Gum graft goes fine (relax, if you need one)

Here's another in what I hope won't be a lengthy series of "don't worry" blog posts about scary sounding health procedures. (See "Root Canal is nothing to fear.")

I had a gum graft this morning. The worst thing about it was facing the fact that I'm old enough to need one, though I realize that people of all ages get gum grafts.

My dentist referred me to a Salem periodontist because he was worried that the beautiful bridge work he'd just redone, which had cost me more than a VW bug went for new back in the '60s, could be threatened by a receding gumline.

So he cheerily said, "I'd giving you a referral for a gum graft evaluation." That sounded ominous. So naturally I fired up Google as soon as I got home from the dentist's office.

I learned that its formal name is a gingival graft.

The usual approach is to chop out borrow some tissue from the roof of your mouth. That is sutured on the gum line, where hopefully it finds a happy new home.

Now, on the Internet I've found that most stories people share about medical procedures have an overarching theme: When Things Go Wrong. So at the moment, the #3 Google search result for "gum graft" is titled "The Procedure From Hell."

The same was true when I researched root canals, and mine went fine. It seems that few patients are motivated to write about their experience when the message is, "No problems, mate."

I talked about this with the periodontist at my evaluation appointment. He said that a balance has to be struck between educating yourself online (good) and scaring yourself half to death (bad).

Speaking of death, one of my first questions to him was whether he did grafts using Alloderm, which I'd read about on the Internet. I liked the idea of not having tissue cut out of the roof of my mouth, and I thought that Alloderm was some sort of artificial material.

But I was told, "It comes from cadavers."

My instant reaction was that I didn't like the idea of having part of my gum be made from a dead person. Plus, my periodontist said that a graft is much more likely to "take" when a person's own tissue is used.

Thus at 9:30 this morning I found myself back in his office, getting ready to be injected with several shots of Novocaine.

Reassuringly, after he was done I heard, "That's the toughest part." And it was true.

I was out the door, my VISA card $840 poorer, in almost exactly an hour. I felt less pain than from a filling or crown work. Afterwards I popped some Ibuprofen that they'd given me, but haven't felt any need to fill a Vicodin prescription.

Everybody's different, of course. Your results may differ. For what it's worth, though, here's some tips and observations.

-- I kept my eyes open throughout the gum graft. Given how much it was costing me, I wanted to absorb every moment of the experience. Such as the drops of red on the gloves of the periodontist and his assistant. Be prepared to see some of your own blood, since there's cutting going on inside your mouth. No big deal -- the bleeding stopped soon.

-- Periodontists must make good fly fishermen, who tie their own lures. I was impressed with the dexterity it took to put in the sutures. Of course, I had an extreme close-up view, since the guy's hands were just a few inches away from my eyes.

-- I was fitted for a roof of the mouth retainer at my evaluation visit. Good move. It protects the site where tissue was removed. I'm barely aware of it now, after wearing it for about 11 hours. I was told that it can come off tomorrow, if I want to remove it. There hasn't been any discomfort at all from the roof of my mouth, probably partly because of this protective device.

-- Don't get home and figure that you can eat whatever you want, even if you're feeling no pain. After I took my first bite of spaghetti with semi-tangy sauce, I did feel some pain at the graft site. Bland food has been my watchword today. Tofu and rice. Macaroni and cheese. Coffee (not too hot), for a mood elevator. Mushrooms. Wine went down fine also.

-- I was given some PerioGard mouth rinse to use. Another good move, as that saved me from trying my usual Listerine mouthwash tonight. I suspect the alcohol in it would create another "ouch" moment, but I could be wrong.

-- Five hours after I had the gum graft, I was out mowing the grass. I read some gum graft stories on the Internet where people said they stayed in bed for days afterward. That may be necessary in some cases. But I wasn't told to do anything but live a normal life, which I've been doing all day (aside from trying to elicit some sympathy from my wife so I don't have to wash the dishes or empty the dishwasher).

I'll add my own comments to this post as my recovery period proceeds. If my brain falls out through the roof of my mouth, I'll let you know -- assuming I have enough gray matter left to type coherently.

