Red aesthetics – gum grafting

Many people do not necessarily think of dentistry when they think of “red and white”, yet “red and white” is a central issue in aesthetic dentistry. The so-called “white esthetics” stands for beautiful teeth. They should be even and bright. Naturally. However, a harmonious, arched gum line is also essential for a beautiful smile – the “red esthetics”. Gum grafting can optimize the smile.

Disharmonies are mainly caused by asymmetries, too much gum (“gummy smile” or too little gum (recession). Modern microsurgical procedures offer the possibility of restoring a harmonious image. With gum grafting, a lot can be done to regain the youthful beauty of the gums. And not only that. Rosy prospects.

The dental specialist Dr. Christopher Köttgen with practice in Mainz, with its specialist practice for aesthetic dentistry, is one of the few medical practitioners to provide a remedy for massive gum recession and the associated exposure of the necks of the teeth with a gum graft. Rosy, healthy gums that close at the neck of the tooth is not only a question of appearance, but also has far-reaching medical consequences.

Dr. Köttgen: “The reduction of the gums simply disturbs some patients when they laugh, and this can be corrected. This is now standard practice in the USA. But the matter goes much further. Gum protection and thus, if necessary, the indication for grafting is also important from a periodontological point of view!” Dr. Köttgen reasons, “Once the tooth necks or even the roots are exposed, they are susceptible to caries and react even more sensitively. Toothbrushing attacks by the wrong brush, brushing technique or toothpaste additionally injure the otherwise protected tooth root.” In addition, exposed tooth necks are often sensitive to pain.

Gum grafting – a long-term solution

Dr. Köttgen is very satisfied with the long-term results of the gum transplantations he performs. Therefore, in the field of gum reconstruction, grafting is now the “gold standard” for him.

In his eyes, the main cause of gum recession (recession) is usually “incorrect anatomy”. Dr. Köttgen: “This means an incorrect relationship between tooth size, root thickness and bone thickness.” First of all, the patient can’t do anything about it. But if the wrong brushing technique is used, the situation usually gets worse. “The famous scrubbing from left to right is problematic,” says Dr. Köttgen. “If you then use a brush that is too hard or worn, you damage the gums and they retract.

Moderate trauma after gum correction

Transplantation of tissue from the palate is now “state of the art.” “The modern methods make the trauma to the palate tolerable – the pain is about comparable to being burned on a hot pizza.”

The pain is easily tolerated these days and subsides after a few days, the dental specialist assures, with some patients reporting that they managed with just one pain pill the day after treatment. In addition, a special dressing plate on the palate would protect the sore area. Medications also help prevent wound infection. “Very important in the therapy is also the application of the protein endogain,” emphasizes Dr. Köttgen. He adds that this perfects this long-term treatment method. The messenger substance endogain – an enamel matrix protein – signals to the body: “Form a tooth retaining apparatus at this point.” In this way, it helps to achieve real regeneration after the procedure. Dr. Köttgen assures, “The gums get their original state!” Without Endogain, the graft is purely a repair job and merely corresponds to scar tissue.

The cost of treatment (if several teeth are affected) is between 2000 and 3000 euros and is reimbursed by private insurance companies (as well as some supplementary insurance companies, at least in part). As always, “prevention is the best medicine”. Here the expert advises: “The right brushing technique is the be-all and end-all! It is best to use an electric toothbrush with soft bristles and always brush from red to white.

Lead photo: Subbotina Anna/

Photo: Dr. Köttgen