Gum graft diary: Day 8 & review appointment

Time for a check-up

I went back to the surgery today for a checkup and was told that everything looks like it is healing nicely. 

The surgeon tightened up all of the loose stitches for me. Not sure exactly what she did, but it seemed to be a case of adding more of the composite that is gluing my teeth together underneath the stitch so that it holds tight.  

My next appointment is in 2 weeks time.  The normal protocol is for stitches to be left in for 4 weeks after AlloDerm, which is longer than for a gum graft with your own tissue.  However, the periodontist said that the stitches are not really active after 3 weeks, it is mainly a precaution. 

Gum graft diary: Day 6 - post-op pictures & mouthwashes

Keeping things clean

The swelling is finally starting to go down. This is now an awkward part where I feel fine and want to go out, but my diet is still restricted and I still have scary-looking stitches in my mouth. 

My top arch looks much, much more terrifying than my bottom arch. I believe this is because the Gengigel I've been using to help speed up healing (more on this below) can sit there longer against the gums due to gravity, whereas it's harder to keep it up against the top arch. 

Let's look at pictures and you can decide for yourself.




*** Warning! Look away now if you don't want to see post-op pictures!! ***







I figured that since my periodontist asked me to send her photos of the loose stitch, we are now at a stage where the graft is a bit more stable and I can take other photos. 

I'm sorry if these are gross, but as I said, a healing graft is not pretty.  Hopefully these will help someone else who is looking in horror at their own graft site.

Bottom arch: The gums are darker pink/red rather than the pale anaemic pink from before. The gum contours are starting to settle back down but are still a bit higher than where they will end up. You can still see a little bit of the white from the AlloDerm around the edges of some of the gums, but most of it seems to be incorporating nicely. The gums are definitely still puffier than usual. Some of the stitches are now looser because the swelling has gone down. 

Bottom arch - day 6

Top arch: This looks much worse to me, even though the recession was actually far less severe on my top teeth! The white parts will hopefully become incorporated into the gums and much as it is tempting to try to remove them I know I must leave them be.  Urgh, but they are extremely gross!  If I hadn't seen this kind of situation before on my previous graft in 2012 I would be panicking that the graft has failed here. From experience, it will start to look better over time. Just be gentle with it! 

Top arch - day 6

So, on to the reason I think my bottom arch looks better than the top:

Today's theme: Mouthwashes

I found that using Gengigel Gel really helped to soothe my mouth whenever it was feeling hot, tight, dry or sore. The gel is easy to use and thick enough that it seems to last in the mouth for a good while. Gengigel has been shown to help speed up healing and reduce inflammation - as I mentioned above, my bottom arch looks so much better than the top, and I think it's because of this (it is much easier to keep the gel against the gums in the bottom arch). 

I also used the Gengigel Mouthrinse to make sure I could get the product into all nooks and crannies. This stuff helps to heal gums!  I would not be without the two Gengigel products. 

Antimicrobial rinses

You should be given some kind of medical mouthwash to use, since you won't be brushing your teeth for a while. According to my surgeon, this is the part that patients find the hardest. 

For my first surgery in 2012 I was given Corsodyl mouthwash. The active ingredient is Chlorhexidine, which is considered the gold standard in antimicrobial rinses. Most normal mouthwashes only kill surface bacteria and don't last in your mouth. Chlorhexidine is different in that it binds to your tooth surfaces so it remains active for longer.

The main drawback is that it stains your teeth!  This can be easily removed with a normal cleaning at your dentist though.  It can also make food taste weird. 

Enter this guy - Curasept which I was given for my second surgery in 2017. Soooo much better!  Definitely ask your surgeon if you can have this instead, or buy it for yourself if they give you Corsodyl.  Seriously, it is so much better.

It has the same active ingredient as Corsodyl, but includes an anti-staining system so that your teeth stay white. 

For both mouthwashes, you shouldn't use toothpaste at the same time because the sodium lauryl sulphate (SLS) can neutralise the active ingredient. 



Other rinses

Aside from the medical rinses, you can use good old salt water (1/2 teaspoon in a cup of warm water). This can help with swelling and is a natural disinfectant.  I find it quite soothing and like to alternate with the Gengigel. 

Don't use regular mouthwashes though - especially not anything with hydrogen peroxide in it (like Peroxyl), as this can interfere with the blood clots and slow healing. 

Things to stock up on

How to make recovery suck less

You're about to go through a major surgery, so it's good to prepare first and make sure you have everything you need for a speedy, comfy recovery.  

These are all things that I personally found helpful - although you might not need everything here.  

Mouth rinses and gels for sore gums

I found that these products helped to speed up the healing process and maximise the chances that the graft takes:

• Curasept. If you are given Corsodyl, buy this instead!  It has the same active ingredient but it won't stain your teeth.
• Gengigel Gel. This really helped to soothe my mouth when it was feeling hot, tight, dry or sore. The gel is easy to use and thick enough that it seems to last in the mouth for a good while. Gengigel has been shown to help speed up healing and reduce inflammation, and I found it really works. 
• Gengigel Mouthrinse. This was also useful to make sure I could get the product into all nooks and crannies. This stuff helps to heal gums! 

Things to help with swelling

Excessive swelling is a big reason that grafts fail - this is because it can pull the stitches loose and expose the immature graft underneath.  Icing in the early stages can help - once the swelling sets in there isn't much you can do except wait for it to go down.  The key is in prevention during the first 24 hours (after this, ice feels nice but doesn't reduce the swelling much).

