What is AlloDerm Gum Grafting and Why do I need it?

 

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Before
Before Gum Grafting
After
After Gum Grafting

Gum Grafting Washington D.C.

Do your gums look like they are receding or getting shorter? Can you see more of your tooth and are you one of the few that now has increased sensitivity? Gum grafting might be the right option to help you fix this problem. Gum grafting is a procedure that places a graft over the problem area and naturally, your gums will accept this tissue and regrow. Gum grafting is a very common procedure but must be done by a highly specialized doctor due to the complexity of the treatment and is the reason it is more commonly performed by a Periodontist.

 

 

Issues with Receding Gums 

  1. Loss of Bone
  2. Increased Tooth Sensitivity 
  3. Increased Cavities near the root 

 

  1. When your gums recede, your bone begins to decrease as well. Since both gums and bone go hand in hand, the stability of your tooth is affected and can cause tooth loss.
  2. When your gums start to recede, it can cause an increase in the sensitivity of your teeth due to more of the root structure being exposed. Recession can cause tooth sensitivity to cold or hot temperatures increasing the discomfort experienced with the specific tooth. However, sensitivity is not always seen in recession patients. Only 1 out of every 10 patients actually experience sensitivity.
  3. Naturally, the crown portion of our teeth has enamel and the roots of our teeth do not. This enamel is what protects our teeth against cavities. When your gums recede exposing the roots of your teeth, you have an increased risk for root cavities. Root cavities are much harder to fill than traditional crown cavities increasing your risk of tooth loss.

 

What causes receding gums? 

Clenching or Grinding 

One of the most common causes of gum recession is clenching or grinding of your teeth. However, a majority of people are unaware they even do it. Clenching and grinding most commonly occur with 90% of the population at night while sleeping, which is why most people aren’t aware they do it. Clenching or grinding puts massive force on the teeth resulting in tiny stress fractures or recession of the gum tissue. This problem can be alleviated with night guards or muscle relaxants such as Botox.

 

Orthodontic Treatment 

When teeth are shifted swiftly with braces or Invisalign your tooth roots can be moved to an area with thinner bone thus affecting your gums. This problem is more prevalent with the lower front teeth because naturally, our gum tissue tends to be thinner in this area.

 

Periodontal Disease

Periodontal disease affects not only the health of your gums but your bone levels as well. Both are a vital part of the health of your teeth, if either is affected it can dramatically increase the risk of tooth loss.

 

Genetics 

Depending on your natural biotype you may have an increased risk for gum recession. For instance, some patients have naturally thick bone and gums and some patients have naturally thin bone and gums. The thinner your bone and tissue are the more prone you are to the recession of your gums. 

 

Piercings 

Many people have lost their teeth due to the impact oral piercings have on their gum health. For example, tongue piercings tend to affect the tongue side of lower front teeth whereas lip piercings tend to affect the outside lower front teeth. This impact piercings have on gum and bone levels is why it must be taken seriously into consideration when considering oral piercings. 

 

Gum Grafting Types 

There are three different types of gum grafting, connective tissue gum grafting, free tissue gum grafting, and Alloderm gum grafting  

 

  1. Connective tissue grafting – To perform this type of graft your surgeon will collect the middle layer of tissue from the roof of the mouth and suture close the surface layer to leave nothing exposed. This type of procedure tends to be less painful since the area can be sutured closed.
  2. Free gingival graft -This type of gum graft requires your surgeon to harvest the donor tissue from the surface of the roof of the mouth where it cannot be sutured closed like a connective tissue graft.  This results in the gum tissues underneath the site being completely exposed and therefore increasing the chance of pain.
  3. Gum graft donor tissue gum graft (alloderm) or pinhole procedure – This type of gum grafting is the least painful type of gum grafting because the tissue is used from a donor, eliminating the need to remove it from the roof of your mouth. Although this procedure is less painful it can have a slightly decreased chance of success because it is not your own tissue.
Gum Grafting

Gum Grafting Pain 

The most common question we receive when a patient requires gum grafting is, what is the pain going to be like? During the treatment itself, you should not experience any pain since you will be numbed and possibly sedated if given the option. However, more of the pain is experienced during the recovery period of the treatment. Depending on the type of tissue graft performed it may not only affect your post-op instructions but your level of discomfort during recovery.

