ICD-10: K06.02

Gingival recession, classified under the ICD-10-CM code K06.02, refers to the condition where the gum tissue surrounding the teeth pulls back, exposing more of the tooth or the tooth's root. This condition can occur in a generalized manner, affecting multiple teeth across the dental arch.

Clinical Description

Definition

Gingival recession is characterized by the migration of the gingival margin apically (downward) from its normal position, leading to the exposure of the tooth root. This condition can result in aesthetic concerns, increased sensitivity, and a higher risk of dental caries and periodontal disease due to the exposure of the root surface, which is not protected by enamel like the crown of the tooth.

Etiology

The causes of generalized gingival recession can be multifactorial, including:

• Periodontal Disease: Chronic inflammation and infection of the gums can lead to tissue loss and recession.
• Mechanical Factors: Aggressive brushing, improper flossing techniques, or the use of hard-bristled toothbrushes can contribute to gum tissue damage.
• Genetic Predisposition: Some individuals may be genetically predisposed to periodontal issues, including gingival recession.
• Hormonal Changes: Fluctuations in hormone levels, particularly during puberty, pregnancy, or menopause, can affect gum health.
• Tobacco Use: Smoking and other forms of tobacco can impair blood flow to the gums, exacerbating recession.
• Misaligned Teeth: Malocclusion or misalignment can lead to uneven forces on the gums, contributing to recession.

Symptoms

Patients with generalized gingival recession may experience:

• Tooth Sensitivity: Increased sensitivity to hot, cold, or sweet stimuli due to exposed dentin.
• Aesthetic Concerns: Visible tooth roots can lead to self-consciousness about one's smile.
• Increased Risk of Cavities: The exposed root surfaces are more susceptible to decay.
• Gum Bleeding: Inflammation and irritation of the gums may lead to bleeding, especially during brushing or flossing.

Diagnosis

Diagnosis of gingival recession is typically made through clinical examination, where a dentist assesses the extent of gum tissue loss and measures the distance from the cemento-enamel junction (CEJ) to the gingival margin. Radiographic evaluations may also be conducted to assess the underlying bone structure and any periodontal disease.

Treatment Options

Management of generalized gingival recession may include:

• Improved Oral Hygiene: Educating patients on proper brushing and flossing techniques to prevent further recession.
• Non-Surgical Treatments: Scaling and root planing to remove plaque and tartar, along with antimicrobial treatments to reduce inflammation.
• Surgical Interventions: In cases of significant recession, surgical options such as gum grafting may be considered to restore lost tissue and protect tooth roots.

Conclusion

ICD-10 code K06.02 for generalized gingival recession encapsulates a common dental condition that can have significant implications for oral health. Understanding its causes, symptoms, and treatment options is crucial for effective management and prevention of further complications. Regular dental check-ups and maintaining good oral hygiene practices are essential for individuals at risk of developing this condition.

Gingival recession, classified under ICD-10 code K06.02, refers to the apical displacement of the gingival margin, resulting in the exposure of the root surface of the teeth. This condition can have significant implications for oral health, aesthetics, and overall patient well-being. Below, we explore the clinical presentation, signs, symptoms, and patient characteristics associated with generalized gingival recession.

Clinical Presentation

Definition and Overview

Gingival recession is characterized by the loss of gum tissue, leading to the exposure of the tooth roots. When this recession is generalized, it affects multiple teeth rather than being localized to specific areas. This condition can be a result of various factors, including periodontal disease, mechanical trauma, or anatomical predispositions.

Signs

1. Visible Root Exposure: The most apparent sign of generalized gingival recession is the exposure of the tooth roots, which may appear discolored or darker than the crown of the tooth.
2. Gingival Margin Position: The gingival margin is positioned apically (lower) than the normal anatomical position, which can be assessed visually or through periodontal probing.
3. Loss of Attached Gingiva: There may be a noticeable reduction in the width of attached gingiva, which can be evaluated during a clinical examination.

Symptoms

1. Sensitivity: Patients often report increased sensitivity to temperature changes, particularly cold, due to the exposure of the dentin.
2. Discomfort or Pain: Some individuals may experience discomfort or pain, especially when consuming certain foods or beverages.
3. Aesthetic Concerns: Many patients express dissatisfaction with their smile due to the visible root exposure, which can affect their self-esteem and social interactions.

Patient Characteristics

Demographics

• Age: Gingival recession can occur at any age but is more prevalent in adults, particularly those over 30 years old.
• Gender: Some studies suggest that males may be more affected than females, although this can vary based on other risk factors.

