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Periodontics/interdental papilla


QUESTION: Hello,  I had a dental cleaning the other day and the distal papilla between tooth numbers 8 and 9 was removed. Thankfully the facial papilla is still there. The problem was immediately noticed after the cleaning because my tongue now is drawn to the space where the papilla was. I am very worried  It will be like this forever now. Can the tissue grow back to where it was? About 2 mm off the tip of  the papilla was removed.    If it can grow back is there anything I can do to further help it regenerate. Thanks so much for your time and expertise.

ANSWER: You apparently mean the inner (or palatal) half of the papilla between your two central upper front teeth.

If the papilla is lost as a result of trauma only, such as an accidental cut, it will eventually grow back when the trauma is no longer there. This will take several months.

However, if there is gum infection between the teeth prior to the injury, healing will result in a slightly flatter or lower papilla. Also, long-term gum infection inevitably leads to the loss of papillae and other tooth-supporting structures, even in the absence of any trauma. So, to let your papilla grow back, make sure that you don't get any gingivitis.

To preserve the papillae, the most important thing is to floss daily and to make sure that the floss glides along the tooth surface and does not damage the gum when it is inserted between the teeth. Gum infection is more harmful to the papillae than is any kind of mechanical injury between the teeth.

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QUESTION: Thanks so much for that response. I now feel much better about the accident with my gum tissue. One thing I don't understand is why can a papilla regenerate and the other gum tissue,(the facial part)I was told cannot, or can it?   I was under the assumption only tissue grafting could be done when recession is bad enough. The only thing to do is maintain what you have by not brushing too hard. The level of recession is slight and caused from brushing aggressively, there are no periodontal issues. On that note, I have read that oil pulling can help with recession but remain skeptical.  I appreciate your time and answers. Thank you.

The regeneration of gum tissues depends on the underlying periodontal tissues. Thus, if there is no loss of attachment fibers (between the gum and the bone) or bone, the soft tissue on top of these can regenerate to their original level.

Local gum recessions are often located on the outer (facial) surface of the teeth (where you can see them). In such places the gum tissue is often very thin to begin with and bone under the gum is, in fact, most often also either very thin or even absent. Therefore the repair of facial  recessions often require grafting to make the gum thicker. Still,such a procedure does not regenerate the bone.

Thus, whether gum recession occurs or not, depends on the original anatomy of the tooth-bearing structures and on their health as well as on the presence or absence of external trauma.

I don't really have any opinion about oil pulling except that I think that natural oils are good for you, either when taken with food, or when used for lubricating skin and mucosal surfaces.  


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Marketta Hormia, DDS, PhD


I am a periodontist living and working in Helsinki, the capital of Finland, where I have my private dental practice. I am an international member of the American Academy of Periodontology. I have a Ph.D degree and a long background in research and teaching at the University of Helsinki and at the University of Turku, Finland. I function as an adjunct Professor at these Universities. I have also worked as a visiting scientist at the Scripps Clinic and research Foundation, la Jolla, CA. I can answer any question in the fields of dentistry and periodontics.


Private practitioner in Helsinki, Finland over 20 years. Former researcher and teacher at two Finnish Universities.

The Finnish Society of Dentists, Division of Periodontology, American academy of Periodontology

Over 30 scientific research articles published in peer-reviewed international scientific journals (can be found on PubMed)

D.D.S., Ph.D, Specialist in Periodontology. Adjunct Professor.

Awards and Honors
Visiting Scientist at the Scripps Research Foundation, San Diego, California, 1992-1994. NIH grant

Past/Present Clients
Dental patients, national and international. All kinds of dental, oral and temporomandibular joint problems

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