Thin Receding Gums And Dental Implants – What’s Important? Video by Ramsey Amin, DDS

Thin Receding Gums And Dental Implants – What’s Important?  Video by Ramsey Amin, DDS

Thin Receding Gums And Dental Implants – What’s Important? Video by Ramsey Amin, DDS

Thin gums area major cause of gum recession and can cause problems with dental implants too.  You are genetically given the thickness of your gums.  When it comes to dental implants…the thicker the gums the better.  This is also true for natural teeth.  This video explains some of the important issues.

When someone has receding or thin gums, I can surgically correct this by a gum graft. So if the gum is too thin, it can be thickened.  Here is a photo of a gum graft I did to cover the root of this long tooth.

Before Gum Graft 

There are a couple of main issues associated with thin, fragile gums and dental implants.

  1. The implant shows through the gums as a grey or grayish tint. This does not look good.
  2. The gums can recede causing the bone to recede too.  If this happens, the threads of the implant can show. This becomes a long term issue.

This picture says it all:
Implant_failure Solutions I use: (much more detail in the video)

  1. Gum and/or bone grafting before or during the implant procedure to thicken the gums
  2. Use of a custom abutment made of zirconia or titanium
  3. Proper implant design
  4. Proper crown design
  5. Precise placement of the implant to begin
  6. At the time that I place implants, if possible, I move some of your existing gum from the palate side to the outside of your implant.
  7. Platform switching design

As you can see, there is A LOT to dental implant success.  It is not just a screw put in the jaw!  Many dentists don’t bother with the gums and just put the implant in.  That is fine for the short term, but in time, you will probably develop problems.

Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow of the American Academy of Implant Dentistry
Burbank, California


  1. Rosanne Bogdan

    Is it ok to see a little of the silver from an implant . It’s been 3 yrs and dentist doesn’t give me a straight answer there’s plenty of gum inside of implant . Had a bone graft that worked . He’s a cosmetic dentist , he said it’s fine and hopefully it will stay that way but he doesn’t know what do you think ?

    January 13, 2019 at 9:34 pm Reply
    1. Ramsey Amin

      It usually needs to be fixed with a gum graft.

      April 29, 2020 at 2:33 am Reply
  2. I had oral surgery when I was 18 to remove 5 teeth being my mouth was to small. I recently now 52 had to have implants. The dentist put 32 teeth in my mouth and the pain terrible. The teeth look like chucklets.. My husband confronter him and he said while did you expect them to look like your teeth My family say they look huge like a horse. I am a teacher and the comments are taking a toll. Also the teeth 6 on a bridge on front get food stuck. they look like dentures. Is there anyway to fix this. Also I had surgery to increase gums prior to this procedure. It is going on 26 months and my bottom not fix permanently.

    June 5, 2018 at 5:34 am Reply
    1. RamseyAminDDS

      26 months!! Yikes! All of this is generally tested during the temporary stage. This is an important step before transitioning to the finals so that all of these issues can be worked out. Please read this post about why making temporaries is important. It sounds like you probably just need to redo most of it… Sorry for the bad news

      The finals should give you ideal lip support… Not too much and not to little.

      June 6, 2018 at 11:10 pm Reply
      1. D Venkat

        Dr. Amin, I have very advanced periodontitis. I have almost no attached gingiva on several teeth on the lip side particularly on my mandibular incisors and canines (though several teeth are in bad shape not just those). On the tongue side things are better. I am wondering if I am a candidate for all on 4 implants (or the like) still. I have read that it can still be done without keratinized peri-implant mucosa (mainly alveolar mucosa) but that hygiene is an issue. I really don’t want dentures. I am still in my 30s.

        June 12, 2018 at 7:01 pm Reply
        1. RamseyAminDDS

          You must be a dentist to speak in such great detail?
          Yes you are a candidate for the all on X procedure. He just has to be done little bit differently and your thin genetic bio type must be taken into a considerable amount of consideration.

          Just because you have a thin gingival bio type does not mean that you are going to lose all of your teeth! Natural teeth can outperform a dental implant in thin tissue any day of the week!

          June 14, 2018 at 3:24 am Reply
      2. DV

        Dr. Amin, I am very nervous about my oral health. I have neglected it for almost 15 years now. I have a thin gingival biotype and have severe recession on several teeth including my mandibular incisors and canines (but a lot of teeth have recession too, molars, upper canines, upper incisors). I am scared of losing my teeth but even more scared of having to wear dentures. I am only 38 years old. I have read that implants can be done even with little keratinized mucosa. Is this true? I am besides myself at the moment.

        June 13, 2018 at 4:28 pm Reply
        1. RamseyAminDDS

          You must be a dentist to speak in such great detail? Just because you have a thin gingival bio type does not mean that you are going to lose all of your teeth! Natural teeth can outperform a dental implant in thin tissue any day of the week!

          June 14, 2018 at 3:20 am Reply
    2. Random person

      I feel so bad for you you should check with a specialist

      October 12, 2019 at 11:54 pm Reply
  3. eilish newcombe

    Hi i got five implants 3 weeks ago on my top I can see 2 implants coming down but I can’t see the other 3 I got the stitches out last week will the other 3 come down or will i have to get my mouth opened again


    June 3, 2018 at 9:47 pm Reply
    1. RamseyAminDDS

      It depends if it was planned that way. Some implants are purposely buried under the gum which require a second stage uncovery to reexpose them in the mouth and finish making the crowns/Bridges. Sometimes it is just a little bit of swelling that covers up the healing abutment. Once that swelling subsides that temporary healing abutments will become exposed. Just asked your dentist next time you see them.

      June 6, 2018 at 11:03 pm Reply
  4. Marie

    Hello Dr. Amin,
    what do you think about interdental implants for papilla reconstruction? After the placement of two implants in the upper front, I‘ve lost my dental papillas in that area. I went to countless dentists, but most of them told me there is nothing to do…but I can‘t accept this. So I‘m still searching for an appropriate solution. Thanks in advance for you answer.