For now, here's my bottom line: this was another example where my worries about what would happen turned out to be more of a problem than what actually happened.

I mean, my fretting about how painful the gum graft might be caused me more pain than the procedure itself. Sure, the anxiety was psychological rather than physical, but it was pain nonetheless.

So relax, if you're told you need a gum graft. If yours goes as smoothly as mine has so far, there's no need to worry about it.

Comments

[Tina]

HI I have to have gum grafting done soon and very very scared. I have some questions does it bruise and how long do you have to eat soft foods? I am a cashier so i will have to talk alot how long should i take off work?

[Brian Hines]

Tina, my experience may not be like yours, but I recall that I ate soft foods for three or four days. For me it wasn't so much the hardness of food that was a problem, but spiciness. Even mildly spiced spaghetti sauce stung for a while.

I don't remember any problem talking. Maybe you won't need to take any time off from work at all, except the day of the procedure. It's normal to be scared. Probably, though, you'll find that the gum graft will go easier than you expect.

[Karen]

Just had my graft 4 days ago. Three lower teeth front and center. Not really a problem. Day 2 I developed a small "liver clot" (blood clot, size of a pea) behind my lower teeth. Called the doc and he said he sees it once or twice a year and to leave it alone and in a couple of days it would "fall" off. It did last night. Also, like Trevor (a few postings above), my bruising in my chin is extensive and I look like a bearded lady! The kids don't like to be seen with me. Hope that dissipates sooner than later!

[Mark]

Hi, I am 19 years old and had a graft 12 days ago. I got my stitches out after 10 days. The procedure wasn't bad and the only real pain was only for about an hour after the novacane wore off. Everything's looking good but I have a question for anyone who will be kind enough to answer. The area where the stitches were in the roof of my mouth is a bit swollen. Like, there's a lump there. It sort of feels like what a fat lip would feel like but without the pain. It doesn't hurt at all, nor does it look bad. It's not horribly unbearable but it is a little annoying. I'm really hoping this swelling goes down, did anyone experience this? Is the swelling going to go down or is it just thicker from the healing process? Any advice would be great. Thanks.

[Pamela]

Just had mine done this morning.... I was so scared I actually cried. The worst part was the needles in the bottom where the had to graft. I have the two front bottom teeth done. I have no pain at all. No bleeding either. This was not bad. They told me I may have to come back and have another one. I'm not even worried about it. I'm a 26 year old female And I was so scared for today I couldn't sleep couldn't eat. But seriously it's no worst then having a filling done. You feel nothing. It's a little swollen and tender to touch but just sitting and watching tv you'll for get you even had it done. :) relax if you need one.

[Barbara]

It's so comforting to read the main blog and all of the comments. I'm going in for my procedure in two weeks and this makes me much less anxious and worried! Thank you everyone for your positive experience stories.

[Sarah]

Thank you for all the comments, I have to get a graft on one tooth next week and I am in a total panic. Ive been searching the Internet and usually find bad stories! But reading these puts me a little more at ease. I am more anxious about recovery than the procedure itself. I had a bad wisdom teeth removal experience so that's where all my nerves come from!

[Kate]

Thank you! This is exactly what I was looking for. I'm facing a surgery in a week and really wanted to know what to expect. I learned some time back not to Google anything any more without being precise as to what I want to find, which is no horror stories. Unfortunately, as you stated, people are generally only motivated to post their stories if there's some sort of horror involved.

[Jen]

Thanks so much for sharing! I feel much better now about my needed gum graft.

[Aleemama]

I just have my gum grafting done on Wednesday. 4 teeth on lower right... The procedure was pretty acceptable, not very scary. I took the alloderm as my gum tissue was weak to start with, my perio suggested to use it rather than my own as they will give more or less the same result. I took his advise
. Right after the surgery , I felt very painful as the pain medication might not take effect on time. After I left the office and got into my car, pain was subside and I took out the guaze and bleeding was minimal. Didn't take a break and resume work that afternoon. Afraid to eat anything, just drink ensure the whole day. Swelling was getting severe the next day, saw blood stain in the second site on Day 2 afternoon. Since I thought it's just the stain from the rinse, perio said he could have it removed afterward. However，on that very same night, just before going to bed, tasted something writes from the month, run into the bathroom and saw blood all covered the second site, felt something like jello in the back of the teeth (2nd site), it was non stop... Scared to death and email the perio, he was do good and guide me through what could that be and how to handle it. Bleeding stopped in the middle of the night... extremely scarey experience as I was so afraid the new tissue's been gone forever.

