Dental Health Topics

Getting A Little Long In The Tooth?

Getting A Little Long In The Tooth? Receeding Gums

Did you know the expression “long in the tooth” comes from the observation that the wisest among us tend to have longer teeth? Well, not actually longer, per se, but more visible.

The reason is because as we get older, and thus wiser, our gums tend to recede. What “long in the tooth” really means, then, is that we haven’t taken care of our teeth throughout life (and that’s hardly wise!).

Regardless, there is a solution that may have been suggested to you at some point. It is what’s known as a gingival graft (or, more commonly, a gum graft).

Traditionally, there were three basic types of gingival graft: a connective tissue graft, a free gingival graft, and pedicle grafts. A new, fourth procedure – which requires no incision or suturing – is named the Pinhole Surgical Technique (PST), and was invented and patented by Dr. John Chao, a dentist from California. Here’s a little more about each procedure:

Free Gingival Graft 

In this procedure, tissue is removed from the roof of the patient’s mouth and sutured to the area surrounding the tooth where gingival recession exists.

The area where the tissue was taken heals on its own (like any other wound), and the tissue transferred to the recession area joins with the gum tissue already in existence.


Connective Tissue Graft 

This procedure is the most common among the four. It’s also less painful than a free gingival graft, because only sub-epithelial tissue (what lies beneath the outermost layer of tissue on the roof of the mouth) is taken for the graft.

This is a preferred choice when exposed roots are a cause for concern.


Pedical Graft 

Pedical grafts are done by making an incision along the gumline of a tooth adjacent to the one needing the graft, and extending the tissue from the first tooth to the second.

This procedure is less common because wear along the gumline of one tooth is typically seen along adjacent teeth as well.


Pinhole Surgical Technique 

As stated above, this procedure calls for no cutting or suturing, and is done by using a small needle to create a hole above the area in need of correcting.

Specialized instruments are then used to loosen and pull the gum tissue down or up over the receded area, and collagen strips are inserted into the pinhole to hold the tissue in place.

The procedure is faster than each of the procedures outlined above, and requires far less recovery time.


For many, there is an understandable amount of concern regarding gum graft surgery. After all, surgery of any kind tends to cause some level of trepidation, and when it comes to our mouth – an area which we consider to be sensitive to pain, our concerns can double.

If you think about it, though, our eyes are also sensitive to pain (perhaps more so), and yet three million people each year undergo surgery to correct cataracts, and more than 700,000 people undergo elective LASIK surgery.

So, fear not, a gingival graft is likely to cause some mild discomfort, but the result (a healthier mouth full of teeth and gums) can be well worth the sacrifice.