Hold on a second!
“What’s that?” you ask yourself.
And as you squint, looking closely and observing intently, it becomes distressingly clear. Some of your teeth look longer as the margin of gum tissue surrounding said teeth pulls back or wears away. The resultant effect is that more of the teeth become exposed.
The medical term for this condition is gum, or gingival, recession (to describe the gums pulling back or receding). And if you need gum grafting done in Carrollton, TX to treat it, then it is most likely at an advanced stage.
But how can that be?
Well, gingival recession develops subtly and gradually, usually without your knowledge. It wouldn’t cause any sharp pain at first. As such, it sneaks up on you.
In fact, if it doesn’t progress too far before your dentist catches it, you’d still have some healthy gingiva. This is a minor recession and significant treatment may not be necessary.
However, by the time you begin to suspect something’s wrong, the recession of the gums—crucial bodily defense against trauma and pathogen penetration—may have reached the mucosa.
It is at about this point that you have tooth sensitivity—where eating something very cold or very hot makes you feel a sharp pain in the tooth. The gum and tooth where the recession is progressing would also have an unsightly appearance. You may also feel a notch near the gum line.
How gum recession affects oral health
As gum recede, gaps or “pockets” begin to form between the teeth and gumline. This creates a perfect abode for disease-causing bacteria to gain a foothold and multiply.
In addition, the loss of critical gum protection makes your tooth root (as well as other supporting tissue and bone structures of the teeth) susceptible to damage. As they are exposed and are not as hard as enamels. This damage may become so severe that it could lead to decay, bone degeneration, and ultimately tooth loss.
Causes of gingival recession
- Gum (periodontal) disease. It is the primary cause of gum recession.
- Genetics. According to some studies, up to 30% of the population may have increased predisposition to gum disease, regardless of how committed they are to oral hygiene.
- Rough or aggressive brushing and flossing. Go gentle. Don’t scrub. And if a toothbrush is not labeled as “soft,” pass on it.
- Poor oral hygiene. On the flip side, not brushing, flossing, or using antibacterial mouthwash as often as you need to worsens gum recession. Inadequate dental care helps plaque become tartar (calculus), which is hard to remove and can cause gum recession.
- Smoking and use of tobacco products. It encourages buildup of sticky plaque that is difficult to get off and can lead to gum recession. Compared to nonsmokers, smokers are four times more likely to develop periodontal disease.
- Bruxism—teeth grinding or clenching
- Hormonal changes. Especially in women, hormonal fluctuations that occur during puberty, pregnancy, and menopause may increase the sensitivity of gums and make them vulnerable to gingival recession.
- Misaligned or crooked teeth bite
- Tongue and lip piercings
Treatment of Gum Recession
Mild gum recession may be treated by a process called tooth scaling and root planing, and colloquially referred to as deep cleaning. It involves
- carefully removing of plaque and tartar that builds up on the teeth and root surfaces below the gum line in the affected area, and
- smoothing the exposed root area to make it hard for pathogenic bacteria to attach to it
Deep cleaning may also be supplemented by administering antibiotics to take care of any remaining harmful bacteria.
However, if the gum recession is extensive and is characterized by overly deep pockets and excessive bone loss, deep cleaning would not cut it. You’d need to have gum graft surgery to repair the damage caused by the gingival recession, halt its progress, and prevent additional infection.
What Is Gum Grafting?
In medical terms, a graft is a piece of living tissue transplanted surgically. Thus, gum grafting is the surgical process whereby healthy gum tissue is transplanted to an area where it is needed. The graft (gum tissue) is used to cover the exposed, damaged area.
The term “gum [tissue] graft” may be used to refer to the healthy gum tissue or as a synonym of gum grafting, depending on context. Aside gum graft, other synonyms of gum grafting are gingival graft (or grafting) and periodontal plastic surgery.
Benefits of Gingival Grafts
- Diminished sensitivity
With the exposed root covered, gum grafting helps reduce the discomfort associated with tooth sensitivity. You wouldn’t have to be selective and overly thoughtful of the temperature of food you’d love to eat making for a comfortable eating experience.
- Improved gum and oral health
Regardless of the reason for your gums receding, the bottom line is that it compromises the health of your gums, teeth, and other structures.
