<p>^^^^I love it when someone who actually knows what he is talking about weighs in. That’s the great thing about CC. You’ve got almost every professional represented here, so it’s usually not too long before you can get the real skinny, or at least some pretty good food for thought.</p>
<p>ditto audiophile…unless you have some reason to believe that the periodontist you were referred to is somehow unscrupulous, this is a very common procedure although $220 for a consult is way more than usual…I’m sending you a PM</p>
<p>Is this procedure common or unusual?</p>
<p>This is all quite helpful. Thanks audiophile. I think I’ll keep my appointment with the periodontist. The $220 quoted would be on the high end, I’m told by the receptionist because of the need for possible x-rays. That said, I do find consult fees higher in our area than other parts of the country we’ve lived in.</p>
<p>And after discussing with my D on the phone last night, she actually wants to have it done. Took to heart the comment about her teeth falling out. I promised we will take care of her teeth.</p>
<p>But I do think that they (dentists and other medical professionals) refer business to each other (as friends, golfing buddies or whatever), and THAT is their financial renumeration.</p>
<p>givings and others: just so you know how it works, periodontists (and endodontists, oral surgeons, and all specialists) receive up to 100% of their patients as referrals…</p>
<p>nobody just walks into a perio office stating, “I want periodontal surgery and I saw your sign”…it’s like a neurosurgeon; you don’t go for an “annual check up”</p>
<p>that doesn’t mean that a consumer cannot explore their options when referred to see “a periodontist”…(just like any other medical specialist)</p>
<p>You’re right, Rodney. I’m just unhappy because I really don’t have a way of cost-comparing without spending more $$ on other consultations.</p>
<p>Ha. I just came back from the dentist from a cleaning and always get my gums checked by him first because I HAVE had grafts done in the past due to gum recession.</p>
<p>Procedure is not difficult - the last one I had a few years ago. Most annoying is the area where they take the graft from - mine, from the roof of the mouth - which leaves you with a feeling of “pizza burn” for a few days. I will say that the grafts I had probably 6-7 years ago are still in great shape and doing well.</p>
<p>Thanks, audiophile, for giving us the inside scoop!</p>
<p>I had gum surgery twice in the past 5 years. They did one side at a time. I opted for the Alloderm because of the thought of having skin removed from the roof of my mouth bothered me more than the thought of having cadaver skin grafted to my gum. Recovery was a snap and I have had good results. My medical insurance covered nearly all of the procedure.</p>
<p>Thanks Audophile for such a sane and knowledgeable answer. Long time dental hygienist here. I have had hundreds of patients through the years that have had gingival grafts (gum grafts). Sometimes the tissue is thin and recessed from orthodontia, heredity, improper brushing, clenching, or very bad occlusion (poorly aligned teeth). </p>
<p>What you really have to know is that where you can see GUM recession it means the underlying BONE has receded also. This means the tooth is not held in place securely by bone. A periodontist will either take a strip of gum from the roof of the patient’s mouth and suture in onto the recessed spot or a newer procedure of using an “allograft”, donor tissue can be done. If you use donor tissue the healing is much quicker because you don’t have a raw spot on the roof of your mouth. But personally, I would rather use my own tissue!</p>
<p>I have observed patients that had this procedure done 20-30 years ago and in all cases the gum recession stopped due to the graft placement. I have also seen patients that chose not to have a graft and the if the tissue continued to recede the tooth was lost. </p>
<p>Now, on the other hand I have a few patients that have had the same amount of recession for years and we are just monitoring it. If it remains stable they may not need grafting. We measure the tissue at each 6 month cleaning appt and let the patient know if any changes are present.</p>
<p>In the OP’s case it sounds like the thin fragile tissue may be a result of ortho. This tissue will never improve and would benefit from the graft to reinforce it. In most cases this is covered by dental insurance.</p>
<p>OP-I have had this surgery done 3 times–approx. 12, 11, and 8 years ago. All were to replace different areas of bottom receeding gum. Periodontist feels my recession was due to ortho issues and brushing too hard. Yes, I have spent the last 25 years getting yelled at, by various dentists, for brushing too hard and often. Who knew this could happen?</p>
<p>The surgery sounds, and feels, in the roof of the mouth, very much like cutting through some very thick, fibrous tissue–like a tough grapefruit. It <em>is</em> painful and something I hope never to go through again, but I will if it’s necessary. Keeping my teeth is very important to me. All of the gum grafts have held up very well.</p>
<p>Two things of which to be aware: the gum graft will not “look” like a person with the normal amount of gum. The gum line will still be much lower than a normal person’s. It looks more like a narrow band-aid of tissue, sewn low on the gum</p>
<p>My most important advice–this was a miracle on helping healing and reducing the pain of food hitting the roof of the mouth in the early days of recovery–have your dentist make a mold and retainer-like plastic appliance which covers the roof of the mouth (and form fits to the upper teeth to hold it into place).</p>
<p>I second that an ethical perio won’t immediately suggest surgery. I see this dr. once per year. He keeps good check on all the measurements, but he certainly doesn’t seem prone to rush into surgery.</p>
<p>I didn’t hear or feel my surgery
OUCH! I had the amnesiac, pain killers - the twilight sleep. I don’t remember a thing and it was all very relaxed - I can’t imagine NOT doing it that way. My gum grafts (all the bottom front teeth, and most of the top) look almost exactly like regular gums, though one little bit bulges a bit more. It’s not really noticable. I also had a plastic retainer, which helped a lot in protecting the roof of my mouth. It still took several weeks to feel normal, but I was back to work after 5 days. Definitely do not have this surgery in an “awake” state! Splurge and get knocked out!</p>
