Gum graft post-op: how long do I *really* have to wear this dang stent?
July 12, 2018 5:26 PM   Subscribe

I am 24 hours out from a minor gum graft surgery (extending the gumline on just one tooth). Recovery has been going great, except that I *hate* the plastic retainer/stent that I'm supposed to wear 24/7 for the next week. How long do I really need to?

The stent is momentarily painful when removed and replaced, maybe due to sharp edges or maybe because it presses against my donor site on the soft palate. The donor site itself feels like a pizza burn, like everyone says. But regardless, I feel way more comfortable with the stent out than while wearing it. Any kind of chewing is especially uncomfortable, even when I direct all food toward the non-affected side of my mouth.

Moreover, the retainer covers a different tooth where a surface cavity filling fell out and I can't get it replaced for a few weeks, so I'm a little worried about further cavity potential when food and saliva is constantly trapped under the stent (I rinse it out after meals but I also snack on fruit, etc., throughout the day).

Calling the dentist's office just got me a receptionist who reiterated the need to wear the stent for a week straight. But I'm annoyed enough to consider not being a model patient this time. What's the minimum amount of time for my donor site "open wound" to heal enough that I can forgo the stent? E.g., surely there's not much difference between "a week" and 6 days... what about 5 days? 4?

Hope me, dentists of MeFi. Or convince me that regardless of my current antibiotics regimen I'll suffer horrible repercussions if I don't wear the stent for a week, and I'll grudgingly comply.
posted by serelliya to Health & Fitness (10 answers total)
I'm not going to counteract the advice of a professional, and I would advise you to do the same.

People are different and heal at different speeds. You might be fast, or you might be slow. Do you really want to find out? If you are wrong the consequences will be much worse.
posted by sanka at 5:30 PM on July 12, 2018 [2 favorites]

But I'm annoyed enough to consider not being a model patient this time. What's the minimum amount of time for my donor site "open wound" to heal enough that I can forgo the stent? E.g., surely there's not much difference between "a week" and 6 days... what about 5 days? 4?

I just had a tooth extracted last week. Obviously my gum is healing. I have followed the dentist's instructions religiously. It's been 6 days and I only just started drinking hot liquids (coffee) today -- a major, major sacrifice for me.

If they say 7 days, you best follow their advice. I, for one, do not want to be back in the dentist's chair for a "complication" that could likely result in a month of discomfort, rather than one week.
posted by JamesBay at 5:44 PM on July 12, 2018 [3 favorites]

Best answer: Here's my cautionary tale. I had my second graft less than a week ago. My periodontist doesn't use the stent for the donor sites at all. After both my grafts he covered the donor site with a dressing but told me not to worry if it fell out, just apply pressure with wet gauze or a wet teabag if it bled. After the first graft I had a close to painless recovery and the dressing remained until my checkup two weeks later. This time the dressing fell out about two hours after the procedure. I applied pressure as told, very little bleeding and continued on with life. Day 2 was uncomfortable but manageable, day 3 was a little worse. By day 4 my donor site was really starting to hurt. By day 5 it was so painful that I didn't want to put anything, including water, in my mouth. I had trouble talking because of the pain, I had a constant headache, pain spread to my jaw, I couldn't sleep at night and I was popping Advils like candy. I went back in and got a new dressing applied and was back to normal levels of discomfort within a few hours.

According to my periodontist it should have healed just fine with nothing on it but clearly it did not (even though he said it looked fine and it would heal faster if it wasn't covered and basically implied that I couldn't be feeling the amount of pain I reported...but that's another story and yes I am considering changing periodontists now). Even if your palette seems fine now my experience tells me it might not in a couple of days. FWIW my periodontist said that the worst days for swelling are 2-3 and for pain in the palette healing are 5-6.
posted by Cuke at 6:00 PM on July 12, 2018

Best answer: Call your dentist! They might be able to smooth the edges enough to get you through the required amount of time of healing. While you have them on the phone, ask about the cavity as well.

I had to wear mine until my follow-up, at least 7-10 days.

Alternately, call your periodontist back and INSIST on getting the rough edges of the stent smoothed down. The sharp edges of the stent were the worst part of the experience. I regret not calling and asking them to address the issue.

