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Good oral health isn’t limited to fighting cavities and tooth decay, restoring pearly whites, and aligning impacted or crooked teeth. An often overlooked portion of dental care is the health of gums — their appearance and condition, as well as the risk of inflammation and infection. Together, these preserve healthy, beautiful smiles.
Pay Attention to Your Gum Health
One of the most common complications of periodontal health is gum recession. Gums typically recede due to over-aggressive brushing or orthodontic treatment in the past and having thinner gum tissue.
A more serious cause for concern is a history of gingivitis and gum disease caused by bacteria and inflammation resulting from poor hygiene. When left untreated, receded gums can expose the roots of the teeth, causing sensitivity and likelihood of decay.
A gum graft can reverse these adverse effects and restore your gums to good health. Your gum grafting procedure's success depends on the right grafting procedure, preparation, and recovery — all of which is possible with an experienced periodontist.
What is a gum graft?
Gum grafting is a dental procedure performed by a periodontist (a gum specialist). It’s the recommended course of treatment for receding gums to avoid exposing the teeth' root surface that leads to decay and sensitivity. Gum grafts help reverse these adverse effects and restore gums' health so that they can maintain their protective seal around the teeth.
Gum grafting involves harvesting a piece of tissue from the roof of the mouth or nearby healthy gum tissue. This piece is then grafted — or attached — where the gum tissue has receded. Essentially, it’s a fast, two-part procedure that requires using existing healthy tissue already in your body and using it to correct issues and protect the rest of your smile against further complication.
What type of gum graft do I need?
There are several gum grafting techniques, each designed to address specific periodontal concerns. Each type of gum graft is recommended based on the degree of gum recession, the extent to which the cheek can pull on the surgical site during daily activities, and whether or not your gums have receded in between the teeth or just on the front surface.
All gum graft surgeries involve harvesting donor tissue from another part of the mouth and attaching it where the gums have receded. What’s different is how it’s done, and the expected results after healing. Your periodontist will walk you through each of these gum grafting techniques and recommend the best type based on your specific case and oral health history.
1. Connective tissue graft
Gum grafting using connective tissue requires opening a small flap — sometimes called a “trap door” — in the roof of your mouth. Your periodontist then uses this trap door to find and remove a piece of connective tissue underneath, and stitch it on the spot where your gums have receded. Out of all the gum grafting techniques, this is the most commonly performed.
2. Free gingival graft
In contrast to the “trap door” technique, a free gingival graft also removes a small piece of tissue from the roof of your mouth. The difference is that the tissue used is from the top layer of the palate and grafted onto the area that needs more gum tissue due to thinning. This technique prevents further recession by taking a piece of gum tissue from one place and grafting it onto another.
3. Pedicle graft
A pedicle graft involves grafting tissue harvested closer to the site of recession using a flap. The flap covers the receding gum tissue, essentially using tissue that’s already local to the problem area, rather than another part of the mouth, like the roof.
Periodontists note that pedicle gum grafting is often the most successful because it doesn’t cut off the blood flow in the tissues involved. The only requirement is, you need to have a lot of healthy gum tissue surrounding the receding area — perhaps less than ideal when the recession is already wide.
4. Alternative grafts
Gum grafting is commonly done using your healthy tissue, but it’s not always possible. In severe cases where much of the gums have receded, or if your periodontist has to cover the gum area of upwards of five teeth, an alternative graft may be recommended.
Largely receded gums would require harvesting a sizable portion of the palate tissue, which then becomes unsafe. Instead, cadaver or porcine (harvested from pigs) grafts are used to ensure full coverage of the receded areas.
What to Expect During Gum Graft Surgery
1. Before the Procedure
One of the best things about a gum graft is that it doesn’t require extensive preparation. It simply involves a consultation with your periodontist to understand how severe your recession issue is, and the best gum grafting technique for your case.
There are no dietary restrictions or medications prior to the procedure; all you need to do is arrange a ride to and from the procedure, as the combined effects of anesthesia, post-op medication, and slight discomfort can make it unsafe for you to drive or be on your own.
Upon arriving for the procedure, you will be escorted to the procedure room where local anesthesia will be applied to numb the area. In some cases, general anesthesia may be applied instead, especially if you feel anxious and can relax better if unconscious.
The gum grafting procedure itself doesn’t take long since the periodontist has already identified the donor tissue for harvesting and mapped out the grafting area. Once the sutures are applied, and the graft is secure, you will be asked to rinse your mouth with an antibacterial mouthwash. Your periodontist may also ask you to stay for an hour or two to ensure that the graft is successful, and there are no issues.
Recovery and Post-Op Care
Just like any dental procedure, the long-term success of gum grafting is in the crucial recovery period. It’s important to follow the post-op instructions carefully to avoid complications. Take the prescribed medications, such as antibiotics and painkillers, as instructed for fast healing.
Stick to a soft diet for the first two weeks of recovery. Opt for soft, cold foods like scrambled or soft-boiled eggs, yogurt, cooked vegetables, cottage cheese, ice cream, and gelatin to avoid damaging the graft. Avoid hard and hot foods that can burn or irritate the graft.
You also won’t be allowed to brush or floss the graft area to avoid disrupting the healing, such as opening the wound, which causes an infection. But even then, it’s important to maintain good oral hygiene.
Your periodontist will recommend an antimicrobial mouthwash to remove plaque buildup and prevent infections in the meantime and inform you when it’s safe to resume brushing and other activities like exercise, likely during your two-week post-op check-up.
Complications During Gum Graft Surgery
Gum grafting is a highly safe and effective procedure; it has been tested and proven successful in treating countless cases of receding and thinning gums due to aggressive brushing and gum disease. Still, complications and infections may occur, especially without proper post-op care.
Call your periodontist right away for emergencies like oozing or unexpected bleeding around the graft site, swelling, bruising, fever, and pus. These indicate that the graft did not properly take or adapt to the site and must be re-grafted.
How much does a gum graft cost?
Gum grafting is a relatively common and affordable dental procedure. Depending on the size of the graft required to correct the recession, it can range from anywhere from a few hundred to a few thousand dollars. This cost may be covered in full or at little cost to you by your dental insurance plan, so make sure to check with your insurance provider prior to the procedure.
Gum Grafting Takes a few Weeks to Heal and Pay Off
Gum grafting won’t magically change the appearance of previously receded gums overnight. It takes a few weeks to heal and swelling to subside, and during that time the graft will adapt to the area. After that, it will take another few weeks to see the full benefits — the restored appearance of the gums.
You may find that you do not like how the graft looks after it heals completely. You can discuss the possibility of a gingivoplasty or reshaping of the gum tissue with your periodontist to improve its appearance and complete your beautiful smile.