One of the most common results of gum disease, infection, or trauma is gum recession, where the gum tissues supporting the teeth pull away and recede from the teeth. This can be the result of brushing too hard, oral trauma, or just genetics where a patient is born with thin gums and underlying bone. The end result, however, is teeth that appear too long and are much more susceptible to developing cavities and sensitivity. To help with these problems, Dr. Lorenzana can skilfully perform gum grafting in San Antonio, TX, bringing the gum line back to where it should be while also restoring a patient's appearance, so they can once again smile with health and confidence.
Why Choose Lorenzana Periodontics
for Gum Grafting?
Periodontist with 20+ Years of Experience
State-of-the-Art Facility
100% Personalized Approach for Each Patient
The Basics of Gum Grafting
The concept of a tissue graft is to take a small portion of either the patient’s own oral tissue (usually harvested from the roof of the mouth using Dr. Lorenzana's published minimally invasive procedure), or other tissue substitutes, and use them to replace the gum tissue where it has receded. This is usually a minor surgical procedure, performed using local anesthetic with or without in-office conscious sedation. Once the donated tissue has been sutured into place, the patient will experience a short recovery time. While the treatment itself is virtually painless, some swelling and tenderness are common afterward, but this can usually be easily managed with OTC pain-relievers.
Gum Grafting FAQs
We completely understand that you might have questions before committing to a gum graft, which is why Dr. Lorenzana and our team are always happy to share any information you might need. If you want to know more about gum grafting, you can always give us a call. Before that, be sure to read over our responses to some of the most common questions we receive below.
Does a gum graft hurt?
Dr. Lorenzana uses his own minimally invasive technique in order to make the procedure as comfortable as possible (which also helps shorten the recovery time). Local anesthetic is usually enough to help someone not feel anything while in the chair, but for patients who are still nervous about the procedure, our practice can also offer sedation to get rid of any lingering anxiety.
How long does recovery take?
The complete recovery time is about a week on average, but you should be able to resume your normal routine the day after surgery. We recommend taking the day of the procedure off so you can relax, and after that, the initial swelling or tenderness can be easily managed with medication like Tylenol or Ibuprofen. Any discomfort tends to go away after about 4 days. To speed up this process, we recommend avoiding any particularly hot or cold beverages.
What will happen if I don’t get a gum graft?
If your dentist has recommended that you get a gum graft, and you delay treatment, then your gums will continue to recede. Not only will this cause your teeth to look unnaturally long, but it will also expose the thinner enamel around the roots of your teeth, raising your risk for sensitivity, cavities, and even tooth loss. The space created in the mouth by gum recession makes it much easier for plaque, food, and bacteria to become trapped between the teeth as well, increasing the likelihood of infections. For your health and appearance, it’s always wise to get a gum graft sooner rather than later.
Will my gum graft be covered by my dental insurance?
Most dental insurance plans provide at least partial coverage for gum grafts, and our practice will accept your plan and file your claim so you’re able to maximize your benefits. If your insurance doesn’t adequately cover your procedure, we also offer low-to-no interest financing that can break up the cost into much smaller installments.
Sometimes patients think that gum recession is a “natural” thing; that it is “normal.” It is
certainly common, but it should not be considered “normal.” As the gums recede, so does the bone
that holds the teeth in place so that eventual tooth loss is a distinct possibility. Also, the
root surface (dentin) is much softer than the tooth enamel, resulting in a higher incidence of
root caries and root sensitivity. We have many different alternatives available to help you,
from transplanting your own tissue, to utilizing less invasive tissue replacement alternatives.
If you notice that the gums are receding around your teeth, ask your dentist about it at your
next check-up or call our office for a consultation appointment.
Below you will see several different exposed root situations where the patient’s own tissue was
successfully transplanted with predictable esthetic results using a minimally invasive,
patient-friendly procedure published by Dr. Lorenzana in 2000. This procedure has been utilized
on millions of patients over the years and Dr. Lorenzana’s technique is taught in residency
programs around the world to this day.
Patient #1: Before
Patient #1: After (6 mo’s)
Patient #2: Before
Patient #2: After (20 yrs)
Patient #3: Before
Patient #3: After
Patient #3: Before and after treatment of anterior sextant
Over the years we have met patients concerned about the removal of tissue from the roof of the
mouth. While using a patient’s own tissue is still the gold standard for root coverage
procedures, years of research have yielded several good techniques and alternatives to palatal
donor tissue.
Mucograft®, FibroGide®, and BioGide® are palatal tissue alternatives made of resorbable non
cross-linked porcine derived collagen that can be used to cover roots, add tissue volume, and/or
improve tissue quality (i.e. keratinized gingiva). It is applied using different surgical
techniques such as suturing it under the tissue flap, or through a small opening above the
recession, oftentimes referred to as a “pinhole” or “apical tunnel” technique.
Emdogain® is an enamel matrix derivative gel that, when applied to a tooth root and covered with
the tissue flap, can stimulate the regeneration of connective tissue attachment and bone. It can
do this by mimicking the processes by which a tooth is formed.
Alloderm® is an acellular dermal matrix derived from donated human skin tissue supplied by US
AATB-compliant tissue banks utilizing the standards of the American Association of Tissue Banks
(AATB) and Food and Drug Administration's (FDA) requirements. It is commonly used as a soft
tissue filler as in lip enhancements, or as skin replacement in the management of severe burns.
In oral plastic surgery, it is used for root coverage as well as augmentation of deficient
ridges, extension of the vestibule (for denture wearers), and tissue extension for bone grafting
procedures.
The examples below show successful treatments performed by Dr. Lorenzana utilizing these
products. Contact us for a consultation to see if these are right for you.
When teeth are lost or, as in the patient below, they never formed, there are deficiencies in the
hard and soft tissues that can cause restorations (bridges, for example) made to replace missing
teeth look artificial and less than aesthetic. By carefully augmenting the deficient areas and
working closely with your restorative dentist, we can “fool the eye” so that people will not
know that you have dental work. All they will see is your great smile.
Restorative work by: Dr. Jason Gillespie (San Antonio, TX)
The closing of interdental spaces created either by tissue recession, infection, trauma, or prior
surgical treatments is easily the most difficult situation we encounter in oral plastic surgery.
Treatment can involve tissue augmentation, orthodontics, crown and bridgework, dental implants
either alone or in combination. Coordination and cooperation with multiple dental specialists is
often necessary and every situation requires individualized treatment.
Dr. Lorenzana works closely with your referring dentist or orthodontist to gather all the
necessary data which is then used to formulate your customized treatment plan. Below is a
successful example of coordination between our office and our restorative colleague, Dr. Kurt
Riewe.
Following aesthetic recontouring of the gum (esthetic crown lengthening), Dr. Riewe created new
crowns that subtly changed the contours of the teeth, thereby closing the unsightly gap between
the two front teeth.
Restorative work by: Dr. Kurt Riewe (San Antonio, TX)
Closure of “black triangles” or “black holes” between teeth can rarely be accomplished with only
tissue augmentation. Adjustment of tooth contours, tooth position and/or bone position using
crowns or orthodontics (braces) is usually an additional requirement.
In the case below, the patient presented with loss of tissue between her front teeth following
resolution of a periodontal abscess. The abscess resulted in loss of bone and tissue which
showed clinically as a “black hole” between her front teeth. In her case, tissue augmentation
was performed by Dr. Lorenzana using a connective tissue graft, followed a few weeks later by
orthodontic repositioning of the teeth. The final result was closure of the “black hole” and a
smile the patient thought she may never see again.
Orthodontic work by: Dr. John Gerling (McAllen, TX)
