<p>My 19-year-old daughter went in for her 6-month dental checkup. I was finally able to exhale thinking that, after three years and two “phases” of orthodontics which included a painful Herbst appliance followed up by her wisdom teeth extraction last August, we are DONE.</p>
<p>Not so! says our dentist. Dentist points to the gum tissue around her bottom teeth. I peer into her mouth. Everything looks fine to me. But dentist says: This gum is so thin and fragile! She will need to see a periodontist, I’m told, for evaluation of gingival recession. They will probably need to graft some gum tissue from the roof of her mouth. And what if she doesn’t, I ask. “Then her teeth will fall out.” </p>
<p>I am told that it has nothing to do with her hygiene or brushing methods. She simply has thin, fragile gum tissue which, by the way, is fairly common with the type of orthodontic work she has. </p>
<p>I am given a card for a local periodontist and cautioned to “not wait” to make my appointment since Spring Break is coming up and he books up quickly for the summer. </p>
<p>Of course, if I visit the periodontist I’m fairly certain he will say she needs gum surgery, since that’s how he makes a living. Does ANYONE have experience with teenagers and gum surgery? Or waiting for a few years before having the gum surgery? I don’t want to put her through this if I really don’t have to.</p>
<p>My best friend had extensive gum surgery (sounds similar to what he’s describing) in junior high. It had nothing to do with hygiene, either. Also, she had just finished an extensive course of orthodontics.</p>
<p>You could always get a second opinion after you see the oral surgeon. But it’s not a given that he will advocate surgery regardless of whether or not it is medically indicated simply because that’s how he makes his living. That would be unethical. In fact, I recently took my daughter in for an oral surgery consult and the surgeon sent us on our way, saying it wasn’t necessary. Ask around and get the name of an oral surgeon who is respected in your area and if you get the same response from both doctors, then you have some good information to consider.</p>
<p>I had gum surgery because the gumline next to the missing tooth was sagging badly. No big problems. The dentist used some tissue from the roof of my mouth, and everything healed quickly (it did feel like I had a pizza burn for a couple of days).</p>
<p>Get a second opinion. I was told I needed gum surgery 20 years ago. Doing just fine without it. Don’t go to a perio for the second opinion…they make their money by doing gum surgery. Ask your friends for a general dentist referral. Good luck!</p>
<p>The periodontist charges up to $220 for an evaluation/consult (receptionist said more likely in the $150-$175 range) so I’m not inclined to get second/third opinions.</p>
<p>Plus, I called our insurance company and was told this might fall under the category of “cosmetic” (???) which means no coverage.</p>
<p>Don’t go to a perio for the second opinion. Perio dentists do surgery…you won’t get a unbiased opinion. Go to a general dentist. Sounds expensive. Potentially painful. IMO…it’s worth the money to see if it’s really necessary.</p>
<p>I’m surprised the consult is $220; that seems high based on my experience. Also, I’m surprised that this would be considered cosmetic surgery. Here is my very recent experience.</p>
<p>My young teen daughter just got through having her excess gum tissue trimmed (it’s called a gingivectomy). The consult was $64, and was not covered by dental insurance, as we only get 2 covered visits for dental per year. However, the gum surgery was covered by our health insurance. Apparently, excess gum tissue makes it harder to keep the teeth clean, which can lead to plaque buildup, gingivitis and eventually surgery on the gums. The surgery was about $700 and we had to pay half of that. The surgeon expected a lot of pain for a couple of days, due to how extensive the surgery was, but with Advil she never had very bad pain at all. The mouth heals quickly.</p>
<p>I would not assume that the periodontist would do unnecessary surgery. As someone else on this thread said, that would be unethical. However, I did put my daughter’s periodontists’ feet to the fire to be sure I was comfortable that she needed the surgery. Also, if I wouldn’t have trusted him I would have gotten someone else.</p>
<p>BCEagle91, you might not want to read this: The periodontist has indicated that she has excess bone growth under both her top and bottom gum tissues. After she’s done growing he wants to peel back her gums, ‘scrape down’ the excess bone growth, and put her gums back. This would be purely cosmetic. Even though she obviously has some extra gum tissue on the top and bottom above and below her teeth, I’m not jumping into that surgery before we do a lot of research, etc.</p>
<p>I would be thrilled with a $64 consult. I wonder why it’s more in our area. Every dental-type consult we’ve done (orthodontist, oral surgeon, etc.) for both kids ranged $199 - $250. </p>
<p>momlove, that really does sound painful for your D…sorry to hear she’s not done. But I will look into the health insurance coverage angle for our’s, although I’m not optimistic.</p>
