Soft tissue grafting – Versatile, predictable and minimally invasive.
Redressing the balance of gum quality.
As an implant dentist and surgeon, one of the procedures I’m often asked to perform is gum grafting. Sometimes referred to as ‘soft tissue grafting’, it plays an important role in the success of dental implants.
One of the main issues that I see in patients seeking dental implant rehabilitation is gum recession. This is a major cause for concern and can be triggered by several factors, including poor oral health, aggressive tooth brushing, smoking, teeth grinding (bruxism) and even genetics.
The problem, as far as tooth implants are concerned, is that receding gum is unable to form a seal around the implant and the abutment. This is important because it creates a protective barrier against infection. Naturally, this doesn’t happen when gums recede, leaving the implant and crown exposed to risk.
Gum grafting is carried out to increase the width of keratinised gingiva (gum), thus helping to prevent problems like peri-implantitis (infection around a dental implant) that can otherwise result in implant failure.
Once patients undergo this ground-breaking treatment, they should be eligible for dental implants and everything that goes with that.
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The importance of gum thickness
Many clinicians now understand that the gums play a key part in implant health. Undergoing an implant restoration without addressing gum health will typically result in implant failure. Therefore, both gum quality and depth are key. The thicker the gum, the better.
The good news is that gum grafting can be performed before or at the same time as implant placement to enhance the success of this missing tooth rehabilitation.
Additionally, from an aesthetic point of view, when gums are thin, they become more transparent, meaning the implant can appear through the gum, giving the smile a greyish tinge. So, a higher-density gum is better for implant functionality and aesthetics.
Gum grafting surgery – What it entails
I typically perform several different types of soft tissue (gum graft) that include:
Connective tissue grafts
Commonly used to treat tooth root exposure, a skin flap from the roof of the mouth is gently created, and soft tissue from under that flap, known as subepithelial tissue, is removed. The soft tissue is then attached (sutured) to the thinning gum at the tooth root.
Gingival graft
Like connective tissue grafting, tissue is taken from the roof of the mouth, but rather than harnessing the under (subepithelial) tissue, gingival grafting utilises the initial tissue and is used to enhance gum width in patients with thinning gums, rather than in patients with gum recession.
Pedicle grafting
Instead of removing tissue from the palate, tissue is taken from a separate gum area adjoining the repair site. During this process, a tiny flap is partially cut in the healthy gum so that one area remains attached. The remaining tissue is then pulled down over the repair site and sutured in place.
Each procedure is a proven method that allows for optimal gum density and health. So, if you require gum restoration before implant therapy, I’ll discuss these processes in greater detail during your implant consultation and recommend the best type for you.
Soft tissue surgery – What to expect
The procedure is relatively quick and is carried out under a local anaesthetic or, if you’re a nervous patient, deeper sedation to help you feel relaxed. Either way, I won’t start the process until you feel ready.
- Typically, the harvesting and grafting areas will already be mapped out, so you’ll be asked to rinse your mouth with an antibacterial wash, and I’ll proceed.
- Once the process is done, you may be asked to remain for an hour or two to ensure there are no risks and the graft is successful.
- Finally, I’ll provide full instructions for the best recovery, including oral care and dietary requirements.
Need a gum graft?
Just because you have thinning or receding gums doesn’t mean that you’re ineligible for dental implant therapy. Book a consultation with me and find out once and for all. You could be only a few steps away from a fully restored smile and a much-improved quality of life.
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FAQs
Is gum grafting painful?
During surgery, patients should expect little or no discomfort. Typically, patients remain relaxed, and most people tell me that the process is surprisingly quick and comfortable. In the immediate days after treatment, patients can expect slight discomfort. However, this should easily be brought under control using over-the-counter pain relief and disappear after a few days as the site heals.
How do I know which type of graft to have?
If I feel that gum grafting is needed, I’ll talk through your options during our consultation. Then, after a scan, I’ll be able to tell you the preferred option for your needs.
Does a gum graft have to be done before any dental implants are placed?
In most cases, yes. It’s carried out before implantation and, just like bone grafting, will require a short healing time before implant placement can take place. However, in some circumstances, such as tooth extraction, it’s possible to perform the gum graft on the same day as implant surgery. Either way, I’ll let you know.
How long does a gum graft take to fully attach?
While complete healing takes several weeks, gum-to-gum bonding is pretty quick, often taking just a few days. Some people may find speaking and enunciation a little awkward for several days, but most people get back into normal living within 2-3 days.