The next day, Perio did a detail check up ... Found out some stitches were gone and that leads to heavy bleeding last might. Some more stitches were placed. Also bruising heavily on the right jaw extended to the neck area. It was ugly and bruises were deep purple in color. Perio suggested putting on the healing cream to help faster healing on bruises as he thought it's pretty serious.

Day 4, swelling still, bruises heavily despit the putting of healing cream. No bleeding after extra stitches. Pain was minimal.

Day 5, swelling seemed getting a little better, bruising still heavily, it gets a little darker, could see a bit yellow on the side. I was afraid it will be there for another two weeks at least.
Still under recovery, will keep updated in later days.

After all, g grafting is not a nice experience at all times, but you have to do it you have to do it... Right. I was hoping after the two gum grafting, I can start my ortho treatment next year. Having a beautiful smile in another two years... It's all for a good cause.

Happy healing everyone.

[Steve]

I had my lower canine and 2 teeth next to that done last thursday. You were absolutley correct when saying that my Perio must be a fly fisherman. He was tying knots like he was tying a fly. Pretty cool overall though. The stinging on the roof of my mouth where the graft came from has posed its challenges but its all good.

I can only eat on one side of my mouth and I have to make sure no food bits get into the big hole on the roof of my mouth. I wasn't given a mouth piece either. It is healing the old fashioned way. Motrin and warm water rinses are the key to sucess for me. Thanks again Brian!

[AJ]

This page is a great resource!

I found this page a year ago and read through it. Today was the day I finally had a gum graft on four lower teeth using my own tissue. I was told by multiple people that my own tissue would take to my own gums better than donor tissue. The procedure went well.

I put the gum graft off for two years because I was so nervous. In the end, the procedure was not a big deal. It was over under an hour. I should have had this done as soon as it was recommended to me by my dentist. My dentist eventually told me that if I didn't have the gum graft at some time, I could lose a tooth.

I was given Valium for anxiety beforehand but I never took it and didn't really need it. I listened to my iPod during the procedure but at low enough of a volume so I could hear the periodontist say "lean toward me" or "open wide." I would recommend bringing your favorite music to listen to, if only for something else to think about while you are getting the gum graft done.

The only thing I really felt during the procedure was the Novocaine going in, as I've felt before when I've had cavities filled.

After the gum graft, I was given a plastic mouthpiece that sits against the roof of my mouth, protecting the donor site. I took it easy today and just rested. I iced my mouth 15 minutes on and 15 minutes off with ice packs as they recommended, and I have yet to take the Vicodin that they gave me for afterwards.

I tried to make an educational video after my gum graft, but hilarity ensued instead.

http://www.youtube.com/watch?v=zwoPwrTeymg

[Jess]

I had a graft done on 2 sites 15 hours ago. I have a low pain tolerance. The only pain that I have had is from a slight headache. I took regular ibuprofin and it stopped. My dentist took my blood and separated the platelets and packed them on the site. That probably helped with the speed healing and no pain. I am using a plastic baby spoon with a very long handle to eat plain pudding and that feels very good. The donor site (platate) does not hurt, just feels like how it would after eating a piece of hot pizza. My gum graft site is tender, but does not hurt. I put this surgery off for 6 years as I am a chicken of pain and I wish I had it done sooner. Just go for it and you will be glad you got it done and over with. p.s. I prayed about it and thought relaxing thoughts the whole time.

