong and even recede the gum even more.
In Australia, a gum graft is done when you have a centimeter of recession, and the tooth is already moving. Since there is already a risk of the patient losing the tooth, the gum graft is the last attempt to save the tooth.
Sandra told me that she would put resin on the exposed root to prevent wear from brushing.
With this explanation I was calmer.
As I had not yet found a periodontist in Porto, I wrote to Covadonga to see if she could please recommend someone of trust in Porto.
She gave me the contact of Dr. Ricardo Faria Almeida from CEPI (Center for Aesthetics, Periodontology, and Implants). I sent an email commenting on my case and this time I said that what I wanted was to monitor the recession to see if it increased or not and, in the future, do the graft if necessary.
https://bqdentalcenters.pt/dentistas-confianca/dr-ricardo-almeida/
The doctor answered me directly in Spanish, and I made the appointment.
In the consultation he also spoke to me in Spanish and explained things that none of the other specialists had explained.
Gum recession can have many causes and clenching is “one of the hypotheses” that are evaluated in these cases, but he ruled it out since my teeth were not worn out.
He also did not believe that it was an orthodontic problem since there was no tooth that was colliding with any other.
He told me that when performing any type of orthodontics in which the bone is pushed forward, there is always the risk that in the future there may be gum recession, which was normal.
In his opinion, my case was not serious and since it was obvious that I had very good dental hygiene, it was not a danger that I could have cavities or tartar.
If I wanted, for aesthetic reasons, I could have the graft done, but it was not necessary for health reasons.
He told me that two teeth had to be paid special attention because they had 3 millimeters of recession, but that it was nothing serious.
He ruled out that I could lose teeth due to gum recession, so I could be calm after the fear that the first dentist in Porto had given me.
I told him everything that Sandra had explained to me, and he confirmed that gum grafts were never 100% good because there were many factors that influenced the result.
Something very important is that, if you have the surgery, it is not only that you must rest for a week, but you must avoid even talking and eating as much as possible.
He also told me that the longer one waits to do the graft, the more likely it is that it won’t be 100% right.
In cases where many teeth must be grafted, Dr. Ricardo prefers to use a collagen matrix to do everything at once because if you must wait 4 months each time for the palate to heal, the procedure becomes endless and too expensive.
Regarding placing resin on the root, he told me that he did not recommend it because it could cause more recession as the gum moves away from foreign bodies.
Consultation: 60 euros
I made the appointment in 6 months for dental cleaning and to follow up on the recession.
So, it is important to know if you have gum recession:
- Gum recession can occur due to multiple factors, brushing too hard, bruxism, bad position of the teeth, after orthodontics, poor dental hygiene (tartar), etc.
- If the recession comes, for example, from two colliding teeth, first you have to get orthodontics and when the teeth are in the correct position, you can have a gum graft.
- I would not advise anyone to have an occlusal adjustment. For that, you better get orthodontics.
- If the recession comes from brushing, you must improve the technique and the brush.
- When the recession starts, it’s important to follow up with a periodontist to see if it continues to progress. There are cases in which the recession stops and does not continue advancing.
- If you need a gum graft on many teeth, some professionals recommend using a collagen matrix to be able to do it all in one session.
- The result of the gum graft depends on several factors and it is likely that it will not be perfect.
- The rest after a gum graft is very strict and you have to avoid even talking and eating.
- Your gum recession is dangerous if your tooth moves, if you have a red gum line, if the gum line moves or detaches from the tooth.