<p>I want to thank everyone who took the time and was willing to post information here. It is all very helpful! I have taken notes from this and will certainly use it when we have our consultation in a couple of weeks.</p>
<p>When I had mine I had local anesthetic and was totally fine, couldn’t feel a thing until hours later, which was then just expected soreness. Definitely make sure he gives your D the roof of mouth retainer thing-I got that, but a friend who had the same thing done at the same time didn’t, and he was much more uncomfortable for the next few days than I was. </p>
<p>Other than some soreness at the top of the mouth for a few days (and a little bit where the graft was actually placed) she should be totally fine. I had mine done two days before starting college, and completely forgot about it immediately in all that excitement, that’s how slight the pain was.</p>
<p>I had gum surgery last spring. I was given the option of using tissue from the roof of my mouth or using some kind of “artificial tissue” (probably the wrong term), I opted for the artificial as it seemed like less stress on my mouth. Surgery was done on Friday and I was back to work on Monday with no problems. I barely needed Motrin (can’t take prescription pain meds). The worst part was not being allowed to eat popcorn for a month.</p>
<p>My parents were “depression babies” and like many in their generation did not have the advantage of dental care growing up and have had a lot of dental issues as adults. I still remember a relative (same generation) recalling how she had all of her teeth pulled for dentures. That was a story that really convinced me to take take care of my teeth!</p>
<p>I had this procedure just last fall. My perio called it a “connective tissue graft.” She took the graft in a front-to-back location, which avoided the “pizza burn” pain effect of a lateral graft. Then, she pulled the existing gum away from the tooth, placed the graft underneath and then stretched the existing gum down over the graft. Apparently, this method makes for a more natural looking gum line. </p>
<p>I had a local anesthetic and she never offered a twilight. I would imagine that it would only be necessary for someone with anxiety.</p>
<p>The hard plastic covering the graft location bothered me more than the pain at the site, and I removed it after a few days. I took Advil on the day of the procedure, and then nothing afterward - it was just uncomfortable, but not really painful. I’m very happy that I had it done. I’ve protected my teeth in that area and the esthetics are much improved.</p>
<p>Thanks everyone, especially audiophile and Sammy the dog. I’m joining the conversation late but just met with a periodontist last week to discuss the gingival graft surgery. This was a 2nd opinion (periodontist recommended by dental hygienist friend; $215 consult) because I didn’t feel comfortable with the first perio recommended by my dentist, who seemed to be rushing me into surgery and didn’t listen to my fears/concerns or explain the expenses/financing. I realize that paying for a 2nd consult was expensive, but if you’re looking at thousands of dollars in future surgery, I think paying for a 2nd opinion is a wise investment. I have always taken good care of my teeth, so my problems are an unfortunate combination of bad genetics and bad luck.</p>
<p>The 2nd periodontist was very thorough, taking time to explain the procedure and why it is necessary. He also explained the evaluation process in “rating” the gum pockets around the teeth. If a pocket is rated “3” or more (“4-5”) in terms of recession, then it usually qualifies for dental coverage (not cosmetic). If the pocket recession is “1” or “2,” then insurance will look at it more as cosmetic surgery. His office was also very good about explaining upfront costs. I will use the second periodontist, even though he is more expensive, because he was much more informative and I would have a better working relationship. Like BCEagle, I cringe when dental topics come up - I guess that makes me more of a chicken than an eagle :). I’m kinda hoping for the twilight anesthetic.</p>
<p>The 2nd perio also discussed a “laparoscopic” type of tissue removal, where 2 small incisions are made but only the second layer of skin is used for the donor tissue, leaving the outer tissue layer intact. Is anyone familiar with this procedure?</p>
<p>The surgery will not be fully covered under our dental insurance, but given the potential loss of a front tooth, I would like to be proactive and reinforce the supporting gum structure. I appreciate all the comments about surgery and recovery. I do NOT want to be out of commission this spring with 2 upcoming graduations (college & high school) in May/June!</p>
<p>Last summer my then 18 year old son was sent to a periodontist to have 3 spots on his gums evaluated for grafts. After initial exam it was determined that he needed one graft immediately and the other 2 will be watched. Had the procedure with virtually no complaint (other than he couldn’t play baseball the day it was done). He was given a big bottle of some type of oral rinse that he had to use twice a day for about 6 weeks. Told to brush with an extra soft brush and FLOSS (once healed). His was from rigorous brushing so he has had to stop that. Other than the cost of the procedure (around $1600) it really wasn’t a problem for him at all.</p>
<p>Hey, I remember another thread on this topic. The responses were very helpful. S had a gum graft nearly 3 years ago. Still looks good…</p>
<p><a href=“http://talk.collegeconfidential.com/parent-cafe/378715-18-year-old-receding-gums-any-alternatives-tissue-graft.html?highlight=gum+graft[/url]”>http://talk.collegeconfidential.com/parent-cafe/378715-18-year-old-receding-gums-any-alternatives-tissue-graft.html?highlight=gum+graft</a></p>
<p>Thanks Karen, I read that entire thread. You S’s sounded quite involved. My D’s consult appointment with the perio is scheduled for one week from tomorrow at 8:00 a.m…her first day of her Spring Break! Fun! I have taken extensive notes from both this thread and yours, including some of audiophiles comments. It didn’t sound like you were too concerned with the cost/insurance factor. DH’s employment situation is rocky right now, so I’m trying to reign in some costs. I would love to hear that she doesn’t need this surgery after all…</p>
<p>Anyway, CC is so great.</p>