<p>My dental insurance did not cover my gum surgery (it was considered a “non-dental” procedure), however, my medical insurance covered it in full. So check with your medical insurance if they cover it.</p>
<p>My son needs a round of orthodontics. He didn’t have them when he was younger due to other health problems. He’ll probably need four teeth removed as he has a massive crowding problem. I think that this stuff is easier (though longer) than the gum surgery stuff. I’m just wondering if orthodontics contributes to the gum problems in the short run.</p>
<p>My D had to have a gum transplant before she started ortho, and even for an 8-year-old, it wasn’t all that bad in terms of recovery and pain. Seemed pretty routine, and was covered by our dental insurance.</p>
<p>Honestly, me too. When I’m at the dentist and I hear the drill going in the other room, I almost have a heart attack. Even a cleaning is torture for me as I have really sensitive teeth. My husband loves getting his teeth cleaned. I just cannot fathom that…</p>
<p>There are ethical and honest people in all business and there are less than ideal people in all businesses. 20+ years ago we moved 500 miles. I asked my lifelong dentist to tell me exactly what I needed done- 3 things. I went to 3 dentists in the new town, 2 said more than 10 things needed to be done. I saw these as fund raisers or at the very least overly aggressive treatment recommendations!</p>
<p>Within a couple of years neither of those guys were in business in that town any longer, so people seemed to learn their style and not care for it. Even if it is not actually unethical, there are different levels of assertive/aggressive treatment.</p>
<p>Also, it seems like gum surgery is quite the new fad thing over the past 20 years; never heard about it when I was a kid, but when my kids were doing phase I ortho, so many other kids were having gum grafts etc.</p>
<p>Nrd- I am with you there; I used to love having my teeth cleaned and polished as a young person, then I got migraines for a few years and now I despise it!</p>
<p>Do try to get a second opinion, I think that’s the best route with these things. And look into insurance options-I just had what sounds like the exact same thing done to my teeth in September and I’m 99% sure it was covered by medical, not dental, insurance. </p>
<p>(I’m also a 19 year old girl! and mine was very obvious I needed it-so little gum you could see one of my teeth right down to the bottom of the root-always had been that way too, not a hygiene issue). Good luck to your daughter if she ends up actually needing it!</p>
<p>I had it done - again not for dental inflamation, but for loss of gum tissue/thin gum tissue. Covered in part by dental insurance. Pain wasn’t too bad, but I had a major bleed from the donor graft site a week later and had to have area restitched… I had two separate surgeries (called “free tissue graft” - a misnomer if there ever was one! Definitely NOT free! ;)), since they had to do both the tops and bottoms…</p>
<p>For those who have had this procedure, about how long is the recovery? I’m thinking D will have a couple of weeks before Spring finals and summer job, sometime around the end of May. Would she be 100% after two weeks?</p>
<p>As a dentist, dad and former active member of this community, let me weigh in.</p>
<p>The problem that the OP’s daughter has is called “lack of attached gingiva”. It may have been caused by her thin tissue type and exacerbated by the orthodontics. I congratulate the general dentist for picking it up, because too frequently this problem is ignored until it becomes more major. The dentist receives no financial remuneration from the referral (illegal), so his only motive is for the health of your daughter. We can also assume that he referred her to the periodontist that he believes will give her the best care (though I’ll admit sometimes personal relationships like “golfing buddies” may enter into it…hopefully not). Go to the periodontist recommended and see if you’re comfortable with him/her, if not, ask the GP if there’s anyone else he recommends. I disagree with the “continue to get 2nd opinions until someone tells you what you want to hear” approach. As far as the surgery itself, as other posters pointed out, it is typically the donor site that is most painful afterwards. It’s been described as a “pizza burn”, but that may be understating it a bit. She could probably resume her normal activities with diet modification a couple of days after the procedure. Ask the periodontist if it’s possible to use “Alloderm and PRP” instead of donor site tissue, it will be more expensive, but so much more comfortable. With that approach, there’s virtually no downtime. She will probably need to return 7-10 days after the surgery for suture removal, so take that into account.</p>
<p>Oh, by the way, I referred my daughter for the surgery described in the last paragraph of momlove’s post #9. It was done by arguably the best periodontist in the country for this procedure. She had very little post op pain and this is a kid who complains for a week about a mosquito bite.</p>