What is gum grafting?
Gums are the protective, pink tissue that cover the bony structure of our jaws and parts of the roots of our teeth. Healthy gums should be thick and firm. The thick and firm consistency of healthy gums maintain gum health. Thin gums and infected gums will compromise the structural integrity of the gums. When the gum line recedes (pulls back), the exposed roots will be quite sensitive to cold air/water.
In some cases, a graft (new piece of tissue) can be placed over the exposed root to bring the gum tissue back to its original form and position.
Who needs this treatment?
People whose gums have receded may require gum grafting
The possible causes of gum recession are gum disease, an overly abrasive tooth-brushing technique or misalignment of teeth. The key is to have the causative factors properly identified.
When a dental implant is planned to replace a front tooth that has very thin overlying tissues, a gum graft is also helpful in providing the "cushion" for a healthy and esthetic final result.
What are the benefits of gum grafting?
The gum graft covers the exposed dentine of root surfaces and reduces sensitivity. It stops the tooth from further wear and tear at the root area, which in turn maintains stability of the tooth. It also adds to a more esthetic and youthful appearance by restoring the normal balance between the length of teeth and the gum line.
What does gum grafting involve?
There are two different ways of obtaining the graft:
- The palate (roof of the mouth) offers good quality tissue that can be used as a graft (autograft) and transplanted onto the recipient area.
- Another source is Alloderm, which is donated human skin tissue matrix. This tissue matrix is meticulously treated to remove donor cells in a hi-technology aseptic procedure that is approved in the USA. This offers an abundant source of graft tissue that is safe and convenient to use. It is useful when a large number of teeth require the grafting procedure and removes the need for a second operation site (e.g., the palate) in the mouth.
The gums around the recipient site (the exposed root) are gently lifted away and the graft material is secured in place with fine sutures approximately the size of a hair. This can be likened to plastic surgery in the mouth.
How much time before the whole treatment is completed?
The underlying cause(s) for receding gums should be treated prior to undergoing gum grafting.
If the cause of receding gums is excessive tooth brushing, modification of tooth brushing technique is important. Sometimes, simply making the person aware of the need to lighten up on the abrasive tooth brushing technique should be sufficient. In other situations, it may take several weeks to months for gum disease to be treated, or between one to two years for orthodontic realignment of teeth.
After the underlying cause for receding gums has been addressed, the grafting procedure takes about an hour for a small area. Wider areas will require a proportionately longer time. The patient comes in for reviews in the first two weeks and stitches are removed within that time frame.
Regular reviews are maintained for the first three months so that the periodontist (gum specialist) monitors and helps the patient to maintain an optimally clean environment around the grafted site.
When will I be able to resume daily activities?
Minimal pain, bleeding or swelling is usually experienced after a gum grafting procedure. The patient will be taught to minimize any trauma to the operation site. The patient should essentially feel 99% like normal.
After about three days, one can expect to resume most normal daily activities. Medications such as antibiotics, painkillers and antiseptic mouthwashes help the healing process.
Will I be in pain?
Discomfort is minimal for the first three days, especially if Alloderm, and not the tissue from the palate is used.
What are the risks/side effects?
Over a million Alloderm procedures have been carried out worldwide with no side-effects reported. On the other hand, when one's own tissue (from the palate) is used, there is virtually no risk of rejection.
How effective / long lasting is this?
When surgical principles are observed and home care maintenance is performed, then the treatment outcome is highly predictable and lasts for many years.
However, not every person is suitable for gum grafting. Smokers are strongly advised to stop smoking totally. Diabetics need to have their blood sugar level well-controlled with proper diet, medicine and exercise. It is also crucial that regular maintenance with the periodontist is carried out to ensure that previously treated gum disease does not recur.
What other factors should I consider?
The position of the tooth/teeth in the mouth may determine suitability for grafting. The input from an orthodontist (braces specialist) may be necessary. Our clinic has multiple specialists under one roof and a joint consultation can be arranged where needed.