Gum Grafting/Soft Tissue Graft

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There are many reasons why you may require a gum graft.  Gums tend to recede due to age and gum disease, leading to exposed teeth and an unattractive look.  Having a gum graft can help to improve the appearance of your teeth, prevent bone loss due to infection and help to desensitise your teeth.  Having a gum graft reinforces the gum line and slows any further recession that might take place. 

There are two types of gum within your mouth:

• Gingiva mucosa – the soft, pliable parts of your gums
• Keratinised gingival – the harder parts of your gum, this is protection for the roots of your teeth

The soft tissue is the most vulnerable, and as such it is this, which starts to recede and disappear.  Your dentist or periodontist can replace the areas affected either with healthy tissue from your own mouth or with tissue from a donor. In severe cases of gum recession your periodontist might need to replace the connective tissues that hold the gum and tooth together.  This involves the harder material necessary for tooth protection. 

Your gums can start to recede for a number of reasons.  The main ones are:

• Excessive brushing over a prolonged period of time
• Tooth clenching or grinding
• Malocclusion
• Gum disease

Reasons for having a Gum Graft

• To prevent cavities and infections that are more likely when the lower parts of the tooth are left open

• To prevent any bone loss caused by receding gums
• For aesthetic reasons
• To prevent further gum recession

Gum Graft Procedure

Initially you will have the connective muscles repositioned away from the top of your gum.  Your periodontist will remove a strip of gum tissue from the roof of your mouth and place it onto the area where it is needed, covering the root and lower parts of the teeth.  The tissue reattaches itself and forms a new layer of gum and the area where the graft was taken from heals quickly.  The replaced gum ought to last forever.  You ought to be able to control any pain you are in with normal, pharmaceutical painkillers such as paracetemol or iboprofen.    

Gum Graft Recovery & Risks

You will have swelling over your gums for a while after the surgery as your mouth accepts the transposed tissues.  Soft tissues are bound naturally to their location and new blood vessels with develop so that the grafted tissues don’t die.  Usually it will take one to two months for a complete return to normal.  This varies depending on the thickness of the graft, where the graft is and the type of gum being grafted.  If you had bone exposed then the recovery time is likely to be longer. 

Gum grafting is usually successful, and normally the graft takes and there are no complications.

• Bad swelling.  It is important that there is blood transported to the graft from the bone near to where it is placed.  It is essential that the tissue is stable so that blood vessels can form quickly.  Bad swelling or loose sutures can displace the graft, and prevent the blood vessels from forming.  This is a rare condition and tends to occur in areas that have had multiple problems. 
• Tissue coming loose from the roof of your mouth.  This can be prevented by the use of a strip of plastic that keeps the tissues in place while they heal.  It also prevents food and tongue contact. 
• Infection.  All forms of surgery contain the risk of infection.  So long as it is caught early it is easily treatable with antibiotics, although if left can lead to serious complications.  You will be given an antiseptic mouthwash to use after the surgery, and must follow your periodontists advice. 
• Asymmetrical healing.  It might be that the graft heals and grows unevenly.  This can be rectified through further surgical techniques. 

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