Wednesday, October 22, 2014

Surviving My Second Gingival Graft

I wasn't pleased when the periodontist confirmed my suspicions that I would need gum graft surgery to maintain a couple of teeth for the long run. From past experience I knew that it would cost the better part of a thousand bucks. But my memories of recovering from this same type of surgery 14 years earlier played a larger role in my psyche.

A dentist friend of mine says that they have a low follow through rate on patients being referred for this type of surgery. People know it's going to cost money. They usually aren't in pain. Often the danger of serious dental issues is not imminent. So they put it off. But I like having my natural teeth. I'd rather get it over with than deal with anxiety niggling in the back of my head for months on end.

So about seven weeks ago I reclined in a chair at the dental office. I knew that the doctor was highly experienced. He approached the procedure with a calm but confident demeanor. I never once saw the muscles in his face reflect anything but serenity during my hour in the chair. He pleasantly hummed 80s pop tunes as he went about his work, occasionally chatting with his assistant or informing me of what he was doing or was about to do next. It was all very disarming.

After the local anesthetic took effect, the doctor hopped right into the part of the procedure that I liked the least: obtaining the graft tissue from the left side of the roof of my mouth. He took the donor tissue from the same spot that another periodontist had taken some 14 years earlier.

The doctor explained that the tissue in that part of the roof of the mouth is particularly dense and is prime for adhering to the graft site. I surmised that they always take it from the left side because they tend to sit on the right side of the patient, making that spot more readily accessible than the other side. I knew that the healing of the donor site would be the most bothersome part of my recovery.

After a few stitches were applied to the donor site, the doctor went to work opening up the graft site. Then he carefully stitched the donor tissue into place. He pressed some substance over the area and cured it with some type of light, creating a type of shield. Then he applied a temporary plastic retainer (built from an impression that had been taken a couple of weeks earlier) that covered the roof of my mouth and my upper teeth.

I was given a sheet of instructions, a prescription for antibiotics, and prescriptions for serious painkillers. I opted not to fill the opiate based pills. I really dislike the way they make me feel and I figured that I would get by without them. But I was grateful for prescription strength ibuprofen when the anesthetic started to wear off.

Over the next three weeks I was very careful to avoid chewing on the side of my mouth where the graft was trying to adhere. I wore the plastic retainer part of the time and I ate only soft foods, avoiding anything that might be caustic (like salsa). As expected, the rawness in the roof of my mouth was more bothersome than the graft area, which was relatively easy to maintain.

Within a week the stitches in the roof of my mouth started to come out on their own, as the doctor said they would. Later, the stitches in the graft area came apart one by one. The shield that had been applied to the graft area washed out, as predicted. I took care to keep my mouth clean, frequently and carefully swishing with salty water. The doctor removed the last of the stitches at a follow up visit.

One of the things that bothered me the most during the second week of recovery was pain emanating from a molar near the donor site. That eventually abated as the site healed.

Today the graft area feels pretty much like part of the original gum tissue. The doctor is very pleased with the results. The donor area in the roof of my mouth is recovering well. The tissue still needs to thicken a bit. It also feels somewhat dead, so it feels a little weird. But I know from past experience that it will enervate over time.

If were able to go back and change a minor thing from my youth I would go back and train my younger self to brush my teeth gently while also brushing thoroughly. In those days I thought that you had to brush hard to do it right. I was wrong and I am now paying the price for such zeal.

If I were advised by a competent professional today that I needed gum graft surgery in another area, I wouldn't be very pleased with the news. But I would move ahead without delay. I can see that the grafts I have received have been effective and are doing a good job of protecting my teeth. At any rate, I'd prefer to endure gum graft surgery than to deal with the consequences of failing to do so.

1 comment:

Derrick Sly said...

My brother is going to have a grafting soon. I think that he'll be fine. He's a little worried though. He's had a skin graft before and it wasn't pleasant for him. It did save his life though.
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