Gum Tissue Grafts

If you've recently been told by your dentist or gum doctor (periodontist) that you need a gum graft, don't panic. Gum surgery sounds worse than it is. A gum graft may be necessary to protect your teeth from the damaging effects of gum recession, or you may choose to have one to improve the appearance of your smile.

Gum recession is the process in which the tissue that surrounds the teeth pulls away from a tooth, exposing more of the tooth or the tooth's root. This can cause damage to supporting bone. Gum recession is a common dental problem; it affects 4% to 12% of adults and often goes unnoticed until it becomes more severe.

Many people don't even notice that their gums have receded, because it is a gradual process. However, over time, an exposed tooth root can not only look ugly, but can cause tooth sensitivity, especially when eating cold or hot foods. Eventually, gum recession, if not treated, can cause tooth loss. To repair the damage and prevent further dental problems, a gum tissue graft may be needed.

Here's what you can expect during and after a gum tissue graft procedure.

Gum Tissue Graft: What Happens During the Procedure

Three different types of gum tissue grafts are typically performed. Which type your dentist uses on you will depend on your specific needs. The graft procedures include:

• Connective-tissue grafts. This is the most common method used to treat root exposure. During the procedure, a flap of skin is cut at the roof of your mouth (palate) and tissue from under the flap, called subepithelial connective tissue, is removed and then stitched to the gum tissue surrounding the exposed root. After the connective tissue -- the graft -- has been removed from under the palatal flap, the flap is stitched back down.
• Free gingival grafts. Similar to a connective-tissue graft, free gingival grafts involve the use of tissue from the roof of the mouth. But instead of making a flap and removing tissue under the top layer of flesh, a small amount of tissue is removed directly from the roof of the mouth and then attached to the gum area being treated. This method is used most often in people who have thin gums to begin with and need additional tissue to enlarge the gums.
• Pedicle grafts. In this procedure, instead of taking tissue from the palate, it is grafted from gum around or near the tooth needing repair. The flap, called a pedicle, is only partially cut away so that one edge remains attached. The gum is then pulled over or down to cover the exposed root and sewn into place. This procedure can only be done in people who have plenty of gum tissue near the tooth.

Some dentists and patients prefer to use graft material from a tissue bank instead of from the roof of the mouth. Sometimes, tissue-stimulating proteins are used to encourage your body's natural ability to grow bone and tissue. Your dentist can tell you which method will work best for you.

Recovery From Gum Tissue Graft

You will be able to go home following the procedure. However, if your dentist gives you a sedative to help you relax, you will need to make arrangements to have someone else drive you home.

Your dentist will give specific instructions regarding postoperative care, such as diet, physical activity, and medications. Do not floss or brush the gum line that was repaired until the area has healed. You will be asked to rinse your mouth with a special mouth rinse to help control plaque during the healing process, and you may be put on an antibiotic to reduce the risk of infection.

For a week or two following gum grafting, eat soft, cool foods, such as eggs, pasta, Jell-O, yogurt, cottage cheese, well-cooked vegetables, and ice cream.

The amount of pain you have after surgery depends on the type of gum graft performed. If no tissue is removed from your palate, you should have little to no discomfort. However, if tissue is removed from your palate, you may be uncomfortable for a few days following the procedure. The wound on the roof of your mouth has been described as feeling like a major pizza burn, but the good news is it tends to heal quickly. Over-the-counter anti-inflammatory medication or prescription pain medication can help keep you comfortable in the days following surgery.

While it may take a week or two for your mouth to fully heal, you should be able to return to work or normal activity the day after surgery.

Gum Tissue Graft: When to Call the Doctor

Call your dentist if you experience any unusual symptoms following surgery, including:

• Bleeding that won't stop after applying pressure for 20 minutes
• More pain, swelling, and bruising than your dentist said to expect

How Much Will a Gum Tissue Graft Cost?

Many dental insurance companies will pay a portion of the cost of gum grafts. If you don't have insurance, the cost of gum surgery will depend on how much work is being done. Talk to your dentist to learn about your payment options.

Will I Need Another Gum Tissue Graft?

While gum tissue grafts are effective at repairing gum recession and preventing further damage, there is no guarantee that gum problems won't develop again in the future. However, with regular dental checkups and careful dental care at home, serious damage requiring surgery can be prevented. Other ways to prevent gum disease include:

• Brush your teeth twice a day with a fluoride toothpaste.
• Floss daily.
• Rinse once or twice a day with an antiseptic mouthwash
• Visit your dentist routinely for checkups and professional teeth cleaning and see your periodontist as needed.
• Eat a well balanced and healthy diet.
• Don't smoke.

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