Gum graft - help me comparison-shop periodontists and not freak out

May 13, 2019 12:31 PM

Does anyone have experience getting a gum graft in NYC? Anyone have recommendations for NYC periodontists I could get a second opinion from? How common/necessary even are gum grafts? Anyone have experience getting them? If the graft is from a donor, do they ever get rejected by the host, and what happens then?

My too-ritzy dentist on Central Park West insists I need a gum graft for receding gums on my lower teeth. He referred me to Dr. Toffler, a periodontist whose gentleness I really loved, but again, he's a Central-Park-adjacent dentist and the price he quoted was a lot. My insurance was only going to cover about 1/5 of it.

I've scanned the back archives of Ask and found this. I'm wondering if anyone has gum-graft-specific information about those providers, either positive or negative. Or anyone else to recommend.

p.s. also WHAT IS UP with dentists straight-up saying "cadaver tissue" when they're talking about what they're going to sew onto your face, don't they get some kind of marketing training in dental school?! please, just say "donor tissue"!

posted by Oda_a_los_calcetines to Health & Fitness (9 answers total)

I have had a gum graft, as have several members of my family. In all cases, the graft was from patient, to the same patient. In my instance, they took gum tissue from the roof of my mouth, and attached it to the gums around my teeth that were getting kind of thin.

The price was a lot even after I found periodontal surgeon who was a Delta (insurance) preferred provider. That meant that the price was set as part of their contract with Delta, but, since it exceeded the Delta yearly maximum cap, I was responsible for the remaining cost.

Being a lay person, I'm not sure about the evidence base for this kind of procedure. I asked my regular dentist who said there was a good evidence base for it, but I'm not motivated to look it up. One thing I can tell you for sure is that the recovery is painful AF.

Feel free to MeMail me if you have questions.
posted by jasper411 at 12:42 PM on May 13, 2019

I recommend my general dentist Dr Hamidi at Tribeca Dental Associates to everyone. He doesn't specialize in perio but he has taken such good care of my receding gums and I trust him deeply. Might be worth a visit to a new to you dentist. My understanding from working several years in dental offices is that all dentists have referral networks. Some are stronger than others. You are right to want to choose a dentist and periodontist that you are personally comfortable with.

That said, dental insurance is...not really great about paying for big ticket things. Think of dental insurance more as a discount program. While that's frustrating, the change in perspective does help.
posted by bilabial at 1:35 PM on May 13, 2019 [1 favorite]

I had a gum graft about 10 years ago due to receding gums over a couple of teeth because of my teeth grinding at night (got a nightguard at the same time). I am incredibly squeamish about medical things and was completely freaked out but I just zoned out listening to NPR and the worst part of it was just the novocaine shots, which I always hate. They took some from the roof of my mouth just behind my teeth and grafted it onto the front. I don’t recall recovery being painful, just annoying, since the “bandage” feels like an enormous piece of flattened chewed bubblegum stuck between your lip and gumline.
posted by olinerd at 5:04 PM on May 13, 2019 [1 favorite]

Years ago a ritzy dentist wanted give me a gum graft due to receding gums and shallow roots. I moved away, started going to less ritzy dentists, and have only been told my gums look healthy, with no mention of the gum recession. I'm not saying you don't need one, but if it were me I'd get a second opinion.
posted by toastedcheese at 6:32 PM on May 13, 2019

I should have mentioned, my ritzy dentist specialized in cosmetic dentistry, hence my extra dose of suspicion.
posted by toastedcheese at 6:34 PM on May 13, 2019

Gum grafts take tissue from your own mouth, likely your palate near the back. Cadaver tissue is usually hydroxyapatite, which is for bone grafts. It is possible you are having both kinds of tissue grafted, but the fact that you aren't sure may be a sign that you haven't had this explained to you well by either dentist.

Ask your general dentist to send you to another periodontist for a second opinion. This is pretty routine, and won't raise eyebrows or hackles from either end. Tell them you want a good communicator , or that you want someone who takes your insurance. They will guide you to the right someone.
posted by OHenryPacey at 8:43 PM on May 13, 2019

I also thought gum grafts were from your own mouth. Mine was; they took tissue from the roof of my mouth and put it on my lower gums (front teeth). The procedure was pretty unpleasant but I don't remember the recovery being too bad.

I think a second opinion would be worthwhile, especially if the suggestion came from a ritzy dentist. In my old town/dentist I had a cavity or *something* that needed a procedure every single time I went to the dentist. They also pointed out my receding gums and suggested it was somewhat urgent for me to get the graft. In my current town I haven't had a cavity for years and they were really unfazed when I told them about my gums. I guess my teeth could have improved (?? my dental hygiene has been basically the same) but I think it's more likely that dentists range in being more wait-and-see versus aggressive on treatments.
posted by kochenta at 2:14 PM on May 15, 2019

My dentist told me recently that the standard has shifted from your own palate tissue to donor grafts. Which I was delighted by, since for my gum graft several years ago, the gum site was no big deal, but the roof of my mouth hurt like a motherfucker.
posted by Stacey at 2:50 PM on May 15, 2019

Just to clarify here, and sorry I'm late to the party -- if you get tissue from a donor, it will be *acellular*--i.e., stripped of cells--which means it's basically just dermal matrix that your cells will grow onto and replace. This also means it's not something where you have to worry about rejection because of an incompatible donor, and recovery will be easier because you only have one surgical site rather than two.
posted by karbonokapi at 4:43 PM on May 17, 2019