FTR I left my in, in spite of the discomfort. It was glued to the top of my mouth with a mild adhesive and I was afraid of what would happen if I removed it.
posted by theBigRedKittyPurrs at 6:30 PM on July 12, 2018

Perhaps you can clarify -- is the stent to protect the graft site or the donor site? If it's the donor site then no, you're not likely to have a bad result from not wearing it and I would suggest orabase w/ benzocaine to protect and numb it.
If it's the graft site then yeah i'd wear it, at least to eat so you don't disrupt the graft before it takes.
your cavity isn't going to get worse in a week.

IANYD however, so a quick visit with them to go over this may still be the best course.
posted by OHenryPacey at 9:22 PM on July 12, 2018

I had gum graft surgery years ago (it was fraught with complications.). And very recent periodontal surgery - PLEASE do whatever they tell you to do.

I am on round two of a surgery that should have been no big deal. I followed instructions, etc. The second time around, I am slightly obsessed because a minor fuck up last time may have caused me to have to do this again.

DO WHAT THEY SAY. It may be an inconvenience for a month or so. Who cares? Trust me, you do not want a repeat surgery.
posted by augustinetill at 10:06 PM on July 12, 2018

Response by poster: The stent is to protect the donor site. I absolutely intend to follow all postop procedures wrt the graft site.

This isn't my first round with periodontal surgery -- have had 2 pocket reductions in the past, and the recoveries were only a minor inconvenience. I didn't realize I'd have a stent this time around or that it would be so bothersome (this particular gum graft was optional, being asymptomatic and not in a visible part of my mouth).

I'm a minimum-viable-product kind of person... e.g. I know that I absolutely need to floss and brush every night or there will be Consequences, but I usually skip brushing in the morning and that's been fine. I once got an interdental cavity from less than 1 week of not flossing on vacation, hence my paranoia about cavities.

Much thanks to BigRedKitty for the brilliant idea of filing down the edges of my stent! I did a quick runover with a glass nail file and that definitely helped with overall comfort, although eating is still a PITA.
posted by serelliya at 10:16 PM on July 12, 2018 [1 favorite]

Best answer: I also had to trim the edges of a stent - I got so irritated that I took a pair of scissors and sliced off modest chunks in a few places, then filed the edges, and the end result was vastly better.

The stent does a surprising amount to reduce pain and discomfort and protect the donor site; I didn't really feel much discomfort or pain there until after I stopped wearing the stent and the wound dressing washed out fully, so it's very, very possible that you just don't realize how much it's doing to make you feel better. (And how much it'll suck the first time you jab the vulnerable site while eating.)

It feels gross to not brush and floss, but the Peridex (or whatever antiseptic rinse they've prescribed) should be doing its job (and making everything taste like garbage - I was as relieved to stop using the rinse as I was to stop wearing the stent).

I don't have an answer for how long you *really* have to wear it - if you normally heal very quickly, are fine with moderate risks, and still can't stand it after best efforts to trim/file the stent, take it out a little early. I hated it, but I used it for the full time because I'm extremely risk averse and So Very Good at Following Instructions. At some point, it's a matter of incremental differences based on averages - a minute doesn't matter, or a few hours, but at some point it definitely does (12 hours? 2 days?), and you can't know whether you're somebody who would be fine at 6 days or somebody who would have been better off with 8.
posted by verschollen at 9:52 AM on July 13, 2018

If you got the thing last Thursday, you could make an appointment for Tuesday so they can check and see if you really need to go the whole week.
posted by wryly at 3:52 PM on July 13, 2018

Response by poster: Final follow-up: I got fed up today with the continuing pain whenever I removed the stent. Inspired by verschollen, I took a pair of scissors and carefully cut off a "bubble" at the back edge of the stent. And after that, I was able to remove the stent without pain -- I've been having almost 0 pain except while removing the stent, when it shoots up to level 2-3 -- for the first time in three days.

I might even be able to get through the rest of the prescribed week of wearing this thing, if I don't have to dread the pain every time I clean it after eating.

Moral of the story for future readers: don't be afraid to take scissors and/or a nail file to your stent, if it's hurting!
posted by serelliya at 12:26 PM on July 14, 2018 [1 favorite]

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