Risk Factors

1. Periodontal Disease: A history of periodontal disease is a significant risk factor, as inflammation and infection can lead to tissue loss.
2. Oral Hygiene Practices: Poor oral hygiene or aggressive brushing techniques can contribute to mechanical trauma, exacerbating recession.
3. Tobacco Use: Smoking and other forms of tobacco use are associated with increased periodontal issues, including gingival recession.
4. Genetic Predisposition: Some individuals may have a genetic predisposition to periodontal diseases, increasing their risk for gingival recession.
5. Anatomical Factors: Thin gingival biotype and high frenum attachment can predispose individuals to recession.

Behavioral and Lifestyle Factors

• Diet: A diet high in acidic foods can contribute to enamel erosion, which may exacerbate sensitivity and the appearance of recession.
• Stress: Psychological stress can lead to bruxism (teeth grinding), which may contribute to periodontal issues and recession.

Conclusion

Gingival recession, particularly when generalized, presents a multifaceted challenge in dental health. Understanding the clinical presentation, signs, symptoms, and patient characteristics associated with this condition is crucial for effective diagnosis and management. Early intervention and tailored treatment plans can help mitigate the effects of gingival recession, improve patient comfort, and enhance aesthetic outcomes. Regular dental check-ups and proper oral hygiene practices are essential in preventing and managing this condition effectively.

Gingival recession, classified under the ICD-10 code K06.02, refers to the condition where the gum tissue surrounding the teeth pulls back, exposing more of the tooth or the tooth's root. This condition can lead to various dental issues, including sensitivity, decay, and aesthetic concerns. Understanding alternative names and related terms for this condition can enhance communication among healthcare providers and improve patient education.

Alternative Names for Gingival Recession

1. Gum Recession: This is the most commonly used term and is synonymous with gingival recession. It describes the same condition in layman's terms.

2. Receding Gums: This phrase is often used by patients to describe the visual aspect of the condition, emphasizing the appearance of the gums moving away from the teeth.

3. Gingival Recession: While this is the clinical term, it is often used interchangeably with "gum recession" in both professional and patient discussions.

4. Marginal Gingival Recession: This term may be used to specify the location of the recession at the margin of the gums.

5. Root Exposure: This term highlights the consequence of gingival recession, where the roots of the teeth become exposed due to the loss of gum tissue.

Related Terms

1. Periodontal Disease: Gingival recession can be a sign of periodontal disease, which encompasses a range of inflammatory conditions affecting the supporting structures of the teeth.

2. Periodontitis: This is a more advanced form of periodontal disease that can lead to significant gum recession and tooth loss if untreated.

3. Gingivitis: While gingivitis refers to inflammation of the gums without recession, it can be a precursor to conditions that lead to gingival recession.

4. Dental Sensitivity: This term is often associated with gingival recession, as exposed tooth roots can lead to increased sensitivity to temperature changes and certain foods.

5. Non-carious Cervical Lesions: This term refers to the loss of tooth structure at the cervical area (near the gum line) that can occur alongside gingival recession.

6. Mucogingival Defects: This term encompasses various conditions affecting the relationship between the gingiva and the mucosa, including gingival recession.

Conclusion

Understanding the alternative names and related terms for ICD-10 code K06.02 (gingival recession, generalized) is essential for effective communication in dental practice. These terms not only facilitate better patient understanding but also enhance the accuracy of diagnosis and treatment planning. By familiarizing oneself with these terms, dental professionals can improve their interactions with patients and ensure comprehensive care for those experiencing gum recession.

Gingival recession, classified under ICD-10 code K06.02, refers to the apical migration of the gingival margin, resulting in the exposure of the tooth root surface. This condition can lead to various dental issues, including sensitivity, aesthetic concerns, and increased risk of root caries. The diagnosis of generalized gingival recession involves several criteria, which are essential for accurate coding and treatment planning.

Diagnostic Criteria for Gingival Recession

1. Clinical Examination

A thorough clinical examination is crucial for diagnosing gingival recession. The following aspects are typically assessed:

• Measurement of Recession: The distance from the cemento-enamel junction (CEJ) to the gingival margin is measured. A recession of 1 mm or more is generally considered significant.
• Extent of Recession: Generalized gingival recession is characterized by the presence of recession at multiple teeth, rather than localized areas.
• Gingival Health: The condition of the surrounding gingival tissue is evaluated, including signs of inflammation, bleeding on probing, and overall periodontal health.