[Shawn]

Thought I should chime in as well. Just had my two lower canine teeth grafted with tissue from my palate. I was lucky to have very little notice before the surgery so I didn't have time to worry about it too much, especially because I had a very bad experience with my wisdom teeth. I went in for a consultation a week ago only to realize that my coverage on my parent's dental insurance was about to run out. The office calls me on Tuesday morning saying they can do the procedure Wednesday morning (yesterday) with a different doctor. I said let's do it.

So the procedure itself was uncomfortable, but that's it. No pain. The perio's assistant was not sucking the saliva and blood out of my mouth until she realized I was growing uncomfortable from swallowing so much of it. But after that I was fine. They covered the lower sites and gave me a retainer type thing to wear over my palate. They told me to go fill my prescription for Norco immediately and take it before the pain sets in. I thought I was just gonna tough it out instead. Probably not the best decision because I was definitely in pain about 2 hours after the procedure. I just took 200mg Ibuprofen though and that was enough. Took it twice more the rest of the day.

I bled quite a bit on the bottom, especially while trying to drink water, but the perio called and said it was normal for the first 24 hours. I wasn't really hungry thankfully, because of all the blood I had swallowed, so not eating the first day was fine. Now on day 2 I have not taken any ibuprofen but I'm in a little bit of pain, a little swollen, and my lower jaw is just stiff in general. I have had some protein/fruit/veggie smoothies for nutrition. I could probably eat solids but I'm gonna wait for tomorrow (I could lose a few pounds).

Anyways, I think I should be fine and the whole process is not that bad, and this is coming from someone who was bed ridden two weeks after getting wisdom teeth taken out. My only concern at this point is when will I be able to exercise again and when will I be able to consume alcohol again? Obviously the alcohol's not as important but I'm attending a sporting event on Saturday and I'm not sure if partaking would be detrimental to my healing process.

Cheers to all the responses and to anyone reluctant to get the surgery. Just do it!

[Becky]

I had a free gingival graft done on my 6 bottom, front teeth just over a week ago, almost no pain now just a little on the roof of my mouth where they took the tissue from. I was super terrified of having this procedure done. I was offered ativan to help keep me relaxed and arrived at my appointment half an hour early to allow the pills time to kick in. The worst part of the preocedure was the injections of freezing which really weren't any worse than the ones you get before having fillings done, I didn't feel a thing for the rest of it and the ativan made it so I really didn't care about what was going on. The worst part of my recovery honestly was the constipation caused by my prescribed T3s, I really don't know why I wasn't warned about it and suggest taking preventative measures against this (staying well hydrated, having lots of fiber etc.) The pain on recovery was only really bad the night after surgery. I had a three day weekend to recover which I found to be adequate but I wouldn't suggest trying to go back to work any sooner than that especially if your jobs involves lots of talking and/or physical activity. I hope this helps anyone who is stressed about getting this done, it really wasn't too bad and I was so freaked out about it, just if you're taking T3s look into preventive measures against constipation!!

[Stephanie]

Hi,

Thank you so much for providing this site. I'm going to have my first three grafts done this March. Was wondering what toothbrush and toothpaste any of you use now to prevent gum recession? I have naturally thin gum tissue - and the Sonicare actually made my recession worse. I'd appreciate any suggestions you all can offer. Thank you.

[Sara]

Hi Stephanie,

I just had my second gum graft done 3 days ago and it went well :) Although, today will be my first day out of bed :( after the first graft I switched to a very soft toothbrush and sensodyne toothpaste. Also switched to a method of just flicking the brush from the top of my tooth down. It has seemed to help. Best of luck, give yourself time to heal.

[Kevin]

How important is the plastic stent that they make to cover the site where the gum is harvested? It will cost me an extra $600. Anybody else have the procedure without the stent for recovery?

[Brian Hines]

Kevin, by "stent" I assume you mean the plastic thingie that fits in the roof of the mouth to protect the site where tissue was taken. I had one. I didn't know it cost that much. That seems like a lot.

For a while I tried to get along without it, because it was sort of difficult to get on and off. (Eventually I figured out some tricks to do it.) Eating food made the top of my mouth burn. Wasn't pleasant. I suspect there are good reasons for the plastic thingie. Comfort is one of them, from my experience. Proper healing likely is another.

