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

[Lori]

I had 16 teeth grafted. Took an hour for each set of 8. Four top and four bottom. I was back to work afterwards. The procedure is not bad and if you read others comments, the way they do it is all about the same. Took ibuprofen but no Tylenol or Vicodin. Mouthwash and a z pack to ward off infection. That's it!

[Elin Cook]

Thanks for your positive encouragement. I need to have a graft day after tomorrow for two lower teeth and they'll take donor tissue from the roof of my mouth. They're encouraging me to take Halcion beforehand, and I'm hesitating about that because I've never taken it and I don't like the idea of being "out of it". But I was really nervous before an extraction and implant a few years ago, so maybe I will. Actually, the nervousness was worse than the extraction/implant itself!
I've read all the comments here, and it puts my mind at ease. I do need to have this done, and I know I can deal with the discomfort afterwards: it's just that I had gotten very scared, not only doing research online, but also, my periodontist's office has told me that this is pretty painful. :( I guess I'll be glad when this is over with!

[Anonymous]

I think i made the most stupidest mistake to not take an advil right before bed. Just woke up 2 hours later in really bad pain on the area they did the graft. Just had my surgery yesterday morning. Can't wait for this torture to be over. For now I'm icing the area and just popped another advil.

[Rebekah]

How many gum grafts did you have done? I just found out I need 8 in a row (bottom front) and am not sure how many I should get done at once or if I should try to get the majority over with at once.

[Brian Hines]

Rebekah, I believe I had two grafts, but it may have been just one. I'm not sure which is best for you. Your oral surgeon must have had experience with people needing multiple grafts, so I'd be inclined to take his/her advice. You could also Google this question and see what others have done.

[maria]

Hello,

Has anyone had any experience with Platelet Rich Fibrin (PRF) technique for grafting? I can't seem to find anyone on the internet posting about it besides the doctors that do the procedure.

[Carlos Galvan]

Thanks, I'm getting mine in 2 days.

[Sheree]

Thank you so much for this blog post! I am having a single lower tooth done on July 3 (next Tuesday) to repair a hole on the inside of my gum that I somehow got from wearing my retainer at night (I have worn a retainer to at bedtime for 30 years). The tiny hole has exposed a bit of my tooth root and the periodontist is afraid bacteria will accumulate in there over time and I could destroy the tooth.

I was petrified until I read every single one of these comments (thanks, folks!). I am opting to just have Novocaine as the IV sedation was going to cost another $550 and it wouldn't be covered by my insurance. Plus, I don't want to have to trouble someone to pick me up and take me home. I am hoping it's okay to not take the antibiotics (just don't want to do it) and use a salt-water rinse instead to keep bacteria at bay. If anyone else didn't take the antibiotics and still had great results, please let me know. I read some medical studies that showed the antibiotics didn't help either way.

I will report back with how it goes once it's over! Thanks again!

[Ellen]

I’m having one tooth done next month and deciding between Alloderm and my own tissue. My perio recommends Alloderm since it’s similar results and much less pain. I’ve also heard of people having continued sensitivity and numbness at the donor site. Anyone have any experiences with this or their decision? Thanks so much for this post/chain Brian!

[Julia Lechliter]

I had a gum graft at 23. Going to get it done again because it didn't take...not to mention I have root resorption and bone loss from extensive orthodontics.

[Kel]

I am 5 days post-op from a gum graft.
I have to agree with his story.
I had myself so worked up before the procedure about how awful & painful it would be, I had a migraine for days before.
But. I have been fine.
The roof of my mouth, which is actually what I worried about the most beforehand..given that they slice in to it, actually has been pain free. They covered it and that felt a little weird in my mouth for days but it fell out on it's own. No pain what so ever!
The graft site which was my lower tooth line was tender for the first few days but the pain is manageable. I did fill my prescription for pain because I was so afraid of feeling it but haven't needed it. I have been on an antibiotic, Motrin and a mouthwash.
I did feel weak and chills the night of my procedure but that passed.
All in all.....I would say a root canal is worse!

[Charlie]

It is Sunday and I had a graft on my bottom 2 front teeth on Monday. I had braces when I was younger and was told I would likely need gum grafts on my lower jaw afterward. True enough I was sent to the perio for consult. I put the surgery off for 5 years because I was nervous. By the grace of God I did not lose any bone although my gums had completely receded. Cost was $1100 per tooth. IV sedation was extra $700 so I declined. My insurance covered almost half of the total cost including rx drugs. I had a retainer made to cover the donor site. I was given vicodin, halcion, rx mouthwash, and a 10 day course of antibiotics. I bulked up and gained as much weight as possible before surgery. I took the halcion and got a ride to the office for my surgery. One .25mg Halcion barely made a dent, but was enough to take the edge off. I should have taken 2. I am 160lb. The actual surgery was pain free (after the numbing shots) and very fast. I was in and out in less than an hour. I got a ride home and took the next 6 days off work to relax and heal. I urge everyone to take at least a few days off. Pain was managed the first 3 days with Vicodin and after that I did not need any pain medicine. If anything, my teeth are a little tender from the deep cleaning/root scraping. I did bleed a lot the first day and kept a bloody spit cup by my side. I had huge clots form that dissolved the next day. The retainer was out for good on day 5. My donor site was stitched. No issues there. I was a little swollen the first 3 days in my lower jaw but no bruising. The antibiotic and rx mouthwash dry me out a little but it is manageable. I have been surviving on Ensure Plus and bone broth. Bone broth, gelatin, and collagen supplements are supposedly great for healing so stock up. I have not lost any weight due to drinking 2000+ liquid calories everyday while laying in bed for a week. I have a 2 week follow up and I can post more here then. For anyone that is scared or nervous, don't be and don't put it off.