Gum tissue graft halts and reverses tissue loss, bone loss, disease progress, and protect against further decay or related problems.
- Improved appearance
Receding gums don’t look great. The gumline is uneven and asymmetrical, the tooth appears to be longer than normal, and your smile will appear “toothy.”
Gingival grafting helps restore the evenness and symmetry of your gumline, make the teeth look shorter, restore you smile, and make the tooth and gum structure pleasing to look at.
Types of Gum Grafts Carrollton, TX
- Subepithelial connective-tissue grafts
Often just called a connective tissue graft, it is the most common type of gum graft. It gets its name from the actual type of tissue used for as the graft.
The procedure involves cutting a flap of skin (palatal flap) at the roof of your mouth (palate). Then tissue underneath the flap, called subepithelial connective tissue, is removed to be used as the graft.
The subepithelial tissue graft is then stitched to the gum surrounding the exposed root.
The flap is stitched back down after the graft is removed.
This method has the benefit of excellent predictability of root coverage. Also, compared to the free gingival graft type, there is less pain at the palatal donor site.
- Free gingival grafts
For this procedure, the roof of your mouth (palate) is also the donor site.
However, instead of going underneath the skin to get the graft, a small amount of the free-lying tissue at the palate is cut out directly to serve as the graft.
This graft is then attached to the gum area being treated.
This method is often used in people who have thin gums.
- Lateral pedicle grafts
Often just called a pedicle graft, the donor site to source the graft is the area immediately adjacent to the damaged gum area. It does not involve the use of graft taken from another region of your mouth.
The procedures involves cutting a flap, called a pedicle, but not completely (only partially) so that one edge remains attached to the mouth. The pedicle is pulled down or over (depending on the orientation of the cut) to cover the area being treated and is then sutured into place.
The constraint of this method is that it can also be done in individuals who have plenty of gum tissue near the receding gum area. However, it is usually the most successful.
- Acellular dermal matrix allograft
This type of gingival graft does not use grafts sourced inside your mouth. Instead, it uses medically, processed donated human tissue as the graft.
As a result, there is no need for a donor site, which also means less pain.
- Another option is to use tissue-stimulating proteins to encourage the body’s natural ability to grow tissue and bone
Gingival Graft Surgery Carrollton, Texas
Going over your need for a gum graft is naturally the first course of action. It’ll be thorough and would involve some examination to determine amongst other things, what type of gum grafting would be best for you.
It’d also involve sharing your dental and medical history as well as any medication you’re on to identify any that may pose a problem for surgery. For example, anticoagulants, aspirin and aspirin-containing products, and vitamin E supplements inhibit clotting, which may cause perioperative (occurring around or at the time of your operation) complications.
It’ll also be the time to give you detailed information about the procedure, how you should prepare, any pain and possible risks associated with it, and what it’d cost.
- Eat light on the day of your gingival graft surgery
- After eating, endeavor to brush and floss properly. The risk of getting a post-operative infection decreases substantially if your mouth is clean.
- You would have to give up smoking at least a week before your surgery is due. Turning to tobacco alternatives like nicotine gum or patches should help.
Additionally, the specialist will give you detailed preoperative and postoperative instructions.
Periodontal plastic surgery is a minor procedure. It is also an outpatient procedure, so you’ll return home one or two hours after your surgery is complete.
How it proceeds will depend on the type of gum grafting you’re having. However, it typically starts with administering anesthesia. After the surgery, you may be asked to stay back for one or two hours for observation. This is to confirm there aren’t any immediate issues with the graft.
After the surgery, you’d be given prescribed medications and/or antibiotics. You’d also be given instructions to avoid post-op complications. The success rate of gum grafts is high.
Recovery and Follow-Up Care
Bleeding, Swelling, Pain, and Inflammation
It isn’t unusual to experience light bleeding a few hours after surgery. It’d typically be a small amount of blood mixed with abundant saliva.
You can apply a moist tea bag or gauze on the bleeding site. Then apply firm pressure or bite into it for about 20 consecutive minutes. This should make the bleeding cease.
This may not be the end of it, so you may want to place a towel on your pillow when sleeping to avoid waking up to blood stains. It isn’t cause for panic as it’d likely be due to a small amount of blood dripping out of your mouth (unbeknownst to you) while you sleep.
