The Basics of Gum Graft Surgery

Gum graft surgery is a procedure that dentists use to reinforce the gum line.  Typically, a dentist will use it when a patient has severe decay at the roots of his or her teeth because of a receding or defective gum line. 

Although, dental experts don’t usually recommend this as a reason for gum graft surgery, some patients opt for this kind of surgery for cosmetic reasons, feeling that their receding gums literally make them look “long in the tooth.”  Somewhat similarly, some patients opt for the surgery because of the discomfort caused from having their roots exposed when their gum line drops out of the way due usually to age.  (Although certain types of gum disease may cause a similar occurrence.)

The most common method of gum graft surgery involves the removal of tissue from the roof of the mouth, in order to replace or reinforce the gum at the root line.  The prime type of tissue that oral surgeons prefer for this procedure is the connective tissue that separates the surface tissue of the palate from the bone of the upper jaw.  The surgeon removes this tissue by creating an incision in the roof of the mouth and removing the tissue.  Dental professionals prefer this strategy because it expedites healing since the outer surface of the palate acts as a protective barrier.

Unfortunately, some patients do not have enough of this tissue to complete the surgery.  When this is the case, the surgeon will usually remove some of the surface layer as well.  Removing the protective layer of the palate slows down healing because it leaves a larger area exposed to the bacteria and possible trauma of the oral cavity.  The patient is also likely to experience higher rates of bleeding and discomfort when the circumstance requires this method. 

The least desirable material for gum graft surgery is Alloderma, a manufactured material that is only effective in small amounts since it requires quite a bit of gum reinforcement and since it is not a natural organic material.  Dentists will usually only use this to shore up gum graft surgery, not as the primary material for it.

The prognosis for gum graft surgery is generally good.  Patients who undergo it generally heal within a month or two, the first two weeks being the most difficult part for most because it is both the most uncomfortable and because they must be careful not to stress the grafted area or to infect it.  Typically, the dental surgeon will prescribe pain medication for the discomfort.  Usually the pain medication will also have an anti-inflammatory component to help in the healing process.

Your dental professional is also likely to prescribe anti-biotics for the early stages of your recovery since wounds from you surgery are likely to come into contact with the bacteria in your mouth.

The success of the surgery will also depend on your ability to avoid stressing the graft by pulling at your lip to look at it or eating foods that may damage the graft.  You should avoid hard foods or foods that require a great deal of chewing since these are likely to complicate matters.

Another common problem is sloughing.  Sloughing occurs when the tissue doesn’t quite take and starts falling off.  As a remedy for this eventuality, your dentist may place a temporary clear support over the grafted tissue to add pressure and protect it from trauma.  Your dentist will remove the support when the healing is complete.

As with any surgery, infection is a possibility.  The dentist may need to extend or revise the antibiotic treatment in order to remedy this possibility, should it occur. 

It is also possible that the grafts will not grow in adequately or that they will grow in at different levels.  Your dentist may have to do further surgery to correct this condition.

More often than not, however, gum graft surgery goes off without a hitch and within a couple of months, all is back to normal.