[Jason Stewart]

Hellooooo - was scheduled for a soft tissue graft gum yesterday (tell you about that in a second) and came across this blog as part of the "R&D" phase many of us needing this procedure obviously go through. Thought I would add a nice and relevant 2019 recount so here it goes.

Firstly, a little disclaimer, I was actually pretty lucky in that I basically needed only half a molar done. This was a result of crappy brushing over the years. I know there are many out there not as fortunate as I was and need a lot more done. However it of course doesn't change what happens or what you feel in the actual procedure per se, but the impact is almost certainly post op.

So on to the "procedure from hell". Well ladies and gentlemen I have to tell you that this is pure NONSENSE. I mean unless myself and the original poster are just fortunate to live in Oregon where the Periodontists are incredible, the only way this procedure is "hell" is if you have the misfortune to go to a really sub par practice and practitioner. I have had a root canal done before and that is far worse than this. I've had regular cavities filled before that I thought were worse than this. The worst thing you can do is educate yourself somewhat on the procedure and then letting your mind run wild with what you think may suck about it. But that's all it is - in the mind.

My advice - choose one of two paths. Either educate yourself fully or not at all. Now me, I'm a geek in this way I and I wanted to know exactly what was up. That's how I came across this blog and many other recounts, and how I even ended up watching on Youtube exactly the procedure I was going to have. Yeah, it's a bit gory and not for the weak of heart BUT it helped me understand what my doctor was doing to me (as it was happening) and helped me compartmentalize things. So I knew when he was tunneling and cleaning the root, I knew when he was harvesting the gum and I knew when he was placing and suturing it. Believe it or not this really helps to get you through the time as you check things off - "okay he's done the first part, we are halfway through" etc etc. Helpful for me and made it not scary at all. Or go no education, don't wanna know - I could have done this as well to be honest. Either way PICK YOUR PATH. Don't go in 50/50 or your mind will take over and send you into panic with self actualized fake news ;)

My actual operation? Took about an hour and 15 minutes. He took a 12x6mm piece of tissue from the roof of my mouth - its close to the teeth line about 3mm away (I learnt this online :) ) and sewed it over the gum below T30 on the lower right side. I had just local anesthetic (honestly you need nothing more) and I felt absolutely no pain whatsoever. Even the hygienist who gave me the injections was so good I didn't feel those either. I didn't need music (the claims of terrifying scraping etc are simply not true) and I alternated between eyes open and closed (closed mostly because of the flashlight of my doctor). There were times I consciously caught myself a little tense but it was easy to take a deep breath and relax. I could even readjust my glasses myself and there were no things jammed in my mouth to keep them open (like with a RC). I saw not a drop of blood (I read this somewhere and it's IMPOSSIBLE to see it because of how far back you are tilted) so don't worry about that making you queasy, it won't happen.

I walked in at 9.50am and walked out just before 12pm feeling no worse for wear. Rest of the day I just chilled (you should do this), picked up my antibiotics and periodguard mouthwash, kept my head up, took my advil/tylenol and iced my face for 10min every 2 hours. I ate yogurt with mashed banana and drank coconut water. This morning I started the mouthwash and antibiotics and I don't think I'm going to bother with pain meds because I have no pain. I really thought the roof of my mouth would bother me but it doesn't in the slightest (remember it's on the side not the absolute top). I had a little blood in my spit as things clotted but this morning that seems to really be going away, all to plan. If you follow the plan you most probably won't have any issues at all.
Now I am expecting a little annoyance maybe tomorrow and day 4 but lets see. Tomorrow I will start eating some warm solids again.

Again, I was lucky with not having a lot of work done but remember, the volume of work done doesn't change what actually happens. More work = more gum harvested, more time in the chair and more to be careful with afterwards - it doesn't mean more pain or misery, that's simply false logic.

So signing off, final words of advice (and similar to the original post) - it's going to be okay. Don't panic - it's not bad at all. Reading some accounts it's almost as if people are trolling others to deliberately freak them out. Educate fully or don't educate at all.

Enjoy getting healthier!

JS

[Sherry]

Thanks Jason, good post and info, keep us posted on your progress!

[Penelope Johnston]

I had my first gum graft today after 3 months of stress and anxiety. What a waste of negative energy!
It went a breeze and I was in and out in just 30 minutes. No drilling,, no pain. Easy injections. Had my headphones on and shut my eyes and bingo it was all over. Bit of pain in the car on the wya home and tender if touched but so far not pain at all this evening. I hope it looks good in. A couple weeks.

[Dawn Lachapelle]

I had gum graft on a Monday was in pain for few days lost energy was tired was out of work 5 days at the end if the fifth day starting to feel better I don't care what people say about this surgery it was awful.

[Kelly]

Thank you for this post. I have a graft scheduled for next week and I find this very comforting.

How do the grafts look when they are all healed? I am having work done on one front tooth, as well as two others. I am hoping it will look natural when the healing is complete. 🦷

[Sarah]

Hi, I had a gum graft done on 6 teeth using the flap method, it was no big deal. I've experienced very little pain, lots of swelling though but it'll go down. I want to get all my teeth done. It really comes down to having the right surgeon.