 

Free Gingival gum grafting recovery 

 The roof of the mouth during the first few days following the procedure is usually where most of the discomfort tends to be. Due to the extensiveness of this procedure at the roof of the mouth, most patients say their pain level is anywhere from a 4 to 6 following treatment into about a week after treatment.

 

Connective tissue gum grafting recovery 

Following the procedure swelling might occur and this is where most of the pain tends to be post-treatment. Along with icing, anti-inflammatory drugs such as ibuprofen can be taken to help alleviate some of the pain and swelling. Pre-treatment with a Medrol Dosepak may be given as well to reduce post-op swelling. Discomfort may come from the roof of the mouth as well. However, it is not as painful as a free gingival graft due to the way in which the tissue is removed from the palate. Most patients tend to rate their pain level as a 1-2 on a scale of 1-10.

 

Gum Graft Healing

Days 1-4: Most swelling and discomfort will occur during this time. 

Days 5-7: Pain levels start to decrease and this is when you can start to tell if the graft is going to be successful or not. 

Day 30: Your sutures will be removed, and the success level will be determined by your doctor.

Following the one-month mark, your gums will continue to integrate and esthetically blend with the surrounding tissue for the next couple of months.

Gum Graft Failure

Gum graft failure is not uncommon, because it is a very technique-sensitive procedure. It is important to get it done by a periodontist who has had years of additional training. If the gum tissue has been destabilized from the recipient site, this is a sign of gum graft failure. A large white patch is typically seen around the site because the tissue has died and has failed to receive adequate vascularity from the surrounding tissues. If your gum grafting does fail, an attempt cannot be made till at least 3 months after the treatment date.

Gum Recession Recovery Washington D.C.

Following your post-operative instructions are imperative to ensure the success of your gum grafting procedure.  

 

Bleeding: 

Bleeding may occasionally occur at home after a connective tissue graft.  How to stop the bleeding and how much bleeding is normal are the biggest concerns patients have after their gum grafting surgery. Some bleeding is normal after treatment and a few days after the procedure due to the vascularity of the palate. If uncontrolled bleeding does occur remain calm and apply a damp piece of gauze to the roof of your mouth, using your fingers to apply extensive pressure. It is imperative to keep the gauze at the site with pressure for at least 20 minutes. Do not take the gauze out or try to look at it repeatedly to ensure a solid blood clot is formed and not disrupted by movement. After this technique is applied if uncontrolled bleeding is still prevalent please contact your dental provider immediately. 

 

Diet: 

Do NOT pull on your cheek or lip after your procedure is complete. Any sort of disruption to the area can compromise the site. A liquid to soft diet should be followed for the first week. However, when returning to normal food it is best to cut up everything into tiny bites to ensure you are eating on the opposite side of the treatment area. Avoiding hot temperatures and spicy food is also advised to ensure you aren’t irritating the site. 

 

Oral Hygiene: 

Do NOT brush the grafted site or the surrounding teeth for at least 24 hours following the procedure. After 24 hours, it is okay to brush your nontreated teeth as normal but be careful when getting near the treated teeth. You cannot brush the grafted teeth; however, you may dip a Q-Tip in warm saltwater and swab the teeth making sure you avoid the gums. Warm salt-water rinses twice a day are important to promote healing. Flossing is allowed on nongrafted teeth as well. Do not smoke or vape following your procedure for at least 4 weeks. Smoking can inhibit healing and increase the risk of failure. 

 

Swelling and Pain: 

Swelling is normal following treatment and can be controlled by icing and sleeping with your head elevated. Swelling peaks on the third or the fourth day following treatment so do not be alarmed if you see this. Pain can be controlled by over-the-counter medication as well as stronger pain medications such as hydrocodone. The antibiotics that were prescribed are to be taken as directed to avoid an infection. 

Before
Before tissue grafting
After
After Tissue Grafting