    May 23, 2018 at 4:17 pm Reply
    1. RamseyAminDDS

      This is extremely technique sensitive and could make things worse than they already are. Additional surgery carries risk.
      Can consider addition of a very tiny bit of pink porcelain or pink composite bonded right between the teeth. When done correctly it can camouflage things quite a bit.

      May 23, 2018 at 6:34 pm Reply
      1. Petra Hicks

        Hi Dr. Amin
        I have 2 implants tooth #22 and #27 which were placed more than 10 years ago
        On my last Dentist visit I was shown that my skin around one of the implants is receding to a point where I will need a skin graft
        I’m terrified of that thought
        Is that a common procedure?
        I’m considering just having the implant removed all together
        I only have teeth # 23,24,25 and 26 left on the bottom
        I wear a partial denture which snaps into the implants
        Any advice is appreciated
        Thank you

        May 26, 2018 at 7:12 pm Reply
        1. RamseyAminDDS

          you are being given good advice….I think.. There is no reason to extract and implant if all it needs is a little bit of gum. The only concern that I have is the partial denture pain be the cause of the recession because it is rubbing on the gum. If a gum graft is done there you have to be certain that the new or old partial denture will never touch that area or the same thing will just happen again

          June 3, 2018 at 5:02 am Reply
  5. Barbara Mangini

    Yesterday, I received the permanent crown on my dental implant. It is on the upper left, I think it’s the first bi-cuspid. This morning, I noticed the crown doesn’t meet my gums. I can stick my fingernail in the space and there is wiggle room. I have regular crowns (one about a month ago), and have never experience this before. They didn’t mention this to me at the dental office. Will this fix itself, or was the crown seated incorrectly. I am very worried and upset about this.

    April 18, 2018 at 10:44 pm Reply
    1. RamseyAminDDS

      Hmm…best to give the office a call and have it looked at.
      My guess is that you are missing a bit of bone or gum which leads to the implant looking a bit different than the other teeth. Upper implants in the smile zone are technically the most demanding of all. Almost every person needs either a gum or bone graft to get full volume back.

      On a more simple note, there is a chance it just needs to fill in over the next few days.

      April 27, 2018 at 5:20 am Reply
  6. Ed

    Is root planing ever done on an implant?

    March 20, 2018 at 6:29 pm Reply
    1. Ramsey Amin


      April 29, 2020 at 2:35 am Reply
  7. Gerdaline mcdonagh

    Hi, I got a tooth implant 3 months ago and my gum is receding up revealing a lot of the screw and the rest of the screw is clearly visible through the gum, what do you think I should do? Thank you in advance!

    March 1, 2018 at 9:48 pm Reply
    1. RamseyAminDDS

      See your DDS ASAP. Something is not right. Hopefully you don’t have a removable temporary over the top of it. That would cause recession.

      March 1, 2018 at 10:20 pm Reply
      1. Gerdaline mcdonagh

        Okay, yes I have a temporary tooth in place at the moment, I am meant to be getting the real tooth next month.

        March 1, 2018 at 10:33 pm Reply
      2. Gerdaline mcdonagh

        Thank you for your reply! Okay, yes I have a temporary tooth in place but I’m not due to get the permenant one till next month.

        March 1, 2018 at 11:04 pm Reply


    January 9, 2018 at 1:04 am Reply
    1. RamseyAminDDS

      That sounds like more of a personal decision. I do not know the skill and expertise of either dentist. Ultimately you want a good outcome and not to end up worse than where you start!

      January 10, 2018 at 7:20 pm Reply
      1. Nick s

        Had a bone marrow infection and an implant about 10 years ago. Found out today my gum is receding and showing .07mm of the implant.

        Doctor wants to give it a year and see how much is regresses before acting. Do I have to hve the whole thing redone??

        February 20, 2018 at 2:29 am Reply
        1. RamseyAminDDS

          0.7 at 10 years is not bad. I would take his advice and monitor for awhile. You don’t necessarily have to redo the whole thing. Each situation is going to be unique especially if this is a front tooth.

          February 21, 2018 at 4:57 pm Reply
  9. Julie Huffman

    Hello my name is Julie Huffman. I had 4 mini implants put in my mouth 2 years ago and that was due to my dentures not fitting and there all on the bottom. I’m still having issues with dentures getting food under them. They used my original Denture and made it to fit the implants. I got it done in grand junction Colorado. I was on SSI and had Medicaid. I now live in Marysville California. California doesn’t do implants on medi cal. I can’t afford to pay out of my pocket for dental work. My issue is I’m noticing that my gums are receding and showing more of the posts. I’m afraid the implants will break through my bone. I can’t wear my dentures on bottom due to the uncomfortable feeling I’m getting when I wear them. Can you help me figure out a way to help my gums to stop receding ? It makes me sad that I finally got teeth to eat healthy with. But now I can’t wear them all the time. I’m afraid to eat nuts or anything hard. I had weight loss surgery and I can’t eat apples or carrots to get healthy and thinner. This gives me many self esteem issues. I don’t know who else to talk to. The dentist here won’t talk to me because of me having medi cal. And I don’t have money out of my pocket. Thank you for your time. Please give me ideas on a solution.

    December 30, 2017 at 5:51 am Reply
    1. RamseyAminDDS

      You may want to have the implants removed if they are not working for you. The miniature dental implants are often considered temporary dental implants and do not function the same way as real implants would. I am sorry you’re having all this trouble. You may want to consider seeing a dental school.

      January 29, 2018 at 1:57 am Reply
  10. Amy

    My dad’s denture implant screw shows through his gums. Is that a problem?

    December 25, 2017 at 8:19 pm Reply
    1. RamseyAminDDS

      are you saying that the threads show? That is not a good thing if that is the case.

      December 26, 2017 at 6:28 pm Reply
  11. Sharon

    Hi Dr.Ramsey,

    I had a sinus lift, bone grafts and implants done in January on both sides for premolars. I went to periodontist today and he did X-rays and pressure test and said I was ready for impressions and crowns….yea…..he did mention something about the gum line on one side and I may need to have something done but wanted me to go to restoration dentist and proceed with crowns then he would check it. I found this thread talking about gum grafts and I assume that is what he is talking about but after reading some of the post I’m concerned that the implant or threads are going to be showing? Any thoughts? Thank you so much for this site great information!!

