What to expect/post op suggestions - gum graft edition.

May 19, 2014 4:04 PM

I'm really excited to be receiving a gum graft later this week! If anyone has had one of these, I would love to hear about what I can expect from the procedure as well as post op suggestions re: care, food, etc.

My upcoming gum graft is really harshing my mellow. I'm sort of prone to medical anxiety, so I'd love to be able to mentally prepare a bit for the fiasco.

They're going to rob my palate of some tissue and sew it on to the front lower portion of my gum. I believe I will be getting some sort of special mouthwash and some Norco (hydrocodone/acetaminophen). I've read some sample post-op sheets around the web, and my general impression is that it will hurt and be basically a pain in the ass. Furthermore, I won't be able to clean that area for a while, which seems kind of gross to me.

I would like any general info you can give me on what the procedure is like and what I can expect in the weeks following.

But just a few specifics as well:

-Prior to the procedure, I am planning on taking .5mg of Klonopin, which I have laying around for exactly these sorts of situations. I spoke with my doc, and she says that's fine and good and just expect to be pretty fucked up once I also take the Norco. I haven't heard anything regarding getting sedation of any sort during the procedure, which is partially why I'm taking a bit of klonopin beforehand. Please let me know if you see any reason why this is a bad idea (I have taken Klonopin on occasion for years and never had any issues. Also yes I have someone driving me to and from my appointment).

-I'm supposed to eat 'soft' foods for a while after. Nothing too hot or too cold I've read, which is a bummer because I was hoping this could be an ice cream binge. Do you have any suggestions for 'soft' foods I could eat? I have a blender, so I could also perhaps make smoothies, though I'd prefer things I could just buy pre-made honestly.

-No exercise for like a week, but will some gentle yoga (no standing on my head stuff) be okay maybe a couple days into it?

Any other suggestions/experiences/advice/warnings?

Thanks everyone - and please tell your children to wear a nightguard if they grind their teeth at night.

posted by Lutoslawski to Health & Fitness (12 answers total)

I had a gum graft about 4 years ago. It was fantastic. And I had the gum protector made to protect the open wound on the roof of my mouth, and everything, and then it turned out that they didn't have to cut any pieces out of my mouth. Fantastic!

It was super easy.

Also, I have had my tongue pierced and although the pain factor is totally different with the tongue, I can tell you from experience that the mouth heals remarkably fast.
posted by janey47 at 4:20 PM on May 19, 2014

oh and I was given a little xanax before they realized that there would be no need for slicing out my mouth and it was delightful.
posted by janey47 at 4:27 PM on May 19, 2014

After having 3 wisdom teeth pulled, I lived on yogurt, applesauce, oatmeal, and soft (not toasted) bread.
posted by Carol Anne at 4:40 PM on May 19, 2014

I had a gum graft a few years ago. It heals fast, the mouthwash they give you is meant to take the place of brushing, soft foods include things like bread, fruits, some meats, fish, etc. Just avoid hard foods like pretzels, stale bread, etc.

As for no exercise--I don't understand that limitation, but I suppose go with whatever your doctor said.
posted by dfriedman at 4:42 PM on May 19, 2014

I had a gum graft done and requested, but was denied, Xanax by that doctor. I think probably my unmedicated anxiety (and the way he blew me off) made the actual graft much worse than it had to be - I'd say it's actively a good idea to take the Klonopin, if you're nervous enough to be asking about it. Also, do not hesitate to tell/ask them to numb your mouth but good, and to signal at them if you think the numbness might be wearing off - I had to get re-numbed partway through and they didn't catch my hand-waving motions that I was in pain at first, and that really sucked. Up until that point the procedure was weird but not painful, so again, that could have been avoided with a more attentive doctor and a more assertive and possibly also more sedated me.

Although the graft experience sucked, I blame it on that particular doctor and not the procedure itself. The post-op care was pretty much a breeze. The roof of my mouth was sore for several days, but not terribly so. I think I only took the hydrocodone for a day or so and then regular over the counter painkillers were fine.

