Gum Grafting / Recession

Gum Grafting before and after.

Aggressive tooth brushing, periodontal disease, and genetically thin tissue can lead to gum recession, which ultimately results in exposed tooth roots. When tooth roots are exposed, teeth appear too long and can become sensitive to hot and cold liquids and foods. Also, the exposed roots are in danger of decay.

Soft tissue grafts are available to repair this problem by increasing the amount of gum around your tooth as well as preventing further recession, bone loss or decay. The procedure covers the roots as well as increases the amount of gum tissue where excessive gum recession is present. Gum grafting involves carefully placing a small amount of new tissue in an area where little or no gum tissue currently exists — typically recommended to prevent further gum recession or to cover root surfaces of your teeth that have become exposed. The tissue used in this procedure may come from a variety of sources but usually is taken from the palate (roof of the mouth), after the area has been numbed for your comfort. Then it is delicately sutured (stitched) to secure it in place where it's needed.

Your body's natural recovery process takes over after the grafting procedure is complete. During this time, new blood vessels grow into the graft and help it to become integrated with the surrounding tissue. A successful graft can reduce or eliminate problems like tooth sensitivity, root cavities, and further gum recession, as well as improve the aesthetics of your smile.

How do you know if you need a gum graft?  Often, you can clearly see or feel the problem. Exposed tooth roots can make your teeth look overly “long,” and they also generally appear somewhat darker than your pearly white crowns. Gum recession is a condition that can increase with age, as we recognize when we hear the phrase “long in the tooth.” But the potential problems of gum recession aren't just cosmetic — they can also seriously impact your oral health.

A Closer Look at Your Gums

Inside your mouth, gum tissue forms a barrier that resists the vigorous mechanical (and microbial) effects of eating, chewing and biting. Gums may begin to recede, or shrink down, for several reasons.

One is ineffective oral hygiene: This includes both inadequate brushing, which fails to remove dental plaque; and excessive brushing, which erodes the tissue. Foreign objects in the mouth that rub against the gums, like poorly fitting removable dentures, tongue bolts, or even fingernails, can also contribute to gum recession.

When the tooth's roots lose the protection of healthy gum tissue, they can become extremely sensitive to hot or cold temperatures, causing pain when you consume many foods and drinks. Worse, missing gum tissue makes it easier for bacteria to penetrate the roots and cause decay — or for minor trauma to result in rapid gum recession. In either case, the eventual result may be tooth loss. That's why proper treatment of gum recession is so important.

Treating Gum Recession With Gingival Grafting

After a thorough examination and assessment of your teeth, gums and overall health, the gingival grafting procedure may be recommended. The tissue used in this procedure may be obtained from a variety of sources: an area next to the area of recession, from the hard palate, or donated tissue from another person, which has been medically processed to make it safe to use.

There are several different methods of gingival grafting. For example, if you have lost gum tissue in an area of your mouth that's not highly visible when you talk or smile, additional gum tissue can be placed there to prevent further recession without trying to cover the tooth root surface completely. This procedure is referred to as a free gingival graft since the tissue is separated from its blood supply and has a very high success rate. To view before and after photos

A connective tissue graft is used if the objective is to cover root surfaces, improve your smile, and reduce tooth root sensitivity. This soft tissue graft is highly esthetic and used routinely in areas that are visible when you talk or smile. To view before and after photos  

Grafting procedures are typically carried out under local anesthesia, and are generally pain-free. You should experience very little discomfort after the surgery, even if tissue has been removed from your palate, because the areas are usually covered by a soothing, putty band-aid-like material. Fortunately, any discomfort that you do have can be alleviated with over-the-counter or prescription anti-inflammatory medication, and it is generally short-lived. A soft diet (and an antibiotic) may also be recommended for a week or so thereafter, enabling the tissues to heal fully; otherwise, your normal activities will not be limited.

Post-surgical care Instructions for Gum Grafting

RECOVERY

Rest with your head elevated when you arrive at home after the procedure. We ask that you please limit your physical activity and keep moving to a minimum for the first 24-hours.

ICE APPLICATION

For the first 4-5 hours after the surgery, we recommend placing an ice bag to your face in 20-minute intervals. This will help reduce facial swelling. If needed, you can use an ice bag for 24-hours.

MEDICATION INSTRUCTIONS

Please take anti-inflammatory medications (NSAIDs) to prevent inflammation, swelling, and pain. For the next 4-5 days, we suggest taking 400mg-800mg of Ibuprofen every six hours to reduce swelling and pain and quicken healing. DO NOT take more than 2400mg in a 24-hour period. If you experience excessive pain or discomfort, take the narcotic that has been prescribed to you. If you do not have one, please call our office and the doctor will call in a prescription to your pharmacy. Please take as directed along with the NSAID. If you’ve been prescribed an antibiotic, please take as directed. We ask that you finish the entire dosage. If any of the medications are causing you extreme nausea, itching, or a rash; discontinue its use and call our office immediately.

IF YOU EXPERIENCE BLEEDING

If your donor site has some minor bleeding, this is no cause for alarm. You can either gently rinse your mouth out with iced water or iced tea or apply gentle pressure to the donor site with a moistened piece of gauze or a tea bag for 20 minutes. (Tea contains tannic acid which can help stop the bleeding.)

To prevent irritation of the donor site and grafted site, we will place a bandage over each area. Please DO NOT brush the bandaged areas. If the bandage should become loose or fall out and you feel comfortable, then continue to avoid brushing the surgical areas. If the donor site and/or grafted site is uncomfortable without the bandage, then we can attempt to place another bandage or you can apply “Orabase” on the donor site only.

By the second or third day, you graft will look white in color, and it will stay that way for several days. Do not worry; this is normal. We do ask that you refrain from smoking and drinking alcohol as these activities will interfere with blood clotting and healing of the grafted site.

EATING GUIDELINES

When you arrive home after surgery, you may have something very soft to eat or cold to drink. In the evening on the day of your surgery, we recommend eating a soft, bland meal as this is usually the best way to help you feel better. For the first week, please do not eat anything hard or crunchy.

CARING FOR YOUR MOUTH

We ask that you PLEASE DO NOT PULL DOWN YOUR LIP TO LOOK AT THE GRAFT SITE. By doing so, you can dislodge the healing tissue. We also strongly request that you DO NOT brush the area in which you had surgery as this will hinder the healing process. Please continue your regular oral hygiene habits on all other areas in your mouth. Please use an antiseptic mouthwash at least once in the morning and once at night before bed until your next appointment with our office.

If you have any questions or concerns, please call our office at 847-658-3355.

Keeping Your Gums Healthy

Following a gum graft, it's more important than ever to practice good oral hygiene; this will help prevent gum problems from developing in the future. Your regimen should include proper brushing with fluoride toothpaste, daily flossing, a healthy diet and regular dental and periodontal checkups. Maintaining healthy gums is a key to keeping up your overall oral health — and preserving your smile.

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