    May 16, 2017 at 11:07 pm Reply
    1. RamseyAminDDS

      Get temps only before proceeding to the finals. If you’re having issues with the implants and some sort of peri-implantitis, this would be the time to treat rather than putting on the real crowns but again I have never seen you before so I am making a lot of assumptions.

      May 30, 2017 at 5:15 am Reply
  12. Lynn Byrne

    I occasionally use tumeric powder on my teeth to help with gun disease, would you consider this good or bad?

    January 4, 2017 at 12:52 am Reply
    1. RamseyAminDDS

      likely unnecessary and of no benefit

      January 9, 2017 at 5:56 am Reply
  13. Lynn Byrne

    I have receding gums, would you or would you not recommend top and bottom implants? Are there success regarding longevity simply due to maintenance of the gum disease? Cheers, Lynn

    January 4, 2017 at 12:50 am Reply
    1. RamseyAminDDS

      Please clarify your question. I’m not sure I understand…….sorry

      January 9, 2017 at 5:57 am Reply
  14. Oh I forgot to mention the gums around the implant have always been very sore and prone to infection as food gets trapped under the crowns and is very difficult to keep clean. Similar to another comment on this thread.

    November 3, 2016 at 2:34 am Reply
  15. Hi, I had 2 molars implanted 4 years ago with tissue grafting (alloderm) due to thinning gums.
    Last month the crowns just came off; apparently the screws snapped. When i went back to my dentist to have them screwed back on, she noticed I had significant bone loss since the time of the implants. Is this common? I thought the tissue graft would have helped prevent bone loss.
    Thanking you in advance for your advice.

    November 3, 2016 at 2:31 am Reply
    1. RamseyAminDDS

      I am guessing g the problem is more
      Likely due to your bite rather than gums. The second molars have to endure a tremendous amount of bite force. The bite must be purposely adjusted designed all excursions. This includes when your jaw falls back into a grinding position during sleep. The slightest bit of bite overloading can cause bone loss. I speculate this is the problem because of the location of your dental implants.

      November 21, 2016 at 2:03 am Reply
  16. Martha Beary

    Where are you locate it? Please post a phone number. Thanks!

    July 14, 2016 at 3:53 am Reply
    1. RamseyAminDDS

      Burbank, CA

      July 19, 2016 at 12:12 am Reply
  17. Dawn

    Hi I had my right front tooth pulled a few months ago then a bone graph done in preparation for a implant. My gum has receded up significantly and has also receded up exposing the root of the tooth next to it. My dentist just keeps saying we will see when it’s time to do the implant how the gum is. But I’m thinking of not doing the implant now cause theirs no gum to go around it and the tooth next to it looks hideous. Any advice you could give me I would very much appreciate it thank you dawn

    May 26, 2016 at 6:17 am Reply
    1. RamseyAminDDS

      Sometimes a bridge is a more cosmetic option in the front teeth. This decision has to be made very carefully. I suggest you see a very good implant dentist.

      The tooth next to the implant has to be very healthy for it to look perfect.

      June 12, 2016 at 11:26 pm Reply
      1. Dawn

        Unfortunately the tooth next to it is a crown. Would a bridge still be an option?

        June 13, 2016 at 6:22 am Reply
        1. RamseyAminDDS


          June 13, 2016 at 11:39 pm Reply
      2. Erika Shannon

        Hello Dr. Amin! I have the same concern as this commenter here, where I had a front upper tooth extracted and a bone graft, but the gum has receded up and indented dramatically. I am wondering if that is clear indication that the bone graft was done poorly. The dentist has said I will need a second bone graft at the time of the implant, but that sounds more like just trying to cover up a mistake and making me pay for it. Please offer any advise you can. Thank you so much!

        December 15, 2016 at 7:20 pm Reply
        1. RamseyAminDDS

          not likely the case. Many complex upper front teeth require secondary bone grafting. He want to make sure you have a lot of extra bone in the front of the mouth. Sometimes I have to do a block graft in this area.

          January 9, 2017 at 6:26 am Reply
  18. Sou

    Hi I have 2 molar implants with zero gums showing, and they are humongous. I feel like I have Shaquille oneals molars and I’m only 5’5. They are so big and noticeable I am embarrass to smile. I got it done at clear choice dental and there suppose to give me to more implant crowns on my upper jaw. Do I continue to get those implanted? I need some help

    May 3, 2016 at 8:06 am Reply
    1. RamseyAminDDS

      Why are they so big? Each tooth I make is designed in a 3D software program. This way proportions of the teeth can be made to be harmonious with your other teeth.

      These large implant supercenters do not focus on quality. They focus on quantity. It is unfortunate.

      May 7, 2016 at 3:14 am Reply
  19. susan

    I got an implant a year ago. My gums around it constantly ache. My dentist has removed it several times and cleaned the area but the pain returns. I feel food is getting trapped deep under it

    April 27, 2016 at 8:20 pm Reply
    1. RamseyAminDDS

      Something is wrong. This is not normal. I assume you have had an x-ray or a scan of the area?

      May 1, 2016 at 8:13 pm Reply
  20. Katherine Cheng

    Do thinning and receding gums endanger the implant or is it just cosmetic?

    April 14, 2016 at 5:25 pm Reply
    1. RamseyAminDDS

      The implant is also endangered when the gum is thin. This is not just a cosmetic issue/ Stable gum tissue promotes stable bone and prevents a long-term complication called peri-implantitis which almost always results and bone loss around a dental implant.

      April 21, 2016 at 12:05 am Reply
  21. Elva Brown

    I had an implant done about 6 months ago. It’s very difficult to eat because I have a glob of food trapped in my gums because there’s a deep gash there. Its really embarrassing when I eat in public so I try to get the trapped food out with my tongue. At first the dentist told me it would go back to normal when it heals. I went back again and he was scolding me, saying I need to get a water pick and I have to keep the area clean because that’s the way the gum is going to be. I will get the water pik but I don’t want to take it with me when I go out to eat! I’m not happy at all with my implant because it’s uncomfortable when I eat and that big dent looks horrible! Should he have done something with the gums as part of the implant procedure?