[Avery]

Thank you for your post! I'm usually pretty tough about pain, but I get nervous about getting nervous for this sort of thing. I was looking for someone posting about surviving the experience, and this was a very helpful page! Although my periodontist was pretty clear about not doing too much physical activity afterwards, so I'm pretty sure she'd disapprove of me mowing the lawn the same day :) Again, thanks!

[Sara]

Can I just say that that video is fantastic (AJ, November 1, 2012, http://www.youtube.com/watch?v=zwoPwrTeymg)

I am going for a graft on two lower teeth later this week (my own tissues) - so far I am not too concerned - this site is mostly v reassuring too - but hopefully recovery will not be too bad. I work out a lot and more than a couple of days idle will lead to grumpiness and lethargy! Wish me luck :) I should stop the internet research, I am starting to revisit my old eating disorder issues.

[Katie]

I wish I had found this site prior to my surgery. I only had one graft done (one week ago now) but I was still very nervous prior to the surgery. My dentist told me to eat a very big breakfast before I came in for the procedure as I probably would not be able to eat much the rest of the day. That was probably the best piece of advise!

The surgery itself was very easy. In and out of the office in 30 minutes and no pain at all! My dentist provided me with the retainer to protect the roof of my mouth. I kept it in all day and the first night. I eat/drank fruit smoothies and made sure I did not use acidic juices (so no oj, grapefruit etc) and drank ice tea all day using a straw. There was no need for pain killers or Advil. Day two I went back to work, drank fruit smoothies again but really needed something hearty at night. I made mashed potato with lots of butter and sour cream so no chewing was needed. I had no issues. Eating during the week got better and better. Just stick with really soft foods that require little chewing and you will be fine. The only big mistake I made during recovery is to drink wine on day 5. I assume it was the acidity that caused the roof of my mouth to hurt again. I put the retainer back in to protect it. So far so good. Going back for my one week check up tomorrow.

As other people on this site have stated, it is not fun but I have had relatively little pain from the procedure and I figured out what I could eat and drink to not feel so hungry. The roof of my mouth is still sensitive but in the end this procedure and recovery was MUCH easier than expected!!!

[Reef]

Excellent blog! Has anyone tried the new pinhole surgical technique for fixing gum recession? Basically, they pull the gums over the recessed area and insert collogen to support it. One day recovery and upto 14 teeth can be done in a single setting.

[ryan]

I am also interested in this pinhole surgical technique. anybody has experience on that?

[Foxesinthegraveyard.blogspot.com]

I'm so glad you posted this. I'm about to go in for a gum graft next week and I wasn't sure if I should do anesthesia or just local. I'm thinking with the laughing gas and some headphones I'll do just fine.
Thanks for the post.

[Dawn Cannella]

I am going in tomorrow morning for a gum bone graft. The dentists are not completely sure that there is not a crack (fracture) in the tooth, but say that once they get in to flip the gum and do the bone graft (because it is deteriorating), if at that time they see a fracture, we will have to discuss my options at that time. So, for now, going in for gum flip/bone graft. Nervous, but this site and all the comments have put my mind at ease. It will all be over soon enough. Thanks!

[Casey]

I got mine 6 days ago. I woke up in pain for 4 days and finally yesterday, I was able to eat a pancake (chocolate chip and it was DELICIOUS). Of course, I was worried bout the procedure, like everyone else here. The thing i am most worried about is the actual graft not attaching to my gum. I know you aren't supposed to pull your lip down or anything but I took a peak and lightly pulled my lip and noticed that the graft moved. It seemed like it was only being held on by the stitches. Has this happened to anyone? Has anyone had a graft that DIDNT attach?

