Soft – Tissue Grafts

What It Involves
Discomfort Factor
Side Effects of Treatment
Gums can recede for several reasons. They include:
• Periodontal disease
• Physical trauma (brushing too hard, too often or with a hard brush)
• Tooth position
• Gum tissue that is naturally thin
If gums recede severely, some of the tooth’s root will be exposed. This can make the tooth sensitive to hot or cold temperatures and more prone to root decay. Some people also don’t like the way it looks. So that soft-tissue grafts are used to add more gum tissue. This can accomplish several things:
• Prevent further recession
• Cover the exposed root
• Stop the sensitivity
• Improve the look of the tooth
Some people’s gums are naturally very thin. This increases the likelihood they will recede. In these cases, a soft-tissue graft may be done to prevent problems in the future.
What It Involves

There are three different types of soft-tissue grafts:
• Free gingival grafts
• Connective-tissue grafts
• Pedicle grafts
In a free gingival graft, a small strip of flesh is removed from the roof of the mouth (palate). The tissue, called the “graft,” is then stitched to the gum tissue in the area being treated. A free graft is often used for people who naturally have little gum tissue around their teeth and need to have the gums enlarged.
In a connective-tissue graft, a flap is cut in the roof of the mouth. Some tissue from under the flap is removed. The flap is then stitched back down. The tissue that was removed is known as subepithelial connective tissue. This graft tissue is slipped under the gum tissue that surrounds an exposed root. Then it is stitched into place. This is the most commonly used procedure for treating root exposure.
A pedicle graft uses a flap of tissue from the gum of a tooth next to the one with recession. The flap is partially cut away, with one edge still attached. This flap is called a pedicle. It is slid sideways to cover the exposed root and stitched into place. A pedicle graft may be more successful than a free gingival graft. That’s because at least some of the blood vessels that feed the grafted section remain in place. However, a pedicle graft can be done only in certain cases. There must be a tooth next to the one being treated that has enough gum tissue to “share.”
With all of these procedures, many periodontists will use a periodontal dressing. It will be used to cover and protect the grafted tissue for the first week or two of healing.
Discomfort Factor

With free grafts and connective-tissue grafts, you will have two wounds. One will be near the tooth; the other will be on the roof of your mouth. Both can create discomfort. The wound on the roof of the mouth is often described as feeling like a significant pizza burn. Prescription pain medicine can help control discomfort after surgery.

Be sure to keep the mouth clean. This means that unaffected teeth will have to be brushed and flossed as usual. Mouth rinses that contain chlorhexidine usually are prescribed to help control plaque during the healing period. Antibiotics may be prescribed, but usually are not.
Side Effects of Treatment

Typically, there are no long-term side effects after soft-tissue grafting. In some cases, the new gum tissue may need to be reshaped. This procedure is called gingivoplasty. It is used to make the gum look as natural as possible.