A healthy, beautiful smile. Dental Grafting

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A healthy, beautiful smile. Dental Grafting
October 27
15:54 2016

Article Highlights

  • Women are more prone to developing gum tissue issues
  • Gum grafting can fix gum recession and other mouth tissue injuries
  • Dental grafting procedures can use tissue and bone to fix among other dental problems

Your smile plays a crucial role in the impression you make on others. A healthy, beautiful smile can connote a desire to connect and a decaying smile can have the very opposite effect. Over time, the esthetic appearance of your smile can become compromised by problems like receding gums and tooth loss, which affect both your self-esteem and oral health.

According to Dr. Bobby Birdi, a Vancouver periodontist and prosthodontist (dual specialist) at BC Perio Dental Health and Implant Centre, women are more prone to developing gum tissue issues for a number of reasons.

“Sometimes that has to do with genetics,” Dr. Birdi explained. “It can also do with the fact that, just personality-wise, we find that a lot of women are much more meticulous about keeping their mouth clean, they take better care of themselves in general. So, sometimes that can result in over-aggressive hygiene and a lot of toothbrush abrasion.” Fortunately, there are dental grafting procedures that use tissue and bone to fix this among other dental problems.

Dr. Birdi performs far more tissue graft procedures on women than on men, which can be done for both functional and esthetic reasons. Gum grafting can fix gum recession and other mouth tissue injuries. Gum recession, which is caused by toothbrush abrasion, disease or trauma, results in more of the tooth and its root structure being exposed, increasing the chance for cavities and injury. For a gum graft, your dentist will take tissue, usually from the roof of the mouth, and graft it either onto or underneath the recessed gums, depending on the type of graft harvested.

Bone grafting procedures, on the other hand, may be performed to treat a stubborn tooth fracture, shattered bone or in preparation for dental implants. It’s true that in order to build something, you need a strong foundation, and when it comes to implants, our teeth follow that same rule. In order to place implants, we need a sufficient amount of jawbone, which can be inadequate for various reasons such as infection, injury, disease and tooth extraction.

After teeth have fallen out or have been removed, the surrounding bone starts to be resorbed back into the body. Bone grafting procedures are typically performed as either a socket graft (bone added to the tooth socket), sinus lift (bone added between the upper jaw and the sinuses) or ridge expansion (bone added to the top of the jaw in order to widen it). Ideally, bone grafting is done at the time of extraction.

“That’s the very best time to do it,” said Dr. Birdi. “As soon as you take a tooth out, the body is going to heal and remodel that area into an area that’s not stimulated like it was with the tooth. By placing a bone graft in the area, the body doesn’t resorb even close to where it would before.”

Bone grafting procedures are performed around four to six months prior to placing implants, according to Dr. Birdi. There are three different types: bone taken from the patient’s mouth or another part of their body (autogenous), bone taken from a cadaver (allogeneic) and animal bone such as bovine (xenograft), which is taken from a cow. The most widely utilized bone graft material, according to Dr. Birdi, is a cadaver or bovine, which comes out of a bottle.

“The patient’s own bone is something that I offer every patient,” said Dr. Birdi. However, he sees most patients choosing the cadaver or bovine graft to avoid a secondary wound and in turn, more pain.

“A patient’s wishes are always going to be paramount,” said Dr. Birdi, adding that religious beliefs might interfere with the decision. Hindu patients, for example, may not want bovine and Muslim patients may not want porcine (pig bone) grafts. After harvesting allografts, the bone is freeze-dried and irradiated. “What we end up getting in the bottle is truly just a scaffold. It’s just particles that have a resemblance to bone, so that it ends up tricking the body into replacing it.”

The first two to three days after grafting procedures are going to be the most uncomfortable, said Dr. Birdi. Tissue takes around six weeks to remodel and up to a year to finalize. Patients can expect a sore mouth post-procedure but will still be able to eat soft foods. Antibiotics and painkillers may also be prescribed. The most important thing is to prevent bleeding so that the area is kept clean and trauma is reduced. According to Mount Sinai Hospital, this might involve using a special mouth rinse and avoiding flossing, and brushing the newly repaired area.

Risks of grafting are similar to those of any surgical procedure, such as discomfort, swelling, bleeding and infection. It is possible that a new tissue graft could fail or result in an uneven gum line, and with bone grafts, nerve damage and rejection of a graft from another person is also possible, according to Mount Sinai Hospital.

However, Dr. Birdi said grafting procedures are routine, predictable and when done well, benefit a patient’s health. Tissue grafting in particular can stop further gum recession, which is known to increase the risk of injury, cavities and potentially, tooth loss.

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