• Ice packs - any kind of reusable gel ones are great. I have Theraflex ones, which have held up for years and years. They remain soft enough when frozen to mould nicely to your face.
• Swanson Enteric Bromelain. Enteric bromelain can help to reduce swelling after surgery or injury. Check with your doctor before adding supplements.

Things to help with bruising

You might not have a big problem with bruising, but if you do, these things can help:

• Nelsons Arnicare Arnica Cream.  Brings down bruising like magic. 
• Vitamin K. Used by plastic surgeons to reduce post-surgical trauma, but please check with your periodontist first. 

Gum graft diary: Day 3 & medication

How's the pain?

My face is more puffy and painful than yesterday - a bit of a hamster face look today.  I have to be careful not to accidentally ding the areas when washing my face.  Swelling will usually tend to get worse for a few days after any kind of surgery (peaking at day 3-5).  My face is tender, stiff and hot - icing helps.

The grafts themselves have swelled up a bit more, so I can see the ones on my front teeth without lifting my lip. It is a mix of pink gum tissue and white AlloDerm at the edges and around the tracks of the stitches. I remember this from last time, so I am not worried. But it is certainly not attractive. 

When the graft site is swelled like this, it can pull on the stitches and the whole area looks puckered, totally gross and definitely not gum-shaped.  In some areas the swelling can mean that most of your teeth are covered. I notice that the graft is sitting higher up on some of my teeth whereas on others it is lower.  Don't worry, the gum contours will settle back in time once the swelling subsides.  

Today has been fairly pain-free - I feel that I can thank the skill of my surgeon and also my extensive list of medications for this. Even if you don't have pain, it is still a good idea to take the meds. Let's take a look shall we?

Today's theme: Medication

Here's a picture of my goody bag:

My goodie bag

• Antibiotics: Amoxicillin, the old faithful. One every 8 hours for the next 7 days
• Painkillers: Ibuprofen and co-codamol (paracetamol and codeine). Every 8 hours - although to be honest, I've only taken the ibuprofen (200mg, mainly to help with the swelling)
• Anti inflammatory: Dexamethoasone. Starting with 3 a day for 2 days, then 2, then down to 1

When I had my previous surgery in 2012, and also when I had a wisdom tooth out, my face blew up like a balloon.  It caused much amusement for all, but it also really, really hurt!  

This time, I think the anti-inflammatory has done a spectacular job - swelling is still happening but much better controlled... Hurrah for medication!  I don't think it is given out as standard, but when I explained my previous issues to the surgeon she added this to my goody bag and I am very grateful.  

I'm also taking the following supplements to give my body as much support as possible (please check with your doctor before adding supplements):

• Wellwoman original

• Swanson Ubiquinol 

• Swanson Enteric Bromelain 

Have you had gum grafts - were there any medications that particularly helped you?  Leave your comments and tips below, let's all help each other! 

Gum graft diary: Day 2 - first day after surgery & post-op instructions

Good morning - first day after AlloDerm gum graft on all teeth

I woke up without much pain today, after having all of my teeth grafted (more on the surgery itself here).  No one is more surprised than me. 

It is definitely best to take the day after surgery off work - in fact, I have the rest of the week off.  I noticed that swelling increased throughout the day and I was quite puffy in the evening.  I am trying not to speak or move my mouth too much - when I do, it feels like it contributes to the swelling.

I have not tried to look at the graft, but since it has been done right at the front I can see parts of it anyway - it is quite red but held in place with the stitches.  Today.  I know from experience (the last bout of grafts in 2012...), that it will probably look horrendous if I have a closer peek.  

Today's theme: Post-op instructions

Let me read out my post op instructions for you below.  I'm the kind of person that needs to be told why I should follow them, otherwise I may just forget to comply:

• Plenty of rest - seems obvious. Try to sleep with extra pillows to keep your head elevated and reduce swelling.
• Do not bush or rinse on the day of the surgery. After the first day you can very gently rinse by tilting your head to let the mouthwash move around your mouth (no swishing!).  Not brushing for so long feels kind of icky, but my surgeon will give my teeth a good clean and polish when I come in for review appointments to make this part easier and more socially acceptable. 
• Avoid lifting the lip with your fingers to look at the area.  As I note here, it's best not to look. You can accidentally tear the sutures, and because the tissue is so delicate, they might not be able to replace them. You may think you are being gentle, but your gums may disagree.
• Apply ice, 15 minutes on and 15 minutes off.  There is some debate over this one, but as I understand it the ice helps to bring down swelling.  A little bit of swelling is good as it brings nutrients to the area; a lot is bad since it can break the stitches.
• Start taking painkillers before you feel the anaesthetic wear off. It is much easier to prevent the pain than it is to make it go away once you start feeling it.
• Take the medication with food and drink. This reduces stomach upsets.
• Eat a soft diet. More on this in Day 4.  The first 24-48 hours are the most critical for your graft, so be extra careful for the first few days. 
• Avoid exercise for 7 days. This keeps blood pressure low, reduces bleeding and aids healing. As an avid gym bunny, this one is extremely difficult for me. More on this in Day 7.

Too much swelling is a bad thing and can lead to graft failure.  Icing in the early stages can help - once the swelling sets in you just have to let it take its course, so the key is in prevention. 

I use Theraflex gel packs, which have lasted me for years and years.  Wrap these in a tea towel before pressing against your face to prevent freezer burn!  They remain soft and flexible so they can fit nicely against your cheek. 


Have you had gum grafts - were your post-op instructions different ?  Leave your comments and tips below, let's all help each other!