    March 18, 2016 at 4:42 am Reply
    1. RamseyAminDDS

      You might want to see another dentist to help correct the situation. It would be difficult for me to live like that also.

      Very Respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      April 4, 2016 at 9:57 pm Reply
  22. Feizz Afsari

    Hello, I got a dental implant done on my front tooth over a year ago. As of right now, it actually looks just like the picture you posted above, this exact picture.

    I asked my dentist if my gums will ever grow or heal back, and he said no. I hate how it looks and I think he did a terrible job. Is there any possible solution? Thank you.

    January 17, 2016 at 10:48 pm Reply
    1. RamseyAminDDS

      Ugh…you are going to need to start all over. Get yourself treated by an expert in this field. This will be a complex replacement and may require a block graft

      January 18, 2016 at 6:20 am Reply
  23. Susan

    Hello, I had an implant on #7 done 1/12 yrs ago and have had many problems since. I am currently seeing a periodontitis for these problems. I have chronic pain around the gums and receding gums as well along with obvious bone loss where I can see the outline of the implant. My crown was taken off 4 weeks ago thinking it may have been due to cement causing my pain and told to let it rest for 4-6 weeks. I am still experiencing significant pain and it almost feels like something is attacking and eating away at the area and the teeth beside it. I was told to brush at a 45 degree angle for 3 weeks with a super soft brush that was given to me. This is aggravating the area even more! Also would like to add I had flap surgery 6 months ago which they found a stitch that had not dissolved. Then laser surgery which burnt the roof of my mouth! I now am back to wearing my Essex and still in constant pain until someone helps me! I believe I may have peri implantitis but my all my x-rays look goo? Any suggestions would be GREATLY appreciated. Thank you.

    December 30, 2015 at 4:56 pm Reply
    1. RamseyAminDDS

      It sounds like you have advancing peri-implantitis on the outer wall of your dental implant. This can only be determined by 3-D scan or by direct surgical visualization. If you have not had a 3-D scan yet, you need one. Have you had that done yet?

      if you do have it, taking the crown off will not help. The flap surgery would have had to have been fairly large see this part of the bone is not just a surgical mini flap to check for retained cement which can also cause bone loss.

      I go through great lengths to avoid any patient ever having the problem that you have of making absolute certain that there bone is maximally thick. The best way to avoid this from a surgical perspective is to overbuild the bone.

      I hope I am wrong!!!!

      R. Amin DDS 😉

      December 31, 2015 at 5:52 am Reply
      1. Sue

        Hello. Thank you for your feedback. I did indeed have a 3d CT scan and everything looks fine. The problem is it is not! This has been going on now for 2 years with no answers. Would like to have it removed and cleaned out at this point! Who would be best to perform this removal? An oral surgeon, periodontist or an implantologist?
        Thank you.

        May 8, 2016 at 12:41 pm Reply
  24. My daughter got a implant in one of her front teeth and it is showing through the gum grey, shouldn’t the dentist do a gum graph to fix the problem? Or what needs to be done ? It’s been months and the doctor just says it needs to grow down which it has not yet ! He I don’t think knows what he is doing what should I do ? Mean time my daughter has a grey tooth !

    December 10, 2015 at 11:07 pm Reply
    1. RamseyAminDDS

      hmmm….I would have someone else look at it if the implant has been there longer than 6 months.

      Sometimes a bone graft or gum graft can correct this. Some people, especially women have very thin, see-through gum tissue. The most important thing is that the dental implant has bone covering it on the outside. If it is just the abutment showing not the implant, a custom zirconia abutment may be able to solve this very easily.

      Good luck

      December 26, 2015 at 6:22 am Reply
  25. Shirley Van Noy

    I had 3 implants on the right upper front taking care of a 5 tooth bridge. The gum is receding on the first implant. Is there any way to stop or repair it?

    Thank you so much for your answer.

    Shirley Van Noy

    August 14, 2015 at 4:29 am Reply
    1. RamseyAminDDS

      Most likely scenario is that your bone is too thin in this area. Sometimes this is genetic and sometimes it is caused by the implant being too big or being too close to the outer wall. These are difficult to treat. It may progress or just stop where it is. This post on peri-implantitis may help you.

      August 20, 2015 at 2:32 am Reply
  26. I had all on four dental implants fitted two years ago. I am 70 years old. Now however my gums have receded on three of them . The metal is visible on all of them, one shows the complete abutement. Will the implants fall out or are they fused with the bone that is left.
    ?. Your advice would be appreciated

    April 4, 2015 at 11:40 pm Reply
    1. Ramsey Amin DDS

      Hello Marion,

      As you may know, I am not a big fan or advocate of the all on 4 procedure. It is truly under engineered to support a complete set of teeth all the way to the molar region. It can be done for a smaller segment of teeth when the molar teeth are not included (molars are very important.) What you are experiencing is in fact very common because of the under engineered design. Is it on your upper jaw or lower jaw? That will help me answer your question and a little bit more detail. The upper jaw is the weaker of the 2 jawbones.

      The fact that metal is exposed when it wasn’t before, generally means there is some sort of an active process occurring either in the bone and or the gum tissue which may result in permanent bone loss.

      It may stabilize and stay as it is. Of course I would need to personally see you.

