Gum grafts - do they work?

September 10, 2020 12:13 PM

My dentist just recommended I should get them. For those who've had them, what's been your experience? Would you say they were effective? How long did the grafts last for? Would you do it again if given the opportunity? Thanks for any information. I've had problems finding random controlled trials on this procedure!
posted by storybored to Health & Fitness (17 answers total)

My experience is probably a bit different, because I was hit by a car and my front teeth were knocked out, and gum grafts were one of the many procedures I had to have done. But mine were definitely effective, they're still going strong ten years later, and I would for sure do it again. Happy to answer more specific questions.
posted by leesh at 12:27 PM on September 10, 2020

I had gum grafts at age 24/25 because I wore braces that year and the stress my braces put on my lower two front teeth caused the gum below them to tear away right down to the root. I am 47 now and the grafts are still intact. I would definitely have the procedure done again -- I am sure I would have lost those teeth by now if I hadn't.

If I were doing it again, I would tell the person doing the procedure to take the cheek sample that was subsequently used for the graft from the left side of my mouth instead of the right, because I chew exclusively on the right side of my mouth and it would have spared me some pain/discomfort.

Also, the plaster they gave me to cover the grafted area until it healed did not stay in place. It didn't last even a day -- not even my first meal. The first time it came off I took the time to make another appointment and make the trek back to the office to have a new one put on. Then, again, it didn't stay put (every meal took it off), so after that whenever it came off I'd just rinse it off, make sure there were no bits of food in the area, and and stick it back in place myself. I healed up fine so I think it didn't do me any harm.
posted by orange swan at 12:30 PM on September 10, 2020

I had this done when I was a teen, recommended by my dentist and orthodontists due to thin gum skin (?). This will all be anecdotal!

I sought out two opinions. First surgeon suggested that I use a "skin matrix" from a donor, which seemed gross to me. The second, who did the surgery, said it was more common to use grafts from the roof of the mouth. That also sounds gross, but the cuts were really minor and I found they hurt less than the grafted region and healed much faster.

I had it done twice - I think once was the front of my mouth (top and bottom) and the second time was the back. Surgery itself was fine, healing sorta sucked though - I found the pain to be on the bad side (comparable to cankers, which I get a lot of), and you're restricted in your diet until the stitches come out (no nuts or seeds, other tough things).

On the plus side, I got that done probably 20 years ago and have literally never thought of it again until today. Dentists have never mentioned an issue. I just looked and the bottom looks a bit thin, but I've never experienced pain or anything.

On preview: I never had a plaster or any covering on the stitches. Eating did suck for a while.
posted by Paper rabies at 12:33 PM on September 10, 2020

Are you actually having problems? I had a dentist recommend gum grafts for me about fifteen years ago and they weren't needed - I didn't have pain or loose teeth and no other dentists have ever suggested that I have gum problems. If you're in a similar situation, consider a second opinion.
posted by momus_window at 12:43 PM on September 10, 2020 [2 favorites]

I had this done on one tooth which had been injured playing sports. Graft from soft palate, and had a retainer like thing to cover the donor area. It hurt after a while but it’s been years and was totally worth it. The spot doesn’t bother me at all and I basically don’t think about it now, whereas before it was a constant irritant.

Tl;dr: good, yes, years, yes.
posted by OneSmartMonkey at 12:46 PM on September 10, 2020

I had gum grafts about 20 years ago to correct gum recession due to overzealous tooth-brushing; it hurt for a few weeks but it was effective, they have lasted OK to this point, I think, and I would definitely do it again in a similar situation.
posted by demonic winged headgear at 1:48 PM on September 10, 2020

The most common type of graft is a Free Gingival Graft (FGG)

Here is a google search for scholarly articles on the efficacy of FGG

Here is a PDF copy of the California Dental Association Journal from october 2018 with the lead article to Graft or Not to Graft
posted by OHenryPacey at 2:04 PM on September 10, 2020 [3 favorites]

I would recommend getting a second opinion. I used to brush too hard and that has affected my gums in a few spots. My previous dentist had recommended I get four spots done in four different areas of my mouth (the actual procedure may have been slightly different than what you are looking at but I’m sure there is some overlap.) I waited since it is so expensive and takes such a long time to heal. I changed dentists when I moved and my new dentist doesn’t feel I need the procedure at all. There’s one spot that may need it one day but I’m so glad I waited when I did. Overall I really trust doctors and I love dentists BUT I know the latter can have huge difference in opinion: some because they want to make more money and others simply because there are different treatment approaches. When it comes to anything major (which I consider this to be too!), I get a second opinion. If the second dentist says yes, then you can proceed with confidence; if not, you can wait and decide.
posted by smorgasbord at 2:28 PM on September 10, 2020 [2 favorites]

Looking at all sides of the issue you may wonder, where does the tissue come from, which is used for these grafts? It's harvested from cadavers. Probably the source for most transplants, I guess -- still, it would bother me.
posted by Rash at 3:47 PM on September 10, 2020

I had a gum graft in maybe...2002? Give or take? At least fifteen years ago, anyway. It's held up just fine and my subsequent dentists have not had any concern about it.

I was discussing it last year with a new dentist when reviewing my history and mentioned that the soft palate graft site had been really painful for me. She said these days it's basically always done with donor tissue, which I think is usually a cadaver graft. I was relieved to hear that; if I had to have another graft that's the part I'd really dread doing again. The actual taking of the graft was painful, and the plaster over the donor site wouldn't stay put for me either so the healing process was uncomfortable too.

All of that said, the particular periodontist I worked with at that time had an absolutely terrible bedside manner - making fun of me for being nervous - and I remember feeling like I wasn't numb enough, but at the time I was not very good at self-advocacy and didn't complain about it given that he was already being rude and dismissive of me. These days I would have walked out after the consult and found someone else. Probably with a good trusted doctor who goes heavy on the numbing, it would be a better experience even with a self-graft!

