I hate to boast, but my teeth have always been excellent. A dentist once even told me that I could be a mouth model (which apparently exists). So I took it very personally when another dentist told me that my gum went down – to the point where I needed a gum transplant that I got five months ago.
If that sounds intense, because it is so. A "gum graft" may refer to a few different procedures, but in all it is necessary to place new gums in a part of your mouth where your current gum tissue is going back or has already returned to a problematic point. When your wounds heal, the new tissue protects this recession or helps correct it. (It's like a skin graft, but with gum tissue.)
If your gums go back, this could be due to prolonged, aggressive brushing and in some cases braces . People with thinner gum tissue may also be predisposed to a recession, says dr. Panos N. Papapanou, Director of the Department of Periodontics at Columbia University College of Dental Medicine, told SELF. However, the gum recession is often also a result of gum disease infection caused by bacterial buildup and persistent inflammation in the mouth and teeth, or gingivitis (a milder form of gum disease, usually can still be reversed with better oral hygiene.)
Over time, the gum recession may continue to the point where the tooth roots remain open for infection, also causing some disturbing sensitivity in the area can lead. Yes, it is important to address this gum recession someday.
As someone who has never had a cavity, it was all a shock. So, if you are in a similar boat, you should know the following:
There are several types of graft procedures.
The two main types of gingival grafting are the gingival graft and connective tissue implant, Paulo Camargo, DDS, professor and chair of the Periodontics Section at the UCLA School of Dentistry, says SELF. In both procedures, tissue is taken from a "donor" site on the roof of the mouth and attached to a "recipient" site where a recession has occurred – but in different ways.
A connective tissue graft requires your periodontist to open a small flap – a "trap door," as Camargo calls it, to remove a piece of the underlying connective tissue layer. In a gingival graft (sometimes referred to as a free gum graft), the trap door is not required because in this procedure the tissue is removed from the upper palate. Essentially, they take "gum from one place and place it somewhere else," says Papapanou.
There are several other options, such as a pedicle graft, where donor tissue comes from a gum area that is closer to the recipient area. And there are grafts that use carcass tissue or pig tissue [collected from pigs] which are generally reserved for more severe cases, says Papapanou. The use of patient tissue is always preferable, but not always possible. For example, if your periodontist needs to cover the gum area of five, six, or seven teeth, "you would need to harvest half of your palate to cover it," he says, so that the tissue may come from other sources. 19659010] In order to find out which method is right for you, a thorough interview with your provider is required, usually a periodontist. You will consider various factors, such as the severity of your recession, the extent to which your cheek could pull at the surgical site, and whether or not your gums have declined between your teeth or just on the front, Camargo says.
The preparations are usually pretty low, but still important.
In general, patients need not do too much before surgery, although you will probably have a consultation before the procedure in which your periodontist will walk you through the procedure. During this appointment, your periodontist can also collect some kind of documentation of your gum recession for insurance purposes (eg one or two photos), says Camargo.
You will have a sore mouth for at least a week, so it's a good idea to stock soft foods (more on that in a nutshell). And depending on the periodontist, Camargo says you may also be equipped with a palatal stent, a plastic piece that will hold the donor site in the middle of the meal.
But the most important thing is to do it Certainly, you are addressing the root cause of the recession that made your operation necessary in the first place, says Papapanou. If you have a thin gum or braces in your teens, you can not do much about it. However, if you experience a recession due to poor dental hygiene or improper (or, in my case, overzealous) brushing habits, it is important to treat it before surgery. In this way, you will need to brush carefully after the procedure so as not to be concerned with the graft, as it heals and reduces the likelihood that you will need another graft in the future.
And of course, since this is a surgical procedure, you want to completely treat all infections in your mouth prematurely.
Expect (first) anesthesia and bleeding.
On the day of your procedure, there are some things to do keep in mind. Since your mouth is numb for several hours, you should probably eat before. You may also receive prescriptions (for pain killers, antiseptic mouthwash and possibly antibiotics), and you want your pharmacy to be set up.
During the procedure, usually everything performed in local anesthesia does not need to be sedated, explains Camargo. (For someone like me who has never experienced this in a dental procedure, you need to put a few sharp anesthetic shots directly into the gums, making you feel numb and swollen on that face.) There's an option to let the procedure go General anesthesia, what you can talk to your periodontist about.
Then, your periodontist can get to work: You begin with the preparation of the recipient site that needs to be separated (for a connective tissue graft) a bit from the gum bone and exposes a bleeding area where the donor tissue accumulates. Then they turn to the donor site on the palate, usually on the same side of the mouth as the recipient, so you only have to dodge one side while healing. Your periodontist will harvest the graft tissue and transport it to the recipient site to sew it. (If you have a connective tissue graft, it must be placed under the tissue flap at the recipient site, Papapanou explains.) The donor site is also sewn.
Depending on your periodontist's preference, she is healed. You can cover the sutures in both places with a clay-like bandage for protection or just have them healed and instruct you to use the palatinal stent.
After the procedure, you may need to change your eating habits a bit.  You should not immediately (if ever) feel pain, but you will still be deaf. When the local anesthetic subsides, the pain can begin to creep in. If you can, you should seek your instructions immediately after the procedure. In this way, you can take your first dose of painkillers before the anesthesia disappears completely.
When it comes to pain, "The first two days are the most annoying," says Camargo. However, the swelling tends to peak on the third day before going down. (In my experience, the pain was very low throughout, but I had many swellings that made it a little difficult to talk to the periodontal bandages for the first few days.)
You may notice some bleeding on the first day until the morning after, says Camargo. However, if it is anything other than the pink saliva in the sink, this is abnormal and is worth a call to your provider's office.
And it's probably no surprise that you need to avoid brushing your teeth in the operating areas for at least a week. During this time, you may be instructed to use an antiseptic mouthwash to keep the environment away from bacteria, Papapanou explains.
But the biggest problem is of course the food. For different periodontists different rules apply. In general, however, you do not have to eat anything on the affected side of the mouth for at least one to two weeks. You may also be asked to avoid eating hard or possibly irritating, like hot soup. If you have received a palatal stent, this point is very handy.
Personally, I have worked well with a diet with yogurt, chocolate pudding, and squeezable baby food bags filled with fruit and vegetables ]. As soon as my swelling subsided and I could chew more, I was fine with small pieces of fried chicken, boiled vegetables, hard-boiled eggs, and Klondike bars. It was not my favorite ten days – and my partner still gives me shit because I ate baby food – but it was not as bad as I thought. (I've cheated and eaten very carefully some Halloween sweets with no ill effects.)
Complications with a gum implant are generally rare. However, if you notice any bleeding, extreme pain, or fever after the first day, consult your doctor, as this could be a sign of something serious.
It will take at least a few weeks for you to see the full benefits.  Your periodontist may want to see you at some point, often after about a week, for follow-up to make sure you heal well. At this point, you may be able to start brushing with a baby toothbrush or just lightly brush the affected side of your mouth. Or ask them to wait until the end of your second week. After one or two weeks, you should brush back and use floss normal.
Regarding healing, Camargo says that you have a pretty good idea of what the implant will look like after three weeks. However, it will not completely heal six to eight weeks after the procedure. And as Papapanou explains, you will not realize the full benefits of the procedure until the tissue is completely healed and settled in its new home, which can take up to six months.