[Cara]

I had a gum graft 5 days ago. My doctor took tissue from the side of the roof of my mouth and the tissue was grafting onto my right canine (eye tooth). The procedure went fine. I had laughing gas and several shots to numb my mouth before surgery. During surgery, I could tell that it was quite the procedure--especially as a doctor was stitching up both areas. The doctor and his dental assistant gave some simple directions for the next few days. When I left the office, I was still a little loopy, but my husband drove me home. On the way home, we stopped by the pharmacy to get my pain medication and an antibiotic that the doctor had prescribed. The drive home was about 45 minutes and I did start to experience pain around 20 minutes from home. I had taken some Advil directly after the procedure to tie me over until getting home. Anyways, when I got home I took the pain medication right away with some chocolate pudding so that I would not get an upset stomach. I could not fall asleep, so I rested most of the rest of the day--watching movies, reading, etc. It hurt to talk and smile. I did not experience a headache or swelling until Day 2. I slept that night with my head elevated on 3 pillows as the doctor's directions that told me to. When I woke up on Day 2, I did have a fair amount of swelling (but no bruising as some other people have mentioned). I continued to take 2 pain pills every 4-6 hours throughout days Day 2 and 3. Again, just continued to lay low, eating and drinking soft foods and drink. I did make sure that I had stocked my kitchen with some soft comfort foods (mac and cheese, yogurt, soup, oatmeal, fruit cups--peaches and pears, applesauce packets, pudding, etc.) Make sure that you do not eat ANY hot foods for awhile--it can cause palate bleeding....so all of my food has been lukewarm or cold since surgery. Make sure to drink a lot of fluids--I have stuck to iced coffees and water. On Day 4, I did try to cut back on pain meds since I was running out of pills, but started to have soreness at both sites in my mouth. I ended up refilling my prescription and have continued to take pain medication every 4-6 hours. I plan to finish the rest of the medication and if needed, just stick to Advil after that. I have been brushing the left side of my mouth (that side that had no surgery) and just rinsing my mouth with Listerine. My doctor did not prescribe any special mouthwash, he just recommended Listerine Natural mouthwash (be sure not to use whitening products during this time).
As far as what my mouth looks like, I can't see much where the tissue was taken...it just looks like a deep red color there. Where the tissue was grafted to my tooth, it has started to turn pink (which I THINK is a good thing) in some of the areas, but some of the tissue is now white. I believe that this white tissue will eventually fall/peel/come off. It seems kind of soft almost like it is dead tissue...
I go back to the doctor in 3 more days to have a check up...hoping everything looks good.

[Marlene Bennett]

I had a gingival graft done two days ago. The graft was taken from the roof of my mouth and placed on my lower front teeth. I had had an extraction a month ago and a bone graft done. The gum area didn't heal as nicely as my doctor had hoped so he did this gingival graft. The procedure wasn't too bad. I had nitrous oxide along with the normal numbing shots. I needed more shots during the stitching process. There was a little pain but my doctor took care of it as soon as there was a need. I didn't have anything put on the palate incision. It was stitched. It started bleeding while I was driving myself home. I had to put a gauze on it and some pressure. The bleeding stopped when I got home. I had two other times when the same place bled. It is the second day after my procedure and I am pretty much back to doing normal things. I am still a little swollen and my palate is tender but not so tender that I can't eat. I haven't seen the grafted area as the doctor said not to pull out my lip or even look at the area for a few more days. I am using a prescription mouth rinse twice a day. I am feeling some tightness and soreness where the graft was stitched onto my lower front teeth. I have been taking ibuprophen and half the dose of hydrocodone/apap. I will try to just use the ibuprophen tomorrow. My doctor called me in the evening after my procedure. Everything went as he had explained. I think that it helps to listen to your doctor. Hopefully you have chosen one who has gained respect in your community. It does help to know exactly what is going to happen during the procedure. The doctor is in charge of making sure that you don't feel pain. I will be happy when can eat normally. Ice-cream is great but a some chips and salsa would be a nice change!! I am glad that I read many posts before having this procedure. I would agree that it isn't that bad. I am amazed at how good I feel today. I did some gardening and canning today. I'll see the doctor in two weeks. Good luck and don't worry about it...

[Michelle]

I explained to my periodontist that I am extremely nervous about the procedure and asked to be sedated - he told me it will take longer than the actual procedure. I made it clear I am extremely nervous. Scheduled for a soft tissue graft using tissue from the palate as well as a frenectomy. Anybody with intense anxiety make it through ok with nothing other than the novocaine?