2. Patient History

Gathering a comprehensive patient history is vital. Key points include:

• Medical History: Conditions such as diabetes, hormonal changes, or autoimmune diseases can contribute to gingival recession.
• Dental History: Previous periodontal treatments, oral hygiene practices, and history of orthodontic treatment may influence the diagnosis.
• Lifestyle Factors: Habits such as smoking, grinding teeth (bruxism), and aggressive brushing techniques can exacerbate gingival recession.

3. Radiographic Evaluation

While gingival recession is primarily a clinical diagnosis, radiographs may be used to assess:

• Bone Levels: X-rays can help determine if there is associated bone loss, which may indicate periodontal disease.
• Root Surface Condition: Radiographic images can reveal any root caries or other underlying issues that may complicate the recession.

4. Classification Systems

The diagnosis may also involve the use of classification systems, such as:

• Miller Classification: This system categorizes gingival recession based on the extent of tissue loss and the relationship to the mucogingival junction. Generalized recession typically falls into Class I or II, where the recession does not extend beyond the mucogingival junction.
• Periodontal Disease Classification: Understanding the overall periodontal status is essential, as generalized recession may be associated with chronic periodontitis.

Conclusion

The diagnosis of generalized gingival recession (ICD-10 code K06.02) requires a multifaceted approach, including clinical examination, patient history, radiographic evaluation, and classification systems. Accurate diagnosis is crucial for developing an effective treatment plan, which may include non-surgical periodontal therapy, surgical interventions, or lifestyle modifications to prevent further recession and maintain oral health.

Gingival recession, classified under ICD-10 code K06.02, refers to the apical migration of the gingival margin, leading to exposure of the root surfaces of the teeth. This condition can result from various factors, including periodontal disease, aggressive tooth brushing, and anatomical predispositions. Understanding the standard treatment approaches for generalized gingival recession is crucial for effective management and patient care.

Treatment Approaches for Gingival Recession

1. Non-Surgical Treatments

a. Oral Hygiene Education

Educating patients on proper oral hygiene techniques is fundamental. This includes:
- Gentle Brushing Techniques: Patients should be advised to use a soft-bristled toothbrush and to avoid aggressive brushing, which can exacerbate recession.
- Flossing: Regular flossing helps maintain periodontal health and can prevent further recession.

b. Desensitizing Agents

For patients experiencing sensitivity due to exposed root surfaces, desensitizing toothpaste or fluoride varnishes can be applied to reduce discomfort.

c. Scaling and Root Planing

This deep cleaning procedure removes plaque and tartar from below the gum line, which can help reduce inflammation and promote healing of the gingival tissue.

2. Surgical Treatments

a. Gingival Grafting

Gingival grafting is a common surgical procedure for treating significant gingival recession. There are several types of grafts:
- Free Gingival Graft: Involves taking tissue from the palate and placing it over the receded area.
- Connective Tissue Graft: A more common approach where tissue is harvested from beneath a flap of skin on the palate and placed over the recession.
- Pedicle Graft: Tissue is moved from an adjacent tooth to cover the recession.

b. Pinhole Surgical Technique

This minimally invasive procedure involves making a small hole in the gum tissue and using special instruments to reposition the gum over the exposed root surfaces. This technique can be less painful and has a quicker recovery time compared to traditional grafting methods.

3. Adjunctive Therapies

a. Periodontal Maintenance

Regular periodontal maintenance visits are essential for monitoring the condition and preventing further recession. These visits typically include professional cleanings and evaluations of gum health.

b. Use of Biologics

In some cases, the use of biologic agents, such as growth factors or platelet-rich plasma (PRP), may enhance healing and tissue regeneration following surgical procedures.

4. Lifestyle Modifications

Encouraging patients to adopt healthier lifestyle choices can also play a role in managing gingival recession:
- Smoking Cessation: Smoking is a significant risk factor for periodontal disease and can exacerbate gingival recession.
- Dietary Changes: A balanced diet rich in vitamins and minerals supports overall oral health.

Conclusion

The management of generalized gingival recession (ICD-10 code K06.02) involves a combination of non-surgical and surgical approaches tailored to the severity of the condition and the individual needs of the patient. Early intervention and education on proper oral hygiene practices are critical in preventing further recession. For more advanced cases, surgical options such as grafting or the pinhole surgical technique may be necessary to restore gingival health and aesthetics. Regular follow-up and maintenance are essential to ensure long-term success and patient satisfaction.