You'll definitely want soft foods, but I don't remember either hot or cold really being a big deal. I seem to recall there were a lot of scrambled eggs and pudding and applesauce in my life, some ice cream, a smoothie or two. I bought some instant mashed potatoes in case I was craving something more savory but ended up not needing them. You could probably have like, mac and cheese if the pasta was small bite sizes?

I don't remember any exercise warnings, can't offer any advice there.
posted by Stacey at 4:49 PM on May 19, 2014

Mine was on a top canine rather then a lower tooth.

The actual operation was totally fine, easier than either of the other two oral surgeries I have had (sigh).

Eating on one side of my mouth was kind of annoying but pretty doable. After just a day I was pretty much eating normal food (nothing stupid), just cutting it up pretty small and chewing all on one side for a few days.

I couldn't talk very well for a couple of days due to not wanting to touch the roof of my mouth with my tongue. Luckily my wife thought this was adorable.

The real annoying factor was the roof of my mouth where they took the graft from. For a few days it was like having a too-hot pizza burn, then the main annoyance was the stitches hanging out a bit; it was really hard not to prod them with my tongue. I think the very last one came out on day 9 or so with a little help. By that point I basically felt totally back to normal.

My doctor also told me not to exercise for a couple of days, the issue being that there's a lot of blood flow in that area and you don't want to encourage bleeding there. But I'm sure that some yoga after a day or two would be no problem at all.

You swish around the mouthwash and it keeps the area pretty clean; it didn't feel too gross.

Avoid looking at it! It looked much nastier than it felt.
posted by dfan at 4:52 PM on May 19, 2014 [1 favorite]

I had one done a couple of months ago. The paeriodontist cut a slice off of the top of my mouth and put it below my bottom teeth, it runs underneath five of them. The procedure itself was fine. Because of my terrible gums I'm getting very used to the giant needle jammed in my mouth. After the numbing the surgery was done really quickly - maybe 15 minutes or so. They gave me an ice pack to put on, 15 minutes on, 15 minutes off for the rest of the day. I drove myself home, took that day off work and went back to work the next day.

The site where the graft was harvested had some gauze basically crazy glued on to it. It stayed on for 10 days or so, really didn't hurt much at all. A little bit on days 4-5 maybe. My chin, on the other hand, hurt like hell. I felt like someone had kicked me in the face. Still, I didn't have to take anything stronger than ibuprofen and I survived. It kept hurting for at least a week I'd say, long enough that it made me nervous. The dressing over the stitches stayed on until I returned to have the whole thing checked out two weeks later. Once it was off the stitches came out within a couple of days.

I bought some meal replacement shakes and lived on those, mashed banana and oatmeal for the first couple of days. Soup was good. Spaghetti turned out to be bad for for the first few days because you make a vacuum to suck it in, which threatens to pull off your dressing (which equals a mouth full of blood, yuck). No straws either. After a couple of days I was eating pancakes, soft meats and veg, pretty normal food, just avoiding seeds, crackers and so on.

When I go back again - which given my absolutely horrible gums seems likely to happen - I'll make sure to keep the ice on right after the procedure. There was a good hour or so between when I left the office and when I arrived at home that it wasn't on. That probably made my swelling worse. I'll also take an extra day off work. I have to talk a lot at work and it was pretty awful the next day. If you aren't talking I think it would be fine. When they took the dressing off the bottom it was absolutely disgusting underneath, despite my cleaning elsewhere as much as possible. I'm sure you know this but aesthetically it makes absolutely no difference - I still have horse teeth, just hopefully the recession will slow down now.

My guy told me excercise was fine, but I took it easy for a week. One other thing - the site of the graft still feels a bit weird, like the lower gum area is too big. I'm sure I'll eventually get used to it.
posted by Cuke at 6:31 PM on May 19, 2014

I had top & bottom grafting on one side of my mouth about 10 years ago. I was pretty wiped out for a few days and was glad I had someone with me since I would have had trouble getting my own food.

Ice bags helped. I found acidic foods uncomfortable - so I couldn't eat the mango sorbet I had bought in preparation! I found some food textures bothered me for a few weeks.