The actual gum site was fine; barely hurt going on, healed up nicely, no big deal. It was just the soft palate that sucked.
posted by Stacey at 4:05 PM on September 10, 2020

Looking at all sides of the issue you may wonder, where does the tissue come from, which is used for these grafts? It's harvested from cadavers.

Very likely the palate is the donor site. Cadaver bone is sometimes used, but gum tissue is abundant in the mouth and easy to harvest.
posted by OHenryPacey at 4:28 PM on September 10, 2020 [2 favorites]

Nthing a second opinion if you are not having acute issues. I had a dentist recommend me for gum surgery that I didn’t need. (I didn’t get it, my gums are in decent shape 10 years later.)
posted by gnutron at 4:49 PM on September 10, 2020

+1 second opinion! I know someone who regrets hers.
posted by potrzebie at 5:32 PM on September 10, 2020

I got one two years ago because of a seriously receding lower gumline (apparently my teenage braces were a known contributing factor, even thirty years later). I saw two dentists, who both recommended it, and then had a consult with a periodontist.

The surgery itself was fine, the recovery sucked. "It will probably be like a bad pizza burn on the roof of your mouth" was TOTALLY not the case--it was so much worse. I couldn't talk for a week because it hurt too much pulling the stitches (graft skin taken from the roof of my mouth, and I have 'very thin skin' according to every dentist I've ever seen). I think I spent three weeks on a liquid diet (lots of fruit smoothies). I lost some weight, so that was a nice side benefit.

So far I haven't had any issues, and it's nice to not constantly worry about the gumline receding to the point of teeth falling out/roots showing, and not having to be very careful brushing around the gumline.

I don't regret it, but if I had it to do over, I would look into the 'pinhole surgical technique'.
posted by sazanka at 1:34 PM on September 11, 2020

I had two gum grafts in the last year; one in October 2019, and one in February 2020. The first one wasn't quite as successful as my periodontist would have preferred, so she tried again using a different technique. I just saw my regular dentist last week, and he thought it looked a *little* better, but not great. As per both my periodontist and my dentist, some mouths/recessions take better to grafts than others, and mine just didn't turn out to be a great candidate.

For the first graft, my periodontist took tissue from the roof of my mouth, back near where my wisdom teeth were removed. For the second, I think she used a pinhole technique using some kind of ... porcine material? The concept kind of grossed me out so I didn't ask a lot of questions, haha.

I'm an anxious patient, so I had IV sedation for both surgeries. I highly recommend it, as long as you have someone who can drive you home and look after you for a day or so! I don't remember much from either surgery day. After my first surgery, my periodontist prescribed me some steroids to control the swelling. One of the side effects was insomnia; I either couldn't sleep or got extremely light sleep for about 10 days. I had to take a bunch of time off of work because I was so out of it. So if you know you're sensitive to prednisone, you may want to talk about different ways to controlling inflammation. The second surgery, I just relied on Naproxen Sodium, and my mouth hurt a LOT more and my chin area was swollen, but at least I could sleep.

For me, the most annoying thing about the graft is that you can't chew with those teeth OR brush them for 8 weeks. My graft was on a bottom front tooth, so I could only eat bite-sized food for two months, and I had to go through that twice. Lord, how I missed sandwiches and whole pieces of fruit! That said, after a week or two of soft food right after surgery, I could eat pretty much anything I wanted as long as I chewed it entirely in the back of my mouth.
posted by leftover_scrabble_rack at 11:01 AM on September 12, 2020

I had gum grafts twice in the early 2000's, the first time on the bottom front row of teeth and the second on the bottom right side back teeth, to deal with very bad recession from periodontal disease. Both times, tissue was harvested from the roof of my mouth. I was well-numbed and didn't feel any pain during the procedure, but the part where they harvest tissue from the roof of the mouth? I found all the digging and picking and pulling quite horrifying. I had to make a concerted effort to distract myself with calming thoughts, and it didn't always work.

The first time, the periodontist put some sort of dam or plaster over the gaping hole in the roof of my mouth. My experience was not as bad as orange swan's, but I found that the covering didn't always stay put. The second time, the (different) periodontist was able to use a newer technique of sewing over the hole after harvesting tissue from the roof of my mouth.

Afterward, both times, I was in a lot of pain. I had to go to the pharmacy by myself after the second procedure to collect my prescriptions, when it was the last place in the world I wanted to be. I recommend you have someone take you home who can stop at the drugstore and do that for you. The pain and discomfort, combined with low energy from inability to eat, made it difficult to do anything for a couple of weeks.

I've had some bone loss in my jaw. My dentists told me that gums will always recede to where the bone is. That means that after a few years, my gums looked as though I'd never had grafts done at all. I'm not sorry I had the grafts done, however, because they helped slow the recessions. In the meantime, I developed better habits and have been able to arrest the progression.

I was never given the option of donor tissue, but if I had been, I would have taken it. If you are able to have donor tissue, please consider it. This is a great gift from someone who went to the trouble of thinking of others and it's no different than getting donor tissue for your ACL or some other body part. Once it's grafted onto you, it's no longer the donor's, it's all yours and you'll feel the same about it as you do about any other part of you.
posted by Avalow at 10:42 PM on September 12, 2020

the cheek sample that was subsequently used for the graft

Just correcting myself -- I misremembered where they took the sample for the graft. They did take it from the roof of my mouth, not my cheek. The rest of my comment, including me wishing I'd told them to take the sample from the left side of my mouth because I don't chew on that side, still stands.
posted by orange swan at 8:19 PM on September 13, 2020