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.

[Lauren]

I just want to post somewhere that I had my gum graft and it was so much easier than I was bracing for! I wish I hadn't spent two years dreading it!

My graft was on three of my lower front teeth, and the donor site was the front side of the roof of my mouth. The worst part of surgery was the needle, and I was surprised how lowkey the whole thing was. It wasn't like chopping and gore, more like a 45 minute braces adjustment. The stitching part at the end was actually really cool because even without a mirror you could sense the dexterity.

I took an advil before my appointment and then took one every four hours except when I was sleeping. The pain after wasnt as bad as a pizza burn, like people said it would be. More importantly it wasn't a 'creepy' pain like a paper cut, just a bit of very mild ache that truly didn't bother me, and sharp pain only when I ate something I shouldn't or when I cleared my throat too hard. If you're really worried maybe take some decongestant so you won't have to clear your throat. Warm compresses also felt nice.

Seriously, if this graft had failed I wouldn't have minded that much getting a redo. It would have been more tiresome and annoying that scary.

I was SO afraid before, I cancelled appointments and finally had to take a lot of sedatives.

Bottom line, don't skip any NSAID doses and take it easy for a few days if you can. I felt kind of tired, and it seems that's common.

[Lucy]

I'm getting this done in 3 weeks with synthetic graft material across ten of my bottom teeth. Wondering if anyone can elaborate on a couple things for me. Periodontist said be mindful of how much I talk for a while after the procedure. Was anyone else told this? How long is "a while?" Also, my post op directions say to eat soft foods for two weeks. So at day 15 can I go eat a huge burger or are there still eating restrictions after 2 weeks? I'll ask him of course, but I'm trying to get an idea of what I'm getting into before I get to his official word. I have an anxiety disorder and I sort of need to know things with as much notice as possible to adjust to them. Thanks!

[Gina]

Hi, I had a gum graft done 5 days ago. I have thin gum tissue and some recession on a few bottom teeth. I am also in the middle of invisalign treatment to make matters more complicated. The orthodontist referred to a periodontist as I had lots of crowding in lower teeth, and the movement to straighten them over the last 10 months has made the thin tissue even more evident. They wanted me to get a gum graft now, before any further movement occurs with braces.

I went to see the periodontist and was told they wanted to do NINE teeth. They were all on the bottom, in a row, everything except my back few teeth on each side. I have anxiety and was dreading this procedure from the beginning. I knew I'd have to get it done sometime in my life, but that time was now if I wanted to continue with my invisalign treatment.

I asked a ton of questions at the consultation and of course did a lot of research about it. The worst part to me sounded like the procedure itself and the shots in the mouth. They said they offer nitrous oxide first, along with local anesthetic via needle. I do not like needles so I asked about options to be fully sedated instead. I decided to instead take xanax prior to the procedure and opted out of the sedative. I thought with xanax, nitrous oxide and local anesthetic shots, should at least keep me from worrying and being aware of what was going on. I am happy to say I am glad I did that! My procedure took almost three hours but I had no concept of time and the needles didn't bother me like I thought they would and I had to be numbed several times throughout the procedure. Honestly, was not as bad as I anticipated since I was a bit loopy from the nitrous oxide. I watched the hook as she sutured me up and almost found it amusing, when normally I would have freaked out. I also had to take a bathroom break in the middle of the surgery and didn't seem to be phased about anything.

Also another tip - bring headphones and play some music! They had to direct me quite a bit on moving my head this way or that way, so I kept the sound down low so I could hear them, but the music helped me relax even more as a distraction.

The recovery has been the hardest part for me and not at all what I expected. They used tissue from the roof of my mouth, but I have a guard I wear all day except remove to rinse my mouth/brush teeth. That part is not painful at all, just feels a little weird and sensitive when I remove the guard, and the area looks dark red. The uncomfortable part for me is my entire lower gumline. This surgery is probably much easier for folks only get a few teeth done. All of my pain was in my lower gum line for first 4 days. I also swelled up quite a bit on day 1-3 after surgery and it started fading yesterday (Day 4). I took 800mg ibuprofen around the clock which helps ease the pain quite a bit! Laughing, talking, pretty much any mouth movement was uncomfortable/painful for me. Today is 5th day after surgery and I am finally feeling a little better. Not too much pain today but face/jaw/inner lip area still feels tight, and uncomfortable as if I have tea bags stuffed into my lip. I am told this feeling eases up around 7-10 days.

I have been on a 100% liquid/mashed food diet since surgery (although my instructions say soft foods like pasta can be eaten - I'm not quite there yet!). Mashed banana, overnight oats, mashed potato, mashed beans, soup onces its cooled down to room temp (chunky soup I just put into a blender to smooth it!), lots of protein shakes (prob 2-3 per day). I was told today when I called in to continue this diet for first 2 weeks, until my follow up appointment. My understanding is if you have only a couple teeth done, you can probably chew on the opposite side of your mouth, which is why pasta and other soft, but chewable foods are listed on the paperwork. That doesn't work for me since I had so many teeth done at once! My instructions say to avoid crispy, crunchy, chewy foods for at least 3 weeks and that usually at 4 weeks, can resume normal eating. We will see since my case seems to be more extreme than others.