Eggs, pudding, cottage cheese all were easy.

After a week or so I could use a very soft tooth brush (given to me by the DR.) to carefully brush that side of my mouth. I second the advice to avoid looking at it...

I'm sure the procedure has advance so I would think you will have an easier go of it!
posted by cat_link at 6:37 PM on May 19, 2014

I had grafts done several years ago (top and bottom grafts on opposite sides) and had an experience similar to cat_link in that I was completely wiped out for several days. The pain was not bad, the exhaustion was terrible. My periodontist prescribed Valium for before, oxycodone for after, and was really, really good about making sure that I couldn't feel anything during the procedure. The most painful part was the novacaine injections into the roof of the mouth. Even with the topical numbing gel, they hurt. I think I listened to podcasts during the procedure.

The only annoyance was that the tech did not trim one side of the palate protector correctly, which caused it to dig into the gums right at the tooth line, even with it glued onto the roof of my mouth. If you are going to get one, ask to try it before they start numbing you and shift it around your mouth a little bit before surgery, to make sure it is comfortable. If it turns out to be uncomfortable, call and insist on having it adjusted (which I did not do, in my painkiller haze).

As for food, I at a lot of scrambled eggs, grilled cheese, milkshakes, juice, garlic mashed potatoes, cooked vegetables and crab bisque. After a few days I was even able to gum a little bit of steak, as long as it was cut into tiny pieces.
posted by theBigRedKittyPurrs at 7:54 PM on May 19, 2014

I have not had a gum graft specifically, but I am in the process of getting two tooth implants which both require xenografts of bone, so I've had a number of oral surgeries lately, enough that I feel like I've had some darn good practice at it.

It is really, really not as bad as I thought it would be. Local anesthesia works great -- the initial couple of injections are a nasty little pinching feeling, but that's the worst of it. Take your hydrocodone-acetaminophen afterward and don't be a hero about toughing it out. There's initial pain that will abate after a day or two, and it was pretty obvious to me when I was ready to switch to prescription-strength ibuprofen.

The stitches, though. Try really hard to not fuck with them and worry them with your tongue. But it's like having dental floss stapled to the roof of your mouth and it is really goddamn annoying and I have a terrible time leaving that sort of thing alone. But seriously, don't. And if they break down so that you have a long thread dangling, don't cut it yourself, even if that seems like the most sensible thing to do, because that's actually not sensible and can cause real problems -- instead, call the office.

Gentle yoga without inversions is fine, if you feel up to it. Don't be surprised if you're just too tired to want to do anything for several days, it really takes something out of you.

I lived off of congee, soup, mashed potatoes, risotto, scrambled eggs, oatmeal, and ice cream (just put it on your tongue if needed to keep the shock of the cold from hitting your gums.)
posted by desuetude at 8:44 PM on May 19, 2014

I had a couple of grafts done ages ago. I'm certain the procedure has changed significantly in the intervening time (for example, I don't remember any kind of mouthwash). I don't remember being especially knocked out for too long afterwards - maybe the rest of the day, but that was about it. But here is one piece of information that I found to be ever-lovin' invaluable: perhaps the doctor who performed these procedures on me wasn't the best in the world, but I remember precious little in the way of wound-dressing on the spot where the graft was taken from. This became a problem only later in the day when the bleeding started (I guess when the drugs wore off?). Both times, I found that if I pressed an herbal tea bag on to the location with my tongue, the bleeding stopped almost immediately. Gauze didn't work, paper towels didn't work - but herbal tea bags worked like a charm every time. It lasted only for about 30 minutes, if I recall correctly.

Anyway, perhaps (hopefully) you'll have better dressing than I did, but maybe have some Celestial Seasonings on hand anyway, just in case.

And don't sweat it. It's really not too big a deal.
posted by fingers_of_fire at 9:46 AM on May 20, 2014

Ha, that's right, when the dental assistant was going over post-operative care with me, she specifically recommended using a tea bag if the source location started bleeding. So fingers_of_fire's technique is medically approved!
posted by dfan at 10:32 AM on May 20, 2014