What are the different types of gum grafting procedures?
The most common gum graft that I do is called a connective tissue graft. Basically, the way it works is that we take the inside layer of gum tissue from the roof of your mouth and place it where it's missing. It's placed underneath your existing tissue, and then that tissue covers the root surface that has been exposed. That's the overall idea of how gum grafting works.
There are different techniques, but there are also different materials that we can use. One of the most predictable ways to cover the roots of your teeth is to use your own tissue. The fear for patients usually is, "Okay, you're going to the roof of my mouth. Is it going to be extremely painful? Are there other techniques that can be used?" Donor tissue is an option. I generally prefer using a patient's own tissue because of its predictability and long-term results.
How do we know if you're a good candidate for gum grafting?
Usually, someone who will benefit the most from gum grafting is a person who doesn't have active gum disease. When I'm talking about gum disease, I'm talking about an infection of your gums. If your gums are infected and you're losing bone around your teeth, you're at risk of losing your teeth. You can have gum recession from gum disease, and patients with active gum disease usually are not good candidates for gum grafting.
Patients who are great candidates for gum grafting are those who have healthy gums but are experiencing recession. Sometimes that can happen from brushing the teeth and gums too aggressively, which can traumatize the gum tissue and contribute to recession.
Sometimes these are young patients who have had braces, for example, and the gum tissue is receding. It can happen with Invisalign clear aligner therapy as well. As the teeth are moved and the arch is expanded, changes in the position of the teeth can affect the surrounding gum tissue. These are some of the patients who can be good candidates for gum grafting.
What is recovery like after a gum graft?
One of the main questions and one of the main obstacles to doing gum grafting is the fear of having significant pain on the roof of the mouth. The techniques have evolved a lot, and what we do today is use palatal stents. These are little plastic coverings that we place on the roof of the mouth to protect the wound and help minimize discomfort.
We may also prescribe medication like corticosteroids. We use what we call a Medrol Dose Pack, which is a medication that can help limit swelling and, as a result, help with discomfort after surgery. Most of my patients have a good experience overall. They have some level of discomfort that can often be managed with medications like ibuprofen and Tylenol, but there is a smaller group of patients who might have a harder time. We try to minimize this as much as possible.
The reality is that it's about two weeks of a soft diet. It's not a liquid diet. It's a soft diet. You can eat scrambled eggs, ground beef, ground chicken, yogurt, and well-cooked pasta. You basically don't want to eat anything that's really crunchy. No potato chips, popcorn, nuts, or fruit with small seeds.
There's also no brushing in the area of the graft for two weeks. You can clean your teeth carefully around the area according to the instructions we give you. You have to wait until the appropriate stage of healing to start brushing and flossing normally again, and potentially using a Waterpik if you use one. Basically, the two weeks after surgery are really critical as far as what you can eat and how you clean your teeth.
How successful is gum grafting for an exposed tooth root?
It can be very successful if we select the right candidate. If you don't have gum disease or black spaces between your teeth, even significant gum recession on the front of a tooth can often be treated with substantial root coverage.
Then the question is, how long-lasting is the gum graft? That's one of the most common questions that I get from patients. It's both, "How much pain will I have?" and "How long-lasting is it? Will I need to do it again?" The studies show that using your own tissue can provide stable results over a long period of time, including at five to 10 years. It's a very successful surgical procedure, and I highly recommend it for appropriate patients.
Will your gums look natural after they heal?
With the right procedure and appropriate healing, the goal is for the grafted tissue to blend naturally with the surrounding gums. When we do what we call a connective tissue graft with a tunneling procedure, for example, the tissue can blend very well throughout your mouth.
There is another procedure called an autogenous free gingival graft. And yes, it's not "free." It just means that you take gum tissue from one area and transplant it to another area. With that procedure, the tissue can look a little bit different or a little more whitish. We usually use that technique when it's necessary, such as when you don't have enough gum tissue around your teeth, and often in non-aesthetic areas. What I mean by non-aesthetic areas is that you don't show them when you smile.
How long do gum graft results last?
There are multiple factors involved with that. Studies show that gum grafts using your own tissue can remain stable at five years, 10 years, and potentially longer. But there are other factors involved as well.
You have to come in regularly to get your teeth professionally maintained, practice good home care, and avoid developing gingivitis, which is inflammation of your gums. Overaggressive brushing is another factor. If you don't change your brushing habits, the gum tissue could recede again.
Overall, it's a very successful procedure in the short term as well as the long term when you follow our recommendations on how to brush your teeth and come to see us regularly and see our hygienists here at Ravon Dental.
If you're ready to schedule an exam or would like to learn more about our services, we'd love to hear from you. Call us at (310) 275-5325 or email [email protected]. We look forward to caring for your smile.