Soft Tissue Grafting

Soft tissue grafting is often necessary to combat gum recession.  Periodontal disease, trauma, aging, over brushing, and poor tooth positioning are the leading causes of gum recession which can lead to tooth-root exposure in severe cases.

When the roots of the teeth become exposed, eating hot and cold foods can be uncomfortable, decay is more prevalent and the esthetic appearance of the smile is altered.  The main goal of soft tissue grafting is to either cover the exposed root or to thicken the existing gum tissue in order to halt further tissue loss.

The three different types of common soft tissue grafts include:

• Free gingival graft – A strip of tissue is removed from the roof of the mouth and stitched to the affected site in order to promote thicker, tougher tissue.  This type of graft is most commonly used for thickening existing tissue and preventing further recession.  It is not commonly used in order to cover exposed roots.
  
  
• Connective tissue graft – For coverage of exposed roots, connective tissue is used to remedy the problem.  This connective tissue is removed from the roof of the mouth and stuffed inside of the tissue at the affected site.  Then all of the tissue is moved toward the crown of the tooth in order to cover any exposed root surface.  This is the most common treatment for root exposure.
  
  
• Soft tissue allograft – This type of graft is used in the same way as a connective tissue graft but cadaver soft tissue is used instead of using tissue from the patient's mouth.  This is a good procedure for patients that have several teeth that need to be treated at one time or that want to avoid a second surgical site on the roof of the mouth. 
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• Reasons for soft tissue grafting

Soft tissue grafting is an extremely versatile procedure that has many uses.  Recent developments in dental technology have made soft tissue grafting more predictable and less intrusive.  Here are some of the main benefits associated with soft tissue grafting treatment:

• Increased comfort – Root exposure can cause substantial pain and discomfort.  Eating hot, cold or even warm foods can cause severe discomfort. Soft tissue grafts cover the exposed root, decreases sensitivity and restore good health to the gum area.
  
  
• Improved esthetics – Gum recession can cause the smile to look “toothy” or the teeth to appear uneven in size.  Soft tissue grafting can be used as a cosmetic procedure to re-augment the gums, and make the smile appear more symmetrical.
  
  
• Improved gum health – Periodontal disease is a progressive condition that can destroy soft tissue very rapidly.  When used in combination with deep cleaning procedures, soft tissue grafting can halt tissue and bone loss, and protect exposed roots from further complications.

What does soft tissue grafting treatment involve?

Once the need for gum grafting surgery has been determined, there are several treatments the dentist will want to perform before gum grafting takes place.  First, the teeth must be thoroughly cleaned to remove calculus (tartar) and bacteria.  The dentist can also provide literature, advice and educational tools to increase the effectiveness of homecare and help reduce the possibility of further soft tissue damage in the future.

The grafting procedure can be done under local anesthetic or conscious sedation depending on the patient's preferences.  The exact procedure will depend much on whether tissue is coming from the patient’s palate or a tissue bank.  Initially, small incisions will be made at the affected site to create a small opening to accommodate the graft tissue.  The graft tissue is removed from the roof of the mouth or ordered from the tissue bank and inserted into the space between the two sections of tissue.  Sutures are often placed to further stabilize the graft and to prevent any shifting from the designated site.  Surgical dressing may be used to protect the surgical area during the first week of healing.  Uniformity and healing of the gums will be achieved in approximately six weeks.

If you have any questions about soft tissue grafting, please ask your dentist.