Aside bleeding, swelling is another fairly normal sign after gum graft surgery. To keep it down, apply ice on your face for 15 consecutive minutes on and allow for a span of 15 minutes before applying it again. You can use an “ice pack,” ice cubes in a plastic bag, or a bag of frozen veggies.
After 48 hours, ice may not be effective to reduce swelling. You’d want to move on to applying moist heat using a wet washcloth dipped in hot water (and squeezed before applying) or a bottle filled with hot water. Apply the heat to the side of your face where the swelling is present.
Noticeable swelling should stay on for between two and three days after surgery. It should clear out after 7 to 10 days.
Pain and Inflammation
A certain degree of pain is likely after gingival surgery (more on this in the next section). But it’s nothing a safe dose of over-the-counter pain medication such ibuprofen or acetaminophen can’t relieve.
You may have to take the first dose of analgesics before you feel any pain. As it will kick in and keep the feeling of soreness down when the effect of local anesthesia begins to fade a few hours after surgery.
Healing Time and Recovery
It would take between 1 to 8 weeks for your mouth to heal fully. However, you should be able to continue with your normal activity or return to work the day after your operation.
The duration of healing time depends on several factors. Which is why it varies from one individual to another. The factors include:
- Your general health
- Extent of tissue graft
- Commitment to follow post-operative instructions
Healing starts with shrinking of the soft tissue and reduced swelling. The graft would bind to the root surface and surrounding bone surface. It’d then begin to mature as vascularization (formation of new vessels that ensure stable blood supply) occurs.
Diet, Oral Hygiene, Other Recovery Tips, and Preventing a Recurrence
You’d have to stick to a soft, cold diet for a few days, sometimes up to two weeks, after surgery. You’d be informed of the exact duration, as this is part of the post-op information you’d receive.
You don’t want to bite into hard food as that could impede the healing process and undermine the surgery’s success. Typical soft foods include:
- gelatin, such as Jell-O
- eggs, especially soft-boiled or scrambled
- ice cream
- cottage cheese
- soft-cooked veggies
You’d want to follow specific recommendations given you as to when to resume your normal diet. Sometimes, although quite rare, the duration to stay on soft foods may be extended.
Maintaining excellent oral hygiene offers two benefits. It helps reduce the risk of developing an infection during the healing period. And post-healing, it helps prevent a recurrence.
Preventing gum recession is a lot less costly, painful, and complicated than a gum graft.
For the first couple of days after surgery, you shouldn’t brush or floss the operated area until you’re given the thumbs up. However, you’d have to use antimicrobial mouthwash to forestall infections, buildup of plaque, or issues with the graft.
That said, if you don’t already maintain proper oral hygiene, now’s a good time to start. It’s easy and doesn’t take a lot of time.
- Brush twice a day using a soft-bristled brush and fluoride toothpaste
- Floss at least once a day
- Rinse with an antiseptic mouthwash once or twice a day
And that’s it. Also, endeavor to keep your dental appointments.
Furthermore, do well to eat a well-balanced and healthy diet. And don’t smoke, it’s bad for your gums.
Other recovery tips
- If you grind your teeth at night, you’d want to ask for a mouth guard
- If you’ve misaligned teeth, you’d want to discuss tooth-straightening options
- Do not exercise or perform any strenuous activity until you get an okay to do so. The ban on performing strenuous activities usually lasts for the first three days.
Is Gum Grafting Painful?
During surgery, you wouldn’t experience any pain as you’d be on anesthesia.
After surgery, it is normal to feel pain, typically at the donor site. But it’d usually be manageable. Some compare the pain to the sensation of “eating a pizza with cheese that’s much too hot” or a “pizza burn.”
However as earlier noted, you’d be given pain medication or instructed to get over-the-counter pain medicine to help manage the pain.
Alternative to Gum Grafting
An alternative to gingival graft surgery is the Pinhole Surgical Technique (PST). It is a non-invasive procedure that doesn’t require grafts, incisions, or sutures. However, because of lackluster results, Dr. Choi does not recommend the Pinhole Surgical Technique.
However, you should be mindful of the cost and the reality that improvements can be short-lived, in which case you may have to get a gum graft in the future. Getting a gum graft in Carrollton, TX saves you the worry by offering stellar long-lasting results.