Soft tissue grafting is a common dental procedure that involves transplanting gum tissue from one area of the mouth to another, or using donor tissue, to restore the health and appearance of gum tissue. It addresses various oral health concerns and helps protect teeth.
What is Soft Tissue Grafting?
Soft tissue grafting is a dental procedure that rebuilds or augments gum tissue where it has receded or is insufficient. Its main purpose is to cover exposed tooth roots or to thicken existing gum tissue. This process involves surgically placing a piece of gum tissue, known as a graft, onto the treated area. The newly placed tissue integrates with the surrounding gums, restoring a healthier gum line and creating a protective barrier against bacteria and daily stresses like chewing.
Why is it Needed?
Soft tissue grafting is often recommended to address gum recession, a condition where gum tissue pulls away from the teeth, exposing the roots. Exposed tooth roots can lead to increased tooth sensitivity to hot and cold temperatures, as the protective enamel layer is absent. Gum recession can also make teeth appear longer, affecting a smile’s aesthetic appearance.
Beyond aesthetics and sensitivity, grafting helps prevent further gum tissue loss and reduces the risk of tooth decay on exposed root surfaces, which are more vulnerable to cavities. It also improves overall gum health. Common causes of gum recession include periodontal disease, aggressive tooth brushing, trauma, aging, and certain tooth positions.
Types of Soft Tissue Grafts
Several types of soft tissue grafts are commonly used, each tailored to specific needs and tissue availability.
The connective tissue graft is frequently used to cover exposed tooth roots. For this graft, a small piece of connective tissue is typically taken from beneath the surface layer of the roof of the patient’s mouth. This subepithelial tissue is then placed and secured at the site of recession.
A free gingival graft involves taking a small, thin strip of tissue directly from the surface of the roof of the mouth. This type of graft is often used to increase the thickness and quantity of gum tissue, particularly where existing tissue is very thin. While it effectively augments gum tissue, it may not always provide complete root coverage.
The pedicle graft utilizes gum tissue located adjacent to the area of recession. In this technique, a flap of gum tissue is partially cut away but remains attached at one edge, preserving its blood supply. This flap is then moved sideways or coronally to cover the exposed root and stitched into its new position. This method is often favored when sufficient healthy gum tissue is available near the affected tooth, as it can promote faster healing due to its maintained blood supply.
The Grafting Procedure
The soft tissue grafting procedure typically begins with the administration of a local anesthetic to ensure comfort. This numbs the area where the graft will be placed and, if applicable, the area from which tissue will be harvested. Once anesthetized, the dental professional prepares the recipient site by cleaning it and creating a small pocket or incision to receive the graft.
If the patient’s own tissue is used, a small amount of gum tissue is harvested from the designated donor site, often the roof of the mouth or an adjacent gum area, depending on the graft type. The harvested tissue is then positioned and secured with sutures at the recipient site, covering the exposed root or augmenting the gum line. Following placement, the surgical site is sutured to stabilize the graft and encourage healing.
Recovery and Aftercare
Following soft tissue grafting, a period of recovery is necessary for healing and integration of the new tissue. Patients can expect some mild swelling, tenderness, and possibly minor bleeding in the first 24 to 48 hours. Pain medication, often prescribed or recommended by the dentist, helps manage discomfort. Applying a cold compress to the outside of the cheek near the surgical site can help reduce swelling in the initial 36 hours.
A soft food diet is advised for the first week or two to prevent irritation or damage to the healing graft. Foods like soups, yogurt, mashed potatoes, and scrambled eggs are often recommended, while spicy, crunchy, or very hot foods should be avoided.
Oral hygiene around the surgical site requires specific instructions; patients are instructed to avoid brushing or flossing the grafted area directly for a period, instead using a prescribed antibacterial mouthwash or gentle salt water rinses after 24 hours. Initial healing typically occurs within one to two weeks, with full tissue integration and maturation taking several months. Follow-up appointments are scheduled to monitor healing progress.