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Dentistry/Gingival recession

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Question
Hi doctor,
I'm a recent dental grad and would like to ask ur opinion. Had a 32 yr old  who used to chew, quit 2 yrs ago., placed snuff anterior to 24-23 area. 23 minor recession but 24 has abut 4 mm root showing occlusal gingival and 1.5 wide md. He is not sensitive. will a  gingival graft for this size defect be successful in ur opinion? If he is not concerned for esthetic reason,should  he be urged to see periodontist-will defect worsen? Pockets 2-3 mm.
Also what is ur opinion for local antibiotic delivery for pockets 6 or greater? Reading only .3 mm pocket reduction, is this cost effective for patients?
Thank u so much

Answer
Dee - Again, without examining the patient I cannot completely sure, but a skilled periodontist should be able to restore the gingiva. Although he is not esthetically concerned, the anatomical changes make the area more prone for additional recession. The root is more exposed and more prone to decay and or erosion.  With the changes the pockets may increase if he is not meticulous.  

I am really not overly fond of local antibiotic delivery.  I am more conservative and believe if the patient is completely well trained in proper brushing and flossing and uses an antibacterial mouth rinse twice daily recession can be greatly reduced.

So do some teaching to him.  Have him make sure he does not chew and teach him proper cleaning techniques.

If you have additional questions, feel free  to contact me again.

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Joel S. Teig, DMD, Diplomate ABOMS, retired

Expertise

I am a board certified oral and maxillofacial surgeon and I am available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.

Experience

Board Certified Oral and Maxillofacial Surgeon practicine for over 20 years. Assistant Clincal Professor and State University School of Dentistry.

Organizations
American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

Education/Credentials
BA -University of Connecticut DMD - University of Pennsylvania School of Dental Medicine

Awards and Honors
National Honor Society (OKU), Philadelphia County Dental Society, Mosby Book Award, Oral Surgery Honors, Summa Cum Laude

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