Deanna M. Neff, MPH
Periodontal disease often refers to bacterial plaque and infections around the gum and tooth root. It can happen around one or several teeth. In some cases, the gum tissue is damaged or shrinks. In its more advanced stages, surgery to create new gum tissue (and even bone growth) can be done. There are several techniques used to encourage new gum growth using donor tissue, man-made material, or tissue from the roof of your mouth.
This surgery is needed to:
Not all grafts are successful over time. The level of disease and your personal care routines will affect success.
Problems from the procedure are rare, but all procedures have some risk. Your periodontist will review potential problems, like:
Before your procedure, talk to your periodontist about ways to manage factors that may increase your risk of complications such as:
Sometimes, sedative medications are used to make you more relaxed during surgery. If you are undergoing conscious sedation, you will be asked to not eat for at least 6 hours before surgery. Otherwise, you can follow a normal diet.
A local anesthetic will be used near the affected gum area.
Your periodontist may recommend conscious sedation. You will be awake, but will have no anxiety during the surgery.
This surgery is usually done in an outpatient setting. You do not need to stay overnight. If you are undergoing sedation, the periodontist or nurse will place an IV in your arm to deliver medication. Your heart rate, blood pressure, and breathing will be monitored during and after the surgery.
The periodontist will numb the affected area with a local anesthetic delivered through a needle. The periodontist will make a small cut in the roof of your mouth and remove surface and/or connective (under the surface) tissue. This is the donor tissue that will be used for the graft. This area will then be stitched closed.
The new tissue flap will be repositioned on the damaged gum line and stitched into place. A dressing will be applied. A piece of mesh is sometimes placed between the gum and tooth to encourage growth.
If there is not enough donor tissue available on you, tissue from another person or man-made materials may be used.
The time it takes to complete the surgery depends on the level of damage and how much of the gum areas are affected.
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
During your stay, the staff will take steps to reduce your chance of infection, such as:
There are also steps you can take to reduce your chance of infection, such as:
Healing will take place over the next 4-8 weeks. During this time, pain and swelling can be managed with ice packs, medication, and changes to your diet. Changes may include eating soft or bland foods. You may have to restrict activity for a few days. Be sure to follow your periodontist's instructions.
It is important for you to monitor your recovery. Alert your periodontist to any problems right away. If any of the following occur, call your periodontist:
If you think you have an emergency, call for medical help right away.
Academy of Periodontology
National Institute of Dental and Craniofacial Research
Canadian Dental Association
Dental Hygiene Canada
Gum graft surgery. American Academy of Periodontology website. Available at: http://www.perio.org/consumer/grafts.htm. Accessed August 10, 2015.
Periodontal (gum) disease: Causes, symptoms, and treatments. National Institute of Dental and Craniofacial Research website. Available at:
http://www.nidcr.nih.gov/oralhealth/Topics/GumDiseases/PeriodontalGumDisease.htm#surgery. Updated September 2013. Accessed August August 10, 2015.
pocket reduction procedures. American Academy of Periodontology website. Available at:
http://www.perio.org/consumer/pocket-reduction-procedures.htm. Accessed August 10, 2015.
6/6/2011 DynaMed's Systematic Literature Surveillance
http://www.dynamed.com: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.
Last reviewed September 2016 by Michael Woods, MD
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