We talk about gum recession when the gum tissue that surrounds the teeth moves away from the tooth, leaving the root exposed. As recession progresses, the gum becomes easily inflamed, causing pocket formation around the tooth, followed by loss of supporting bone structure. If left untreated it can ultimately result in tooth mobility and in severe cases tooth loss.
Gum recession often occurs slowly and and is often unnoticed by the patient. The first sign is usually tooth sensitivity. The patient can also notice that the teeth are becoming longer looking than usual. Receded gum cannot regenerate on its own.
Gum grafting surgery
When gum recession is diagnosed in its early stage, precautions can be taken to stop its progression. In advanced cases or in cases where it is caused by a frenum (muscle attachment) pulling the gum in an unnatural way, gum grafting may be needed to repair the damage and prevent further dental problems.
There are different types of gum grafting surgery, but the most commonly performed are the connective-tissue graft and the free gingival graft. They are generally performed using local anesthetics.
The Free gingival graft is often performed when there is excessive bone loss around the tooth, or in an area where the gum is just too thin. It doesn’t repair the recession, but it adds some gum tissue to stop its progression and prevent further damage to the tooth. In this procedure, a small amount of tissue is removed from the palate, then placed and stitched onto a prepared area of the tooth being treated. It leaves an open area on the palate, which is usually covered with a dressing.
The Connective tissue graft is usually performed in areas where there is a minimal bone loss present around the affected tooth. It allows complete or partial coverage of the root, depending on the situation. During this procedure, a small flap is made on the palate (donor site) and tissue from under the flap (the graft) is removed and placed in a pocket initially prepared on the recipient site(the tooth with the receded gum) to cover the recession. Sutures (stitches) are then placed on the palate, and on the recipient site to stabilise the graft and prevent it from shifting.
Pre-operative instructions for gum surgery:
You will discuss the procedure with the dentist on the day of your dental examination and have the chance to ask questions.
Use good oral hygiene leading up to the procedure day, to keep your teeth clean and your gums healthy. An inflamed gum will tend to bleed more during the surgery.
Make sure you have a good meal before your appointment, because you will not be able to eat for few hours after the surgery.
If you feel anxious about the surgery, you could get a sedative prescribed. Take it the night before the surgery to have a good sleep and 1 hour before your appointment. You must not drive after taking the medication, and must arrange to have someone drive you before and after the surgery.
You will generally experience little or no bleeding, but any minimal bleeding may persist for 24 hours. If you experience excessive bleeding later on, dip a gauze in the mouthwash that you received after the surgery and apply pressure for at least 10 minutes or until it stops.
Infection and Pain control:
You could experience some discomfort the first week after the surgery, but the mouth tends to heal very quickly. Some pain medication will be prescribed to you to keep you comfortable the first week, and some antibiotics to minimize the risk of infection. Use them as instructed.
Do not eat for the first 4 hours following the surgery. After that, eat soft foods such as soup, eggs, yogurt, pasta, and well-cooked vegetables. And avoid very hot beverages and do not chew hard, crunchy food for at least a week.
Do not brush or rinse the day of the surgery. The day after, resume brushing and flossing, but stay away from the site of surgery until you return for your follow up appointment. Rinse your mouth gently, using the mouthwash given to you after the surgery. Do not swish vigorously, and avoid using a straw or sucking on candy. Do not pull back on your lips or cheeks to inspect the area.
Avoid smoking. Smoking will delay the healing.
Avoid strenuous activities and exercising the day of the surgery. You will be able to return to work
the day after the surgery.
Call the clinic if you experience following conditions:
- Heavy or increasing bleeding several hours after the surgery.
- Increasing swelling, or pain that persists beyond 3 days after the surgery.
- Odour or bad taste in the mouth.
- Reaction to medications.
You can talk to the dentist, or may be given a follow up appointment if there are concerns.