Revolutionary gum procedure hits Philadelphia

We all know that cleaning up your smile can be like drinking from the fountain of youth. Teeth bleaching, veneers on a chipped or snaggletooth—even those "invisible" adult braces—can take years off your look. What about getting long in the tooth—as in that vaguely skeletal (scary) smile we get as we age, or even when we're younger? That's been a toughie, not to mention painful to fix.

For more than a decade, Los Angeles dentist Dr. John Chao has been working a patented technique called 'Pinhole Gum Rejuvenation' that simplifies the procedure to correct gum recession. The procedure is so effective and seamless that it's been praised by the dental community, and has received a lot of press. It is only available in a few parts of the country, including Philadelphia.

Top Philly dentist and Penn graduate, Thomas E. George, DMD, FAGD, is among the first in the country—and the first from New York to Virginia —to have been professionally trained and certified by Chao himself to perform the procedure. So, you want to say "so long" to long in the tooth? Philly is the place to be. We spoke with Dr. George about Pinhole Gum Rejuvenation and why he, and the country's dental community, believe the technique deserves its revolutionary reputation.

Q: Why do gums recede as we age—and what makes smiles so, well, skeletal-looking?

A: First, you don't need to be old to have gum recession: Inflammation, disease, and toothbrush abrasion from over-zealous brushing can all cause it. And when this happens, you're left even more vulnerable to even more infection, which exacerbates the problem.

But disease aside, gum recession makes the teeth look longer, which upsets the proportionality of the smile and overall face. In terms of esthetics, the eye naturally looks for a height to width proportion in teeth; exceed it, and the smile looks instinctively "off." Symmetry is important both within the confines of the smile as well as the overall face.  Sometimes, the gums can recede to the teeth's bony areas, which can then appear egregiously prominent, leading to that "skeletal" look.

Q: How has gum recession been fixed traditionally?

A: The only real way to fix the problem until recently was via a procedure called "gum grafting." It's a very invasive surgery, very painful, and unfortunately, the way it heals is not predictable. Gum grafting requires removal of tissue from the top of your mouth—the hard palette—and then placing that tissue over the root of the tooth. The procedure leaves a hole in the top of your mouth and pain very much like a bad pizza burn for quite awhile. Because of the invasive nature of the surgery, recovery time is extensive, too.

Q: What's different about Pinhole Gum Rejuvenation?

A: With Pinhole Gum Rejuvenation, there is no grafting, no suturing. It's minimally invasive, which means less pain and less recovery time. We make a hole in the in the inside of the cheek with a needle, three millimeters wide, using special instruments patented for the technique. Through that hole, we are able to release gum tissue around the affected tooth or teeth, so that it can cover the correct proportion of tooth to gum. The hole is very pliable, so we can reach up to five teeth through it.

Q: What are the main benefits—and what's recovery like?

A: First, healing is extremely predictable—practically flawless—and the correction is immediate because you don't have to wait for a graft to take hold. Moreover, the procedure is more time-efficient: It only takes about an hour to correct two to three teeth. Second, Pinhole Gum Rejuvenation can prevent further wear of root structure and recession.

I'm not going to say that there is no pain the night of the surgery, but it is far less than with traditional grafting, and it is easily treated with medication. After that first night, patients can go right back to their regular activities the next day, with some precautions at first. There is no brushing for four to five weeks after the procedure; instead, we prescribe a specialized gum rinse to keep the area clean while allowing it to heal. After that, it's a question of not further traumatizing the gums: We'll teach you how to brush properly.