Gingival Grafting Explained

A gingival graft also called gum graft, can improve the cosmetic appearance of your smile and protect your teeth from gum recession. Gum recession occurs when the tissues around the teeth withdraw from them and expose additional surfaces of the tooth and/or the tooth’s root. This is a common dental problem and can cause damage to the bone supporting the teeth, but patients don’t often notice it in the early stages.

Effects of gum recession

The gradual process of gum recession means that many people don’t realize they have it until it develops into a more severe stage. The exposure of the tooth root caused by gum recession can lead to sensitive teeth when drinking and eating hot or cold foods. If this dental issue goes without treatment, gum recession can lead to tooth loss, so it’s vital to repair the damage and prevent additional dental problems with a procedure such as a gingival graft.

Gingival graft procedure

There are four types of gingival grafts that your dentist usually performs to address gum recession or to improve the appearance of your smile.

  • Connective tissue gingival graft – The most common method to treat root exposure, during a connective tissue graft, the dentist cuts a flap of skin at the palate (roof of your mouth) and removes tissue from under the flap (subepithelial connective tissue). The dentist then stitches the connective tissue to the gum tissue around the exposed tooth root. Following removal of the connective tissue from the palatal flap, the dentist stitches the flap back down.
  • Free gingival graft – Just like a connective tissue graft, this type of graft uses tissue from the palate, but from the roof of the mouth, not just the tissue underneath. The primary use of this method is for people with thin gums who require additional tissue to enlarge the gums.
  • Pedicle gingival graft –For this type of gingival graft, the dentist takes tissue from the gum near or around the tooth that requires repair. The dentist only partially cuts away the flap of skin called a pedicle and leaves one edge attached so they can pull the tissue down or over and cover the exposed root when sewn into place. This type of gingival graft is only viable in patients who have ample gum tissue near the tooth.
  • Soft tissue allograft – Similar to the connective tissue graft and free gingival graft, but there is only one surgical site. Instead of taking tissue from the palate, the tissue used is human cadaver tissue that has undergone extensive processing to remove all cellular elements, leaving a collagen scaffold that autogenous fibroblasts can attach to and eventually remodel into host periodontal tissues.

The ultimate choice of what type of tissue to use depends on what you and your dentist feels is right.

Recovery from gingival graft

Following a gingival graft, you can go home, but if your dentist has given you a sedative to relax, you’ll need someone else to drive you home. The dentist will give you instructions for postoperative care including suggestions on diet, medications, and physical activity. You shouldn’t brush or floss the gum line area where the graft took place until it’s fully healed and you need to rinse our mouth with a special rinse to control plaque as the graft heals. Sometimes the dentist prescribes an antibiotic to prevent infection. In the 1-2 weeks after the gingival graft, your dentist will recommend that you eat cool, soft foods including cottage cheese, pasta, eggs, fish, and yogurt.

The type of gingival graft surgery determines how much pain a patient may experience. For those who had no palate tissue removed, there’s usually little to no discomfort. Patients who did have palate tissue removed may be uncomfortable for a few days with a wound that may feel like a burn at the top of the mouth. Thankfully, the mouth heals quickly and pain medication, and anti-inflammatory medications can help you feel comfortable post-surgery.

It can take 1-2 weeks for the mouth to heal completely, but you can resume normal activity the day following surgery. During the healing process, you should call your dentist if you experience unusual symptoms such as pain, bruising, and swelling that are more than your dentist told you to expect or bleeding that doesn’t stop after 20 minutes of applied pressure.

Gingival grafts are an effective way to repair gum recession, prevent further damage and improve your smile, but practicing good oral hygiene and regular dental checkups are essential to avoid future gingival grafts. Contact Greater Baltimore Prosthodontics today for answers to all your questions regarding gingival grafting and other periodontics treatments.

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