Gum Graft No Problem
I had a gum graft (on 6 teeth) a week ago, here's my story.
Backstory - I've had recession for years (fairly severe on 1 tooth, moderate on 5 others). My dentist would measure the recession at every cleaning and it never increased, so although he always recommended I see a periodontist, I was hesitant to do so without more cause. Last year I starting using a Sonicare tooth brush and whitening toothpaste (evidently both no-nos for people with recession or weak gingiva) and at my next cleaning all the recessions increased. So off to the periodontist I went. He took a look and recommended a gum graft on all 6 teeth (bottom jaw middle, #22-27) because he said I had weak gingiva and inadequate bone support beneath those teeth and he thought the recession would continue to get worse. After I agreed to the surgery they poured some goop into my mouth to take an impression of the roof of my mouth so they could make a guard for it that I would wear after surgery. I think waiting for that goop to harden (while not gagging) and having the hygienist pry it out after it did harden were the worst part of the entire experience for me.
Pre-Op - The periodontist gave me a nifty little checklist of things to do prior to the surgery. Main items were to arrange for someone to take me to and pick me up from the surgery, fill my prescriptions (Triazolam, Ibuprofen, Amoxicillin, Hydrocodone & Chloraseptic oral rinse - 3 bottles) and shop for soft food. I started taking the ibuprofen and amoxicillin the day before the surgery, and had to fast completely for 6-8 hours prior to surgery.
Operation - My brother dropped me off at the periodontist's office at 7 AM. I took the triazolam with me and the receptionist had me take one with a tiny bit of water right away. About 15 minutes later they asked me how I felt. Well, I didn't feel any different, so I took the other triazolam. 15 minutes later when they asked me how I felt I still didn't feel any different, but I wasn't freaking out or stressed really so I said we could get the show on the road. They took me back to a room and had me sit in a chair like the ones you sit in when you get your teeth cleaned at the dentist. They reclined the chair, had me start breathing oxygen, dimmed the lights and told me to just relax for a while. At this point I popped my earphones in and listened to my Ipod which I had pre-filled with relaxing and soothing music. I kept the Ipod going the entire time during the procedure but had the volume low enough so I could hear the periodontist and hygienist. About 10 minutes later the periodontist came in and asked me how I felt. I still wasn't feeling anything from the triazolam but at this point I was ready to get it over with. The periodontist asked me if I wanted nitrous gas, which I accepted, and the hygienist replaced the oxygen I was breathing with nitrous and they left me alone for a few minutes to let the nitrous do its work. Then they came back in and got started by reclining the chair all the way back and rubbing some topical gel over my gums and the roof of my mouth to numb it. The gel worked very quickly and everything was numb, including my bottom lip which felt very strange, like it was ballooning up to humongous proportions. I asked for a mirror to look at it but they told me it was still the same size as always, and then I played for a while by touching bottom and top lips at the same time trying to compare the sizes (I think this must be proof that the triazolam and/or nitrous were working!). The periodontist tested the roof of my mouth and gums by poking them with something and I couldn't feel it at all, so then he started injecting the novicaine. After that I lost track of exactly what he was doing. He had described the procedure to me so I knew it involved cutting a flap in the roof of my mouth, harvesting some gum tissue and attaching it to my gums where the recession was, but I couldn't feel anything other than some pressure in my mouth. At some point I dozed off and when I came to he was sewing the new gum tissue on. The entire procedure took just under 3 hours. When it was over they put the guard for the roof of my mouth in (there wasn't any gauze or anything over the graft site), put me in a wheelchair and wheeled me out to my brother's car. Back at his place I drank a smoothie, an ensure and some water, took another ibuprofen and amoxicillin and took a hydrocodone (I was still numb but the hygienist told me I should take one just in case) and laid down for a nap.
Post-Op Day 1 - When I woke up from my nap I was a little groggy from the hydrocodone and my mouth was still numb. I don't know exactly when the numbness wore off, but it wasn't replaced by any pain. I couldn't resist taking a look at my gums but I was careful not to pull on my lip. They looked a little gross and the stitching was wrapped around the teeth everywhere and threaded thru the gums, but there wasn't any bleeding. The rest of the day I just relaxed and watched tv. I didn't eat anything that had to be chewed, I stuck with yogurt, pudding, milkshakes and apple sauce (nothing hot either, I was told that hot foods cause bleeding). I did use ice packs, 10 minutes on, 10 minutes off, all day while I was awake. I felt fine that evening so I drove myself home and went to bed.
Post-Op Day 2 Forward - The next morning when I woke up I ate some more soft non-chew food and began using the oral rinse. I wasn't in any pain but just took it easy all day, basically sat on the couch and read and watched tv. At some point I tried soft food that required chewing and was able to get some jello and ice cream down no problem. I continued using the ibuprofen and amoxicillin (until they were gone days later) and the oral rinse. I also kept on with the ice packs, 10 minutes on, 10 minutes off the 2nd day. There was no swelling that I could tell but my jaw was a little tender the 2nd day. I brushed my teeth that night being very careful not to get anywhere close to the gum graft spots. I kept the guard in pretty much 24-7 except I took it out to clean it each night. My main annoyances from this whole thing relate to that guard. It would frequently come out while I was trying to chew something, and towards the end of each day it would start to make my top teeth ache a bit. By the 3rd day (procedure was on a Wed, so this was Friday) my life was pretty much back to normal other than what I was eating. I went to the gym on the 3rd day and did some light cardio and had no problem. All in all, I took 3 days off from work but could have gone in the 3rd day if I'd wanted to.
One Week Checkup - I went back to the periodontist yesterday for my first checkup. I was glad to be going because somewhere around day 5 one of the ends of the stitches came loose and I could feel it with my tongue and it was driving me crazy. I was also hoping that he'd tell me I could ditch the guard. The checkup took all of 10 minutes. He took a look at the roof of my mouth and said it looked like it was healing nicely but that I should continue to wear the guard for another week. He took a look at the gums and said everything looked amazing. He cut off the end of the stitch that was loose and told me if more came loose I could snip them myself or they'd eventually dissolve on their own. So that's where things stand now. I'm continuing with soft food, using the oral rinse until all 3 bottles are gone and brushing my other teeth carefully, avoiding hot liquids and foods and keeping the guard in at all times (for one more week only!). I go back in 3 weeks for my month checkup. The periodontist said the gums should be attached by then and I may be able to eat something that requires me to bite into it by that time (but it could be a few more weeks after that depending on how things go).
Finances - If you're interested in how much a gum graft costs, in total (initial consultation, prescriptions and the procedure itself) it was around $3k. My dental insurance covered a good bit of it and I'd beefed up my flexible spending account to cover the rest. The breakdown of costs is $80 for initial consultation, $50 to fill the prescriptions, $1,200 for the graft of the first tooth, $1,100 for the graft of the other 5 teeth ($220 per tooth), $500 for biologic materials used to help the healing, $149 for various other including the nitrous.