      All On Four Dental Implant Procedure Review: Is It The Best? –Ramsey Amin DDS

      All-on-Four Dental Implant Procedure -Ramsey Amin DDS Explains Pros and Cons

      Very Respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      April 5, 2015 at 10:12 pm Reply
  27. Cari

    Hi, I chipped my top right incisor as a child, the tooth was only partially grown in. At 16 I developed a fistula, so I had a root canal. At 24 I had the tooth removed (there was still infection), and then I had a bone graft. After the graft healed, I had an implant placed. My oral surgeon said it was healing well and I retained a lot of tissue. It has been about 6 months since the implant, but my gum just healed from an infection due to cement getting underneath it. That infection has cleared, but about a week ago I had very sharp pain followed by irritation in my gum. I told my dentist that I thought something was in my gum, she looked at the implant and said nothing was in my gum and that I must have just bit down wrong on my temporary crown. Last Thursday, I got a small piece of bone out of my gum, right wear I felt it was, and now it feels normal but my gum started receding rapidly over the weekend and I am so worried and frustrated with all of problems. I have also had chronic sinusitis since that start less than a year after my root canal. In the last 2 years, I have felt as if air is blowing through my upper jaw when I blow my nose during a boutique of sinusitis. I am going to see my ENT soon, but I am just hoping for an impartial opinion. Could I have a hole in my jaw due to having that infected tooth for almost 20 years? Could it have leaked into my sinus cavity? I am feeling pressure in my right sinus, but not full blown sinusitis, could that be causing bone loss and my gum recession? I just want to know what to ask my dentist and surgeon.
    I’m sorry if this post has been a bit jumpy, I am quite upset. My main question is this, is this implant even worth all of the hassle an am I going to lose more tissue if it is removed?

    March 31, 2015 at 3:39 am Reply
    1. Cari

      I had root trauma which caused My root to not develop* I have also been dealing with an ear infection on that side ever since the gum got infected, I have taken 3 zpacks. I am at a loss at this point.

      March 31, 2015 at 3:45 am Reply
      1. Cari

        I apologize for all of the typos, I was a bit frazzled and typing on my phone. Over zealous auto-correct + emotions = a lack of coherence

        March 31, 2015 at 4:12 am Reply
        1. Ramsey Amin DDS

          your question was just answered in the original thread

          April 5, 2015 at 11:23 pm Reply
      2. Ramsey Amin DDS

        your question was just answered in the original thread

        April 5, 2015 at 11:22 pm Reply
      3. Heidi Schnoor

        I have a quick question pertaining to thinning gums. I do not have any implants. I am 46 and have noticed within the last month or so that my bottoms gums, below gumline are thinning rapidly, red but not swollen. I do not have any periodontal disease and have been to the dentist and oral surgeon who all say it is normal. But I know the area is not like it used to be pink and thicker. I do have a lower front canine tooth the seems to be moving forward as well. I fear my bottom teeth becoming loose due to the thinness and fragile gums. Any thoughts on this.

        October 6, 2016 at 11:54 pm Reply
        1. RamseyAminDDS

          genetically many females especially have been common thin bone which will over time proceed slightly even in healthy patients. I have even had a tiny bit of recession myself!!! ARGH!

          October 12, 2016 at 9:40 pm Reply
    2. Ramsey Amin DDS

      Hello Cari,

      Happy Easter. The incisor teeth are not physically connected to the sinuses by anatomy. They are connected to the nasal cavity but not to the sinuses. Whatever sinus conditions you may have are likely unrelated altogether and coincidental. The ear infections are also unrelated to your dental implant but may be related to your sinuses. I would definitely suggest in your ear ,nose and throat doctor and be evaluated with a CT scan of your sinuses and upper jaw. It is not likely that you have a hole in your jaw for 20 years. You would’ve been very aware of this.

      Generally speaking, having a central incisor front tooth dental implant can be complex, but is definitely still the best option long-term. It does require a very skilled team of dentists or an excellent single total solution provider to get a good result. If the gum has receded, it may be best to remove the temporary crown and remove the abutment and allow the implant to be buried again. This may allow the tissue to rebuild itself without having to do a gum graft. The implant can then be reexposed and a temporary be placed again to groom and contour the gum back to normal. I would suggest you stay in the temporary crown for 2-4 months to make sure the gum is stable and healthy before converting to a final crown.

      Most patients that have well done dental implants for front teeth keep them for 20+ years. I am assuming you had a 3-D scan prior to implantation and possible guided surgery.

      How to Choose an Implant Dentist

      Computer Guided Dental Implant Surgery, Things You Need To Know

      sample cases
      examples of other patients

      Very Respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      April 5, 2015 at 11:22 pm Reply
  28. patricia pasquarello

    good afternoon Dr Amin,
    I had one dental implant put in 14 months ago. I was involved in accident and the
    dental surgeon had to do bone grafting first, after area healed (3 months), he then put the implant in.
    My regular dentist put the crown in. However, the “root” of the crown is
    showing at the gum line (doesn’t look right). Can a tissue graft be done? Does the
    crown have to come out?
    Thank you…….

    March 21, 2015 at 9:01 pm Reply
    1. Ramsey Amin DDS

      Hello Patricia,

      As long as there is bone on the outside of the implant, the gum line can likely be corrected. This is a difficult procedure and should be done by somebody who has a lot of experience and repositioning the gumline around an existing front and center dental implant.

      Sometimes the procedure can be done with the crown in place and sometimes it has to be removed and a temporary placed. It depends on your unique situation. Also the procedure can involve taking some gum from the roof of your mouth and transplanting it to the area in need, using tissue from a cadaver, or just sliding your existing gum tissue down over the exposed root.

      Probably the most important thing is going to depend on the position of the implant and whether bone is present on the outer wall. You may need a 3-D scan to evaluate this before doing any treatment.

      3-D scan basics

      Very Respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      April 6, 2015 at 12:09 am Reply
  29. Ann

    I had 3 teeth extracted on my upper right and had bone grafting and implants and the 3 teeth were done with one crown (I guess it’s 3 that are connected). The dentist said that would be stronger. The problem is, my gums have receded and when the mold was made rather than correct the gum problem the dentist just had really long crowns made and then put them in my mouth. When I looked in he mirror after he had cemented it in I questioned why the crowns were so long (almost twice what they should be) and he said that was how it’s done… he never even mentioned he option of gum grafting. It feels weird and even though it doesn’t show that much some people have asked about it when I smile. The crown does not butt the gum but goes on top of it… is all this going to cause problems and if so what should I do about it? Thanks.

