Gum Graft Surgery
A gum graft (or gingival graft) is often required if a patient is suffering from gum recession, typically as a result of a gum disease like gingivitis or periodontal disease.
What is a Gum Graft?
A gum graft is a type of dental surgery that involves placing gum tissue in an area where the gum line has receded or the roots of the teeth are exposed.
Gum recession can happen for any number of reasons, including gum disease, excessive tooth brushing, inadequate tooth brushing, genes, hormone changes or smoking. Leaving the root surface of a tooth exposed can lead to bacteria and plaque buildup, and interrupt the blood flow.
A gum graft can also be performed for cosmetic purposes, if the person is not happy with the way their gums look when they smile.
During a gum graft procedure, a periodontist will remove healthy gum tissue from another area in the mouth (typically the roof of the mouth) and use this to cover the exposed tooth root. They may also take nearby healthy gum tissue and stretch it to cover the exposure site.
The type of gum grafting required will depend on whether the goal is to fully cover the exposed tooth roots or to simply prevent further recession. In some cases, the periodontist may use medically processed tissue from a tissue bank rather than the patient’s mouth.
A gum grafting procedure will usually be the best option if the patient is at risk for severe tooth decay or tooth loss, however alternative treatments, such as tooth extraction, may also be considered.
Types of Gum Graft Surgery
There are different types of gum graft surgeries, and the one you will need will depend on the composition of your mouth and the extent of the damage. Your dentist will discuss this with you.
Before each of these procedures, the oral surgeon will administer a local anaesthetic to the area they are operating on. General anaesthetic may be used in some cases.
Additionally, before proceeding with the gum grafting, the oral surgeon may lift some of the existing gum away to clean the exposed tooth.
Connective Tissue Grafts
A connective tissue graft is the most common type of gum grafting procedure. It involves removing tissue from the roof of the mouth (the palate) by making a flap and then taking the connective tissue underneath the top layer. This tissue is then stitched onto the receding gum tissue in the area that needs it. The flap made at the site of the graft tissue is stitched closed.
This type of procedure will often have the most painful recovery period, because of the incision in the palate.
Free Gingival Grafts
A free gingival graft is usually the best type of gum grafting procedure for people with thin gums. In this procedure, the required gum tissue is removed directly from the top layer on the roof of the mouth and stitched to the existing gums in the area with thinner gum tissue.
A pedicle graft would be performed if the patient has a lot of extra gum tissue surrounding or growing near the site of gum recession or exposed teeth. In this procedure, the oral surgeon will partially cut away the existing gum tissue and then stretch it to cover the exposed tooth.
Reasons for Gum Grafting
Gum grafting is usually performed to treat gum recession, which can result in increased tooth sensitivity and discomfort when eating or drinking very hot or cold foods, tooth decay, abrasion and tooth loss if left untreated. Gum grafts are often needed to repair damage to the teeth and gums and protect from further damage.
Missing gum tissue can leave the exposed roots of your teeth open to bacteria that could penetrate and cause decay, leading to further complications if not treated quickly.
Receding gums can come as a result of periodontal disease, aggressive brushing, poor dental hygiene or genetics, and the immediate signs will usually be very obvious to the person suffering from them.
Gum graft surgery may also be performed for cosmetic or aesthetic reasons – such as to improve the appearance of your smile.
Gum Grafting Treatment
A gum graft is commonly performed on a patient suffering from gum recession, and the procedure takes between 1-2 hours.
No preparation is required for a gum grafting treatment, but you will need to arrange a lift to and from the procedure because the pain medication you receive makes it unsafe to drive immediately after the surgery.
Your mouth will be numb for a few hours after the surgery, so you should eat beforehand. You should also try to fill your prescriptions (if you have any) immediately after the surgery so that you can take any required pain relief before the anaesthetic wears off.
You should be able to go home immediately after the surgery is over, and return to work the next day. You may experience some pain and swelling for the next few days, especially if the connective tissue was taken from the roof of your mouth. You can treat this with over the counter pain medication or prescription medication. The complete healing process takes 1-2 weeks, and there are a few things you should avoid doing during this time. These include:
- Flossing or brushing teeth at the surgical site
- Strenuous exercise
- Smoking, or using tobacco products
- Eating hard or extremely hot foods
You should eat mainly cold, soft foods during the healing period, such as ice cream, eggs and pasta. Your doctor may recommend that you use an antimicrobial mouthwash to control plaque build up and reduce the risk of infection, and you may need antibiotics if the new gum tissue was taken from an external donor.
You will need a follow up appointment after the surgical procedure to have a general check up or remove the stitches.
After you have healed from the gum surgery, you should try to address the issue that caused your gum recession. You will need to maintain good oral hygiene to avoid needing more gum graft procedures in the future.
You should be able to return to normal brushing and flossing 2 weeks after the surgery, but you may not see the full benefits of the grafting until 6 months later. The gum tissue will need time to heal and settle in to its new position, so don’t despair if you don’t see the results you were expecting straightaway.
Complications as a result of gum grafting surgery are rare, but should be treated as quickly as possible. If you notice bleeding after the first day, you should contact your dentist or orthodontist immediately. Other causes for concern would include:
- Oozing gums
- Teeth feeling looser or like they might fall out
- Spaces between the teeth that weren’t there before
In rare cases, the donor tissue (the gum tissue graft taken from your mouth) may not attach properly to the graft site. This would require that the surgery be performed again.
If you don’t like the way your mouth or smile looks after the oral surgery has been performed, you can talk to your doctor about reshaping the gums.
How Painful is a Gum Graft?
The dental procedure itself should be almost painless because of the application of anaesthetic, but you may experience mild to moderate pain in the days following the procedure. The pain will be worse if you’ve had a connective tissue graft procedure than if you received the healthy tissue from a tissue bank, because the removal of the underlying connective tissue will result in soreness at the donor site.
The pain should be fairly tolerable, and can be managed with medication.
How Much Does a Gum Tissue Graft Cost?
The cost of your treatment will vary depending on your specific needs, and your dentist will discuss this with you before proceeding.
The cost may be partially or completely covered by insurance depending on the kind of cover you have, and on whether the procedure is being performed for dental or cosmetic reasons.
How Long Do Gum Grafts Take to Heal?
It may take 1-2 weeks for your mouth to heal from gum graft surgery, but you should be able to return to work within 1-2 days of having the procedure.
You should use a soft toothbrush when you start brushing your teeth again, and try to stick to a healthy diet.
You may not see the final results of the surgery for 6 months after it has taken place.