Q. Dear Dr Patel Despite regularly attending my dentist and hygenist for twenty years I have now been told that gum recession on two lower front teeth is now so bad that I am not a candidate for gum grafting. As you may appreciate I am very annoyed with my dentist for not being more proactive over my recession issues given that I raised this with him from day one of attending all those years ago. On the positive side, radiographs show a substantial amount of bone remaining and I have no mobility whatsoever. My questions are these: Even with such severe gum recession would it be possible to place implants if required in the future? Are there any techniques for gum to be ‘built-up’ to accommodate implants after tooth extraction? By the way the (very) little tissue that remains is healthy and recession has been caused apparently by crowding, thin tissue-type.