    January 5, 2015 at 10:50 pm Reply
    1. Ramsey Amin DDS

      Hi Ann,

      It sounds like you never had enough bone for a cosmetic result to mimic your natural teeth. Even if you have 90% bone volume in the upper front area it is that final 10% that makes all the difference aesthetically. With 90% bone volume you can have dental implants that are strong and healthy but are not likely to appear like your regular teeth. If the implants are already placed, it is unlikely that gum grafting will make those teeth look like your others.

      My guess is your lacking vertical bone. These aren’t things that I like to work out in advance using 3-D planning and extensive photography prior to ever doing any work at all. This allows me in my patient to understand the limitations in advance of doing anything at all.

      3-D planning sample

      Because you likely have 80-90% bone, the implants are likely deeper than your other teeth and pushed more towards your tongue than your other teeth. If you have a very low smile line you may not show this area but it would be very problematic if when you smile, the gum line shows.

      Sorry for the bad news.

      Very Respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      January 26, 2015 at 1:51 am Reply
  30. Leslie

    My 11 year-old daughter has been recommended to get this gum graft as her 4 front bottom teeth are exposed through the gums at the base. My concern is whether to wait a few years to see if the gums will get thicker on their own. They are her adult teeth and they have deteriorated in the past 4 years when it was first noticed. Also, they recommend cutting the tiny muscle that joins between the lip and bum on the bottom of our jaws. This is attached up high in her gumline and he feels it would be hindering the growth of the gums by pulling it down. It is noticably higher than other family members. Thanks for your input!

    July 15, 2014 at 5:11 pm Reply
    1. Ramsey Amin DDS

      Hello Leslie,

      This does not sound to be a dental implant related problem but here are some basics: the daughter your discussing likely needs a procedure called a frenectomy…. My own daughter needs this too.

      The muscle pull causes the gums to recede and spaces to develop between teeth. I would also see an orthodontist and get their thoughts as she likely needs braces too

      Good luck!!!!!!!!!! 😉

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      July 18, 2014 at 1:31 am Reply
  31. Katie S

    Hi Dr. Ramsey, I’m glad I stumbled upon your site. I have 8 dental implants, I’ve had them for 10 years, and one of them(not sure what the tooth # is but it’s in my lower right jaw) has had some bone loss and gum receding,from an xray four years ago to now the bone has gone down about three threads in the implant. The other ones haven’t changed very much. I am wondering what is causing this. Is there anything i can be doing to prevent the bone from receding more? I have had two children in the past three years and I wonder if that is a factor at all. I am really enjoying your blog. Thank you for such insightful information!

    June 11, 2014 at 3:08 am Reply
    1. Ramsey Amin DDS

      hi Katie,

      That is awesome that you are 10 years out at this point. I just saw one of my patients who I did 12 dental implants on almost 14 years ago and has zero problems. he does have some minor recession at his age of 90 years old now around 1 dental implant.

      Having your children did not cause this problem…but they sure do cause a lot of trouble, don’t they? LOL

      Without seen you in person, it is impossible to tell why your losing bone on just one implant. The good news is your only losing bone on just one implant. It is likely that this area had thinner bone at the very top of the implant. Some threads are bigger than others so he micro-threaded implant with 3 threads exposed is different than a macro threaded implant with 3 threads exposed. There are options to de-thread the implant or possibly attempt bone regeneration depending on the shape and size of the defect. Other reasons could be difficult hygiene of the area, plaque and tartar on the implant, bacteria getting into the gap between the abutments and the implant itself, and loose implants abutment that is causing micro-movement, genetically thin gum, thin bone, bone grafted site, implant is positioned too far to the outer wall, implant size too big and a host of other reasons.

      If you’re local to Burbank California, I would love to see you.

      I hope this is helpful

      Ramsey Amin DDS

      June 13, 2014 at 8:56 pm Reply
  32. jean gray

    I had an implant done a long time ago on tooth #7.. However, the gum has gradually receded and it now looks almost exactly like the example in the photo you show above. Is it possibly to get a gum graft to cover that ‘exposed’ area and build up the gum there? I see more people online posting about gum grafts that didn’t work (vs. success stories). What is the prognosis for applying a skin graft to an area that has an implant? Does it have a 75% chance of being successful? 50%?

    April 15, 2014 at 6:24 am Reply
    1. Ramsey Amin DDS

      Hi Jean,

      I see this problem a lot. Many patients come to my office in Burbank with problems from dental implants.

      The gum is receding because you likely have bone missing in the outer wall of the implant and/or between the teeth.

      Recovery of this with a gum graft is difficult and not very predictable. A very skilled implant dentist may be able to do this but will likely and bone too. Combining your own blood products such as PRP PRF and PDGF can help.

      I know this doesn’t help you, but for the many thousands of people that read my blog, the key is to try to avoid this.

      A dentist whose focus and credentials are exclusively in implant dentistry will plan your surgery so that you don’t have or reduce the chance of problems in the future. The experience of someone who has done thousands of implants versus a dentist that has done a few is significant.

      I say this to help many people who seek out the cheapest way to go.

      Very respectfully,

      Dr. Ramsey Amin

      April 18, 2014 at 3:26 am Reply
  33. sara dolby

    Excellent article. Keep writing such kind of info on your blog.

    Im really impressed by your site.

    February 21, 2014 at 9:28 am Reply
  34. latino

    Hi there! I could have sworn I’ve been to your blog before but after looking at some of the posts I realized it’s new to me.
    Anyhow, I’m certainly happy I discovered it and I’ll
    be bookmarking it and checking back often!

    May 16, 2013 at 4:50 am Reply
  35. Dawn steityeh

    I recently did three implants , two of which were fine but the third one looks like it hasn’t been angled properly and will show at the top of the tooth when the new crown is fitted ,what can I do about this , please help.

    March 19, 2013 at 11:30 am Reply
    1. Ramsey Amin DDS

      Hi Dawn,

      The abutment will correct most minor changes in angulation. Natural teeth are not straight in the bone either. Sometimes implants are purposely angulated too!


      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      April 10, 2013 at 10:38 pm Reply
  36. Rod G.

    Very informative article and video! It’s nice to see that you take the possible aesthetic issues into account when performing a dental implant.

