Metal Mouth Message Board

Hey guys, I'm new to this forum and still haven't figured out completely how to search around. I apologize if its a replicated question.

So here's my case... after years of wanting braces but not being able to afford them, I finally got them put on six months ago on July 6th (I was a few weeks away from being 21). My orthodentist estimated my treatment to be 20 months. Before getting braces, I've always noticed that I had receding gum, but every time during my dental checkups, they never said anything so I assumed everything was fine. But recently, I've been noticing the receding gums more and more. I've been freaking out and became quite depressed. From looking at it, I am most certain that I will need to get a gum graft (the recession is definitely more that 3-4 mm for one of my lower teeth at least). I went for my regular dental cleaning under a month ago and neither my dentist or oral hygienist said anything. About 2 weeks ago, I went to see my orthodontist and he didn't really say anything either. Unfortunately, he's on vacation, so I will not see him until 2 weeks later (i'm in complete agony). I mentioned it to him over the phone and he said he'll take a look at it once he's back from vacation.

I was wondering, is it possible to get a gum graft with braces on? I've been searching on the internet, but everyone seems to recommend getting a gum graft before braces. But I'm afraid that I can't wait that long. Also, does anyone know the average cost of getting the treatment in Toronto? What is the pain like? I've read horror stories of gum grafting experience and I must say, I definitely regret reading it. When I first got braces, I wouldn't rate the experience as being very "painful". It wasn't pleasant, but definitely not that bad. So is there anyone else that's been in the same situation as me? Or someone who's had braces and gum graft that could tell me what the pain ratio is like when comparing between braces with gum graft?

Any reply would be helpful! And happy holidays!

Thank you,

Joanne

Hi Joanne88
I had gum grafting about 6 months before I had braces on one of my lower canines and the teeth on either side of the canine. Well they numb you up very well during the surgery so I did not feel a thing then. After I left office I kept an ice pack on it all evening and was popping pain killers. The gave me some REALLY powerful pain killers in case I needed it but I did not. All in all it really was not that bad - an experience for sure. But it was worth it. In my case I had good results.

I've had several gum grafts.

There are two types of gum: "soft" gum and "hard" gum. The one your orthodontist/dentist/perio are most concerned about is your "hard" gum, which is what actually anchors your teeth to your jaw. If the hard gum recedes, the supporting bone recedes with it; that is bad. (Indeed, stopping this sort of recession is the whole reason I'm getting braced 1 1/2 hrs from this post!)

The soft gum receding creates problems for tooth sensitivity, but it doesn't cause structural issues of immediate concern. I imagine that if you had significant hard gum recession, you might need a graft; if you got one, I expect you wouldn't be getting any new wires for a couple months while the graft settled in.

All that said, they are not particularly painful. I think the worst one had me on hydrocodone for all of two days, and then a few days of advil after that. (And naturally you are completely numbed during the actual procdedure)

Hi Joanne,

I had gum grafting about 10 years ago. The gums had receded because my upper canines were way out of line, and the constant brushing and flossing and just normal wear had made the gum recede. If I had gotten braces in my teens, the gums would not have worn down so much, and I wouldn't have needed it. If I had left it, the "hard" gum would have been affected and I would have lost those teeth.

There is grafting with your own tissue and there is grafting with "donor" tissue. I had my own tissue taken from the roof of my mouth. The perio made me a kind of retainer to put over the stitches in the roof of my mouth to prevent my tongue from messing with the stitches. I had it done on two sides at once: two teeth on the upper left (the 3 and 4) and one on the right (the 3). I was totally numbed for the procedure, and had ice and tylenol 3s and antibiotics afterwards.

I found it quite painful for the first 48 hours, then just itchy and annoying for the next few days. Remember it is oral surgery, so much different than braces. It healed well within a week, but I had to be careful eating and brushing, and very, very clean (good oral hygiene) for the next few weeks. The results were great for the first 5 to 7 years. Now the gum has receded again on the left side because the underlying problem (the out-of-place teeth) hadn't been solved. That's why I am now in braces at age 50. Also, one of my left teeth, the number 3, has worn down considerably over the last few years, so I may have it capped or bonded after the braces are off. I may also have it grafted again, if that's an option (not sure if you can do two grafts on the same site.).

Overall, I would do it again to save my teeth. In Kitchener, it was about $2200 (for 2 sites) 10 years ago, so probably $3000 ($1500 per site) now.

If you have concerns, don't wait for your dentist to say something. Ask if he/she thinks it's a problem. Or get a referral to a periodontist for an opinion. It's worth the trouble for your peace of mind. If you need treatment, they always give you a written estimate of the costs of procedures. If you have insurance you can submit the estimate to know exactly how much they'll pay.

If you need it, do it now. I can't see that braces would be an impediment, but only the perio can tell you for sure.

Best of luck in your decision making. And Merry Christmas!

Thank you for all the replies! I feel a lot more at ease now that I know the experience (gum grafting) isn't as traumatizing as others described it as. I have my orthodontic appointment in exactly one week from today, so hopefully he can guide me to the right directions.