My Uneventful Gum Graft

Yesterday I underwent open mouth surgery. From what I hear, open mouth surgery is less risky than open-heart surgery. Today I feel more or less fine and am in no pain. I feel almost ripped off, I was expecting a good story.

Back in the spring I had a post-MSE Hyrax expansion go wrong, and my left upper first molar got partially pushed out of the bony ridge. That tooth already had the most gum recession of any tooth, and the pressure and movement from the Hyrax pushed those gums over the edge. I was going to have the grafts in November, but a spot opened up yesterday, and it worked out quite well schedule-wise.

Before the surgery I was nervous, and I got into the “check everything multiple times” coping mode. I made sure I was wearing clean underwear and counted the cash in my wallet. You could say that is not necessary before an oral surgery where I am awake the whole time, but it helped with the nervousness. What are the chances that gum grafts require suppositories? Do I really think my periodontist is going to take cash out of my wallet when I’m staring at the ceiling?

The staff at my periodontist’s office were very nice, as usual. The most confusing part was all the post-op instructions. They wrote them down, which is good. The most annoying part is I have to have a plastic stent in when eating and I can’t wear my retainer for four days. I wonder what it will feel like when I put it back in. I am also not supposed to brush my teeth or rinse my mouth for 24 hours, which feels wrong. Years of careful oral hygiene has built up good habits, not brushing my teeth feels viscerally wrong. It feels like not wiping after taking a dump.

Now for the gory details. I do not like general anesthetic, so I only had local painkilling injections in my mouth. These were the least painful oral injections I have ever had. I want to send my orthodontist to learn how to give injections from my periodontist. After the injections the perio started working on the site of the gum graft. To place the graft material in a pocket has to be made under my receded gums, so the perio used a series of pointy and sharp implements to cut my gums open, force them away from the tooth, and then massage the spot open. I felt no pain and no direct sensation, but I could feel the force involved. Because of the angle I had to lie at I could also feel the pressure on my neck, which was quite a bit. At one point the perio asked the assistant to pass the tool that looked like a spatula. She used that to apply a lot of force that I felt in my tooth, I think she was spatulaing open the cut she made. At times I could feel the pressure radiating out across all of my maxillary sutures, thanks to MSE all my sutures are more sensitive.

Then she started on the left side of my palate to get the graft material. Again, there was a lot of pressure involved. By watching her hand movement I could see her cutting into my mouth, and then I could see and feel back and forth motions as she cut the graft out. I wondered if there would be some form of medical cheese slicer, but I think it was all knife work. Putting the graft in was the least bad part. I didn’t really feel anything. I also didn’t feel the sutures, they went in no problem.

I wish I had taken a good before picture so I could see the before and after root coverage, that was an oversight. There is a sort of medical glue over the graft, which is the grey stuff in the picture. I keep forgetting to trim my mustache before taking pictures.

Having my MSEs installed and then removed, plus the bicortical punctures, completely knocked me out, and my mouth was in pain for days afterwards. At the time of writing this I am almost exactly 24 hours past the gum graft, and I feel fine. I am taking ibuprofen to keep the swelling down, I don’t really need it for the pain. I feel fine. I was tired this morning, but that could have been because I skipped my morning coffee because it would be too hot for my mouth. When I woke up I hadn’t taken painkillers for ten hours and I felt fine.

So all in all, the gum graft experience so far has been pretty chill. It kind of sucked to feel my periodontist cutting my mouth apart, that could be traumitizing for some people. If you really don’t like feeling your mouth being surgically reassembled you might want to find someone who will put you under. I have been put under before for oral procedures, and it messes me up for days. The instructions I got said I “may feel drowsy” for 24 hours after being put under, it was more like 4 or 5 days of feeling like crap. So now I choose to undergo minor oral stuff without being put under.

My periodontist just called while I was writing the last paragraph. She seemed happy with how I was feeling. I said I felt suspiciously good, which is true. She liked that. I wonder how often she calls patients and gets bombarded with grumpy tired people. It’s fine to be grumpy and tired after a gum graft, but it probably gets tiring for everyone dealing with us.

Anyhow, that’s it for now. Hopefully nothing interesting happens. I am enjoying my soft food diet, oddly enough. I stocked up on the good stuff. Sourdough bread, grapes, mango, blueberry, the most expensive kefir the store had, salmon and liver spread, sushi, three types of fancy soup, greek yoghurt, fatoush chips, brie cheese, and so on. I’d be bankrupt if I ate like this all the time.



30 year old male, undergoing MSE and maxillary protraction for Class 3 malocclusion. Never had orthodontic work before, have all 32 teeth.

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Class 3 MSE

30 year old male, undergoing MSE and maxillary protraction for Class 3 malocclusion. Never had orthodontic work before, have all 32 teeth.