    July 10, 2012 at 7:12 pm Reply
  37. Linda Thomas

    Thank you for posting this information. I had a gum graft at two of my bottom front teeth. I’m very nervous because my periodontist cannot guarantee that this will work. I am 46 with Type ! diabetes and the recession is actually exposing bone. This is due to two different abscesses in my early twenties when my diabetes was not well controlled and flossing was a thing of the future. Fortunately my teeth are not loose but if this doesn’t work they will be some day. I found you as I was looking into whether I could get implants if I did lose those teeth in the future. Also, I’m sorry I didn’t know about you before, I work in Burbank…
    Thanks, Linda

    June 22, 2012 at 12:52 am Reply
    1. Hi Linda,

      Yes, implants can be done in that area. Let me know how I can help.
      Gum grafts usually heal very well. Have faith!

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      June 24, 2012 at 9:45 pm Reply
  38. Waseem

    Thanks. This is useful. My new periodontist has recommended subepithelial tissue grafts on 20/21, 28/29 so I was googling around to find info about this and ran into your site.

    Any thoughts on if platelet growth factor if required or not for this procedure? Its an optional procedure not covered by insurance so trying to figure out if I should go for it. Articles imply that it does seem to help but not sure if it is worth it?


    November 29, 2011 at 2:48 am Reply
    1. Hi Wassem,

      Grafting those particular teeth is very common. Growth factors are helpful and can improve results. The worse the recession is, the more inclined I would be to use growth factors and/or PRP. If the recession is mild and you are very healthy, it may not be needed.

      Does this help you?

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      November 29, 2011 at 10:41 pm Reply
  39. Samuel

    this is amazing, gum issues is is really a lifelong problem though.

    August 29, 2011 at 2:33 am Reply
  40. Hi Sarah,
    Complications can and do occur, but that doesnt mean it is the fault of your dentist or you. He will probably “re-graft” the area and place the implant in a few months.
    Be patient and it will more than likely work out.
    Ramsey A. Amin, D.D.S.
    Diplomate of the American Board of Oral Implantology /Implant Dentistry
    Fellow of the American Academy of Implant Dentistry
    Burbank, California

    August 14, 2011 at 9:28 pm Reply
  41. Sarah Martin

    I am 29 years old and I had a bone graft done in early April on my #7 tooth that I have never had (I have had a marilyn bride in that place for 17 years. My Dentist used mineross as the grafting material. When he opened my gums for the implant a few days ago he was shocked to see that the graft did not work. He said instead of bone it looked like gristle. He said he hasn’t seen anything like this in 24 years of doing grafts and implants. Have you ever encountered a situation like this? I don’t know where we go from here.
    Sarah, Tulsa OK

    August 12, 2011 at 8:07 am Reply
  42. Hi Azhar,
    Gum grafts are usually done on a “per tooth” basis. The average cost is about $1100 per tooth as of 2011.
    Ramsey A. Amin, D.D.S.
    Diplomate of the American Board of Oral Implantology /Implant Dentistry
    Fellow of the American Academy of Implant Dentistry
    Burbank, California

    August 8, 2011 at 9:44 pm Reply
  43. Azhar Keenoo

    I would really like to know the approximate pricing gum grafting in the frontal area of my upper jaw…slight gum loss has started…please help regarding

