Orthodontics Part 2: Tissue Stripping

Loss of normal gum tissue contour around any tooth is referred to as tissue stripping.

This condition can occur around any tooth, and can only be corrected by grafting gum tissue from the palate onto the stripping site.

The most usual cause of tissue stripping is improper brushing technique. Using a back and forth sawing motion with a toothbrush will abrade or wear away tissue in general, or abrade away tissue on the most prominent location on the gums. Tooth position that is forward of normal arch position especially can cause tissue stripping to occur when careful tooth brushing techniques are not used.

Construction of tooth brushes is not standard. Only Oral B, Pycopay, and Butler GUM toothbrushes are made with rounded bristles so they do not have a 90 degree sharp cut. The rounded bristles, plus only using soft or medium bristle stiffness, provides the best protection against toothbrush damage to gums.
Tissue stripping can also be caused by chronic gum irritation from food debris left on the gum margins of the teeth. It is imperative that special attention be given to careful and total removal of all food debris from all surfaces of the teeth every 24 hours, and especially in the area of tissue stripping as infection will worsen the amount of tissue lost.

There is no “healing” or regrowth of gum tissue once it is lost.

It is normal for gum tissue to change in contour as children grow into adults, exposing more of the teeth crowns. Sometimes, adult gum contour will correct the imbalance of tissue contour in childhood when slight or even moderate tissue stripping has occurred. Significant tissue stripping always requires periodontal surgery (gum grafting).

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