I am unable to wear lower invisalign tray for these first 2 weeks also. Any sort of pulling on the lip can cause issues with the graft, so I also haven't peeked at it to see what it looks like (which is good bc I probably would be grossed out!).

Overall, I'd say if you're not getting your whole mouth done, the procedure and recovery are pretty minimal. Even for someone with anxiety, especially medical anxiety, I got through it with nine teeth! Ask lots of questions, know what you are supposed to do before & after. I highly suggest the nitrous oxide, as it doesn't knock you out, but you have no concept of time and aren't worried about what the doc is doing. The shots in the mouth were not a big deal at all and I dread needles!

[jeanne madden]

OMG. I am very nervous cause I am scheduled to get one of these. Thank you for the information.

[Carla]

I would also like to add to this growing resource in the hope that it calms someone else's mind too. I put off my gum graft surgery for 18 months based on the blog mentioned in the main article! I found this the night before I finally went in and it helped calm me down. I have had 3 teeth on my lower right grafted (I need to go back 3 more times to finish all of the teeth off). It really wasn't a big deal. The injections to numb your tongue and mouth are the worst part of the entire thing! After that you don't feel anything and my recovery has also been unremarkable. I rested for 2 days after the procedure and am working from home the rest of the week (I am on day 4 now). I have had some swelling and bruising but the pain has been minimal. I am now not worried about my upcoming appointments so please don't be if you are having this procedure done too. :) Find a periodontist that comes highly recommended and put your trust in them, as my periodontist assured me this is a very basic procedure for them and should not incur complications.

[Anthony]

This post and comments was a huge help to me while I waited anxiously for my gum graft, so now that I just finished it this week I wanted to contribute myself!

It's been three days since my graft. I was honestly terrified of it. To make matters worse it got pushed multiple times because of COVID-19 and my doctor being on maternity leave, so it was months that I spent dreading it and complaining constantly to family. But now that it's over I see what a waste that was. I've had a crown put in and that was honestly worse.

I had what was called a subepithelial connective tissue graft (SECT). This involved taking tissue from underneath the roof of my mouth, suturing my palate closed, and then placing this tissue underneath the receded gums and lifting these gums higher up the tooth. This is different from the free gingival graft (FGG) which involves actually removing a full thickness piece of tissue from the palate and placing it onto the receded gums. From what I was told, the SECT is newer and becoming more commonplace as it's a more advanced and arguably effective procedure depending on the circumstances. The FGG is supposed to be a little more painful as the donor site on the palate can't be sutured closed and is left open (though stents may be placed over it during recovery), while the SECT is an easier recovery because the palate can actually be sutured shut since only the tissue underneath is taken. To be clear, I'm in no way a medical professional so don't take this as 100% correct, I'm just relaying what I learned as a patient.

Anyways, I opted to just have the numbing lidocaine shots to save money, no sedation. I do not regret it as the procedure was way, way easier than I expected. They began by giving me the numbing injections, which honestly weren't really painful either. I've had palatal injections that really smart but my doctor was very good at what she does and applied pressure to the palate before injecting to make the injection almost painless.

Next they cleaned the tooth with recession. I was scared for this beforehand because I was worried it would be loud and bloody, since it involves cleaning the pocket/root instead of just the tooth itself. It was not. Less violent than a typical cleaning, and only a minute.

Next, they made the incision in the roof of my mouth. THIS is what I had really dreaded all those months. My biggest concern had not been the pain, but the idea that they'd be cutting my palate open while I was awake and I'd know they were doing it. However it was really nothing. I imagined it would be rough and lots of scraping and sawing, but to be honest I didn't even know she had made the incision until I noticed she was stitching.

After that hurdle the rest was a breeze. She placed the tissue in the pocket she had cleaned (when she cleaned it she must have made a little tunnel to place it into, which I also didn't even notice) and stitched it tight.

The pain after was nothing as well, which really surprised me. I took Advil and tylenol regularly just to be safe, and iced to reduce swelling, but I really didn't feel a thing. It was tender to the touch, like a small bruise, but no throbbing pain. The worst part of it all has just been the stitches in my mouth and having to eat softer foods to make sure the graft isn't moved at all.

All in all, I wish I could tell my past self to stop worrying. All the time I wasted moping about having to do this, ugh. Really not anything to freak out about!

[Maeve]

I'm just adding to the chorus that my graft was WAY less dramatic and scary than I anticipated, even though I still can't stand reading run-throughs of the operation like some have posted here!

Things I did, in case it helps:

- took ibuprofen an hour before my procedure and continued for a week or so without missing doses. Advil is good for preventing pain but it's no good at catching up!

- hardly moved my lower lip at all for days: minimal talking, or if I had to talk, I just let my words slur if it meant keeping my lip still. (My graft was for four teeth at the bottom front.)

- after the first day, gentle rinsing with saltwater or baking soda water several times a day. I just let it flow in and around for a bit and then out with no swishing.

- lots of relaxing on the couch and lots of sleeping

I also took a ton of Xanax before my appointment and also twice the next week when I got stir-crazy from doing nothing, but that's probably bad advice!