    August 5, 2011 at 3:03 pm Reply

Write a Comment

Monica D.
Monica D.
December 29, 2020.
There aren't enough words (and I have a lot of words) to tell you how grateful I am to have found Dr. Ramsey Amin and his wonderful staff. I had an enormous amount of bone loss and I was hopeless after being treated by a different doctor for two years. I had multiple procedures such as gum graft, extractions, and a sinus lift. After all of that, the doctor released me and told me he could not help me any longer. He sent me to a large teaching hospital - who also had no idea how to help me. I was terrified and embarrassed. I had been missing teeth due to those procedures since 2017. That sent me out on a journey of meeting with no less than five different dentist/oral surgeons. Most of them shamed me for the bone loss and wondered what I had done to cause this. In reality, I had done nothing. The bone loss is my body's immune system fighting me, as well as hereditary traits. In fact not only was I having difficulty being able to have implants, I also had so much bone loss that I was also not a candidate for dentures. I researched "what to do when you have bone loss and can't get implants" and I found Dr. Amin's website. Then I researched him, read his reviews, watched every one of his You Tube videos. I called and got an appointment, and kept going to consultations with other providers. I had long since stopped smiling and being social. Missing teeth and the shaming was affecting my life so adversely. When I met with Dr. Amin for my consultation he was ready. He had all of my records and had already reviewed my scans. But more than that, he genuinely wanted to get to know about my life. He was/is authentic, kind and extremely professional with so much success and experience in difficult cases like mine. He worked up a treatment plan & I came back two weeks later to discuss my options...and the journey began. I have had three procedures under IV sedation, no pain, no narcotics needed for aftercare. Dr. Amin is a consumate, experienced oral surgeon who cares about your health & understands your fears. He communicates every step of the way and will provide you with all the information you need to make a decision to improve your health. I am still working toward my end goal, and we had to zig from traditional implants and zag to zygomatic implants instead...which is the reason I chose him in the first place. If there was nothing else that could be done to get me healthy & smiling again, I knew he would have that option to help me. And of course 2020, the year of CV-19. Don't worry, Dr. Amin & his staff follow all health & safety protocols. This review is long, because it is important you know my journey, so you might understand how fortunate I feel to be healing. I'm torn, because this place is like a great restaurant, I want to shout from the rooftops how great it is, how great he is. And at the same time, I want to keep this all to myself. I come 75 miles each way to see him. I know people travel from all over the world for his expertise. Do yourself a favor, have a consultation. You won't regret it. Dr. Amin is amazing and so is his staff.
Jennifer B.
Jennifer B.
December 18, 2020.
I cannot speak highly enough of Dr. Amin and his professional staff. I have to start off and say that I am absolutely TERRIFIED of the dentist due to several past experiences. I found myself putting this off for YEARS until I was referred over to Dr. Amin. I was petrified on my first visit... but he along with his WONDERFUL staff made me feel so calm and at ease. I had quite a bit of work that needed to be done, but we found the perfect plan that worked out for me, and I couldn't be happier. Words cannot express my gratitude to each and every staff member that made me feel safe and comfortable. Dr. Amin was always so attentive in asking if I was ever in pain... and I never was. These are truly remarkable individuals, and I'm so lucky to have a dentist that I can trust. I ABSOLUTELY LOVE each and every one of you! Thank you,
D M.
D M.
December 17, 2020.
I cannot say enough positive things about Dr. Amin and his staff. I originally found them on Yelp about two years ago. I needed an implant, front tooth of all places, and was extremely nervous not only about surgery but about how it would turn out. Let me just say I just adore the staff. Everyone is crazy friendly and the whole office has a very positive vibe. The staff is adorable and always has me smiling by the time I leave. They are all thorough and on-point about what they do, and I truly appreciate it. They are quick to respond to my emails no matter the question, and their appointment reminders are great too. Dr. Amin is very thorough and reassuring, and answered any questions my husband or I had. My regular dentist had questions about the procedure and Dr. Amin's office even reached out to them at my request (my dentist said they never received a call, but Dr. Amin's staff had date, time and notes - love the thoroughness!). After surgery the Dr. called to leave me a message about how it went. Very minimal pain during healing, never any pain during any visits. It took a few tries to get everything just right for the permanent crown (color, etc), but the end result is beyond fantastic! At one point during healing I thought I was experiencing some looseness or wiggling but unfortunately couldn't make it to the office. When I was finally able to make it in the Dr. was so relieved, bless his heart. Luckily it was just a false alarm and everything checked out ok. They're a bit further out from me, but I wanted the best. I sure found it! I wish they were my regular dentist, and I'm looking forward to seeing them again for my check-up which was delayed due to COVID.
Melissa E.
Melissa E.
December 9, 2020.
I found Dr. Amin a few years back after I hadn't been to a dentist in a decade. Many traumatic dental experiences in childhood have made me so phobic that even getting a cleaning was a knee-knocking, heart-pounding trial. But finally I couldn't put off some things any longer. During my first anesthesia session, Dr. Amin replaced five old metal fillings, and during the second he did three more plus a crown. I was completely comfortable, and never felt a thing. Because they were extra-long sessions, I did sleep for about 12 hours after, but the next day I felt just fine. This past week, my back top tooth cracked in half and fell out of my mouth, and a couple days later the crown on the remainder of the tooth fell out too! Despite being nervous about Covid 19, I had to get it taken care of, so I called and quizzed the staff about precautions, which turned out to be even above and beyond what I would have expected. So yesterday I went for the tooth extraction and plug. After they put on the blood pressure cuff and put in the IV, I gradually got a little tired and closed my eyes. I sat there for about 10 minutes and thought Gee, I wonder if they're going to get started any time soon, and a minute later Dr. Amin said "Wake up, you're all done!" That was a short session, and I didn't have the kind of fatigue I did my first time. I stayed up most of the evening. Today, everything is good! I'm taking my antibiotic and eating soft foods, and there is surprisingly little pain now that the numbness has worn off. The tooth site and my cheek are a little sore, and the corner of my mouth, and I have a very slight headache, but nothing to any great level--I'm not even taking the acetaminophen. I feel good, and wide awake. Thanks to everyone at the office for a comfortable and professional job! I really REALLY appreciate you for giving me painless dental experiences!
Tanya S.
Tanya S.
December 3, 2020.
What can I say about Dr. Amin he is the best! I'm so grateful for him. He has literally changed my life and given me the confidence to smile more. I had major restorative dental work done and everything went smoothly. Dr. Amin is very compassionate and he really cares about his patients he made me feel comfortable and cared for. He is very knowledgeable and has a great sense of humor. His office is very clean and they take the patients health and safety very serious. His staff is also amazing they made me feel very welcomed and important. I'm so happy I did my research and found Dr. Amin.  Thank you Dr. Amin and team.
Sheila S.
Sheila S.
November 6, 2020.
Two implants done! Finished all procedures and I couldn't be happier. It's the first time in years I looked forward to going to the dentist. Even during Covid life the staff and Dr. Amin took care of me. There is a possibility I may move to Long Beach but I would still travel to keep Dr. Amin as my dentist.
Allison S.
Allison S.
November 4, 2020.
I could not ask for a more caring, exceptionally knowledgeable dental care provider. He's not just a dentist, but someone who looks after your immediate dental needs and helps you plan and prepare for the future.
Julia R.
Julia R.
October 8, 2020.
I've been going to Dr. Amin since I turned 16 and have been going since. Before going to Dr. Amin's dental office, I had 4 crowns that I was not happy with and dealt with it until finally I asked Dr. Amin and because I  feel comfortable and because I trust him with his work I recently had my crowns fixed and worked on by  Dr. Amin and have never loved my smile the way I do now, I can actually enjoy my pictures, I can enjoy my smile from either angle and that really mattered to me. Thank you so much Dr. Amin still and will be in love with MY smile
Aaron D.
Aaron D.
October 6, 2020.
I've been coming to Dr. Ramsey for about five years and I have to say, he is by far the best dentist I've had - ever. The staff is professional and kind, the office is exceptionally well maintained, and Dr. Ramsey is careful and extremely knowledgeable about current developments and research in dentistry. I recently had a dental implant which was a long process but well worth it. I required a sinus lift as well as a bone graft. The surgery went off without a hitch, I was comfortable and the healing process was quick and without complication. Highly recommend!!
Flo O.
Flo O.
September 21, 2020.
This is my 1st review of Dr. Amin, and in my over 17 years of being with him, my experiences with Dr. Amin and his staff have always been positive.  I don't recall a bad experience with the several implant procedures i have had.  They run an efficient office.  I like that they are proactive and reach out to their patients to remind us of routine care needed.  Dr. Amin's bedside care is impeccable.  They are also technologically up to date in terms of sending out texts as reminders, ability to incorporate any appointment into your mobile phone.  That is certainly a plus.  Keep up the great care!!!