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Gum Surgery

Gum Surgery

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Gingival graft

Gingival graft

Gingival grafting can be performed to restore a sufficient amount of gum around the teeth or around exposed tooth root surfaces caused by gingival recession. The dental health professionals who are qualified for this type of transplant are general dentists (for simple cases) and periodontists (for more complex cases).

Several techniques are used to perform gum grafts:

  • The free autogenous gingival graft: This is the oldest gingival graft technique. It involves taking the graft from the patient’s palate and relocating it where there is gingival recession. The result of this method is less aesthetic than that obtained with other methods. It is not recommended to use this type of grafting when the tooth roots should be covered because this technique only stops the progression of gingival recession minimally. However, the advantage of this technique is the absence of risk of graft rejection, because it is taken from the mouth of the patient.
  • Connective tissue graft (root coverage grafting with connective tissue): This is a relatively new and versatile technique. The connective tissue is taken from under the gum surface of the patient’s palate and is inserted at the area of gum recession. Its main benefits are the very aesthetic results and the ability to cover exposed roots. With this type of transplant, the patient cannot reject the graft because it comes from tissue taken from his mouth.
  • Allogeneic gum graft (allograft): this type of transplant is relatively recent. A graft from an external donor, who has been treated and is very safe, is located in the gingiva of another patient. The main advantage of an allograft is that there is only a single surgical site because the graft is not taken from the patient’s palate. It also gives results that are as aesthetic as the connective tissue graft. However, there is a low risk of transplant rejection.

The gum transplant success rate is very high.  The beneficial effects of these grafts persist for many years although a little less for smokers.

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Before the surgery

Before the surgery

Medication

  • In some circumstances, you may have to take antibiotics before the procedure to reduce the risk of post-operative infection. It is very important to take them as they have been prescribed.
  • If the surgeon knows the list of medication you are taking and that none of them pose problem for surgery, you must take them at the usual time on the day of your surgery. Bring a list of medication you have taken in the last 24 hours to inform your surgeon.
  • If you take drugs like aspirin, products containing aspirin, vitamin E, or anticoagulants, it is important to inform your surgeon before the procedure. He or she will determine how many days in advance you need to stop taking them. A consultation with your treating physician may be required to assess risks associated with the discontinuation of medication before your surgery. These types of drugs have a blood thinning effect and inhibit clotting, which causes perioperative complications (more abundant or uncontrollable bleeding during and after surgery).
  • With the agreement of the surgeon, you can take a sedative if you are anxious to ensure you a good night’s sleep before the surgical procedure. This medication may be prescribed by your surgeon or by your doctor.  A patient who undergoes surgery and who is well rested will respond better to the surgery and the postoperative period.

PREOPERATIVE ADVICE

Preoperative advice

  • Eat a light and nutritious meal on the day of your surgery.
  • Brush and floss your teeth carefully after eating and before the surgery so that your mouth is as clean as possible. A clean mouth will decrease the risk of post-operative infection.
  • Wear comfortable and loose clothing with roll-up sleeves in order to maximize your comfort and to facilitate the administration of intravenous medication during the procedure.
  • If you smoke, you should stop smoking at least a week before your surgery to increase the chances of success of the operation. Alternatives to tobacco, such as patches or nicotine gum, can be a good alternative during this period. It is also advisable to stop smoking completely after your surgery.

The surgeon will provide you written preoperative and postoperative instructions to familiarize yourself with the surgery.
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