Lingual Gum Graft--How to do it right

Jun 7, 2017
How to Get Your Periodontist to do a Successful Behind the Teeth (lingual) Gum Graft

Gum grafts done on your interior gums (lingual) are notoriously difficult to do, primarily due to the motion of the tongue dislodging the delicate gum graft. Having had two relatively unsuccessful lingual gum grafts done just behind by lower front teeth (lateral incisors), I wanted to try something different. At $2,000 per attempt paid out of pocket, I had strong motivation to try something new.

My periodontist (Dr. Soolari) had previously done four different totally successful gum grafts on my exterior gums demonstrating a high level of skill and a mastery of his profession; although he did say numerous times that I was an excellent patient (excellent I guess means strictly adhering to the post-surgery protocol). Since I knew Dr. Soolari was properly doing the lingual gum graft surgeries correctly, and I knew that I was a good patient, I thought an idea that I had just might work.

In January of 2017 I proposed to my periodontist that he make a relative cheap plastic night guard that would firmly attach to the teeth but would deliberately leave space to completely cover my next lingual gum graft. My thought was that despite very careful daytime management of my tongue while awake (no talking, liquid diet) my tongue was dislodging the graft at night while I was asleep. He agreed to try it.

Making the custom post-surgery night guard was clearly a first time thing for his office. After making a mold of my lower jaw and despite my repeated instructions for a specialized post-surgical night guard, the office staff produced a rugged rigid standard night guard that only fit on the tops of the teeth to prevent teeth grinding at night (I already had one of those). With the surgery only days away, my periodontist managed to make a cheap plastic flexible night guard that covered the lower interior teeth, and some of the gum. When I saw it, it didn’t look like it would cover all of the upcoming surgical area but Dr. Soolari assured me that it would. Otherwise, the thin, flexible, lightweight, clear plastic night guard was just what I had envisioned.

On the day of the surgery (April 22, 2017), after the procedure, he carefully put on the custom night guard and it covered most of the surgical area but not all, which turned out to be good enough much to my relief two weeks later when the night guard came off and the numerous stitches came out.

The results were, quantity wise, absolutely stunning. The amount of new gum was between 10 and 15 times greater than what had adhered on either of the prior two largely unsuccessful lingual grafts. The night guard seemed to both protect the surgical site AND gently apply pressure to the gum graft itself which no doubt helped more of the rather large piece of tissue ‘stick’ to the target site.

So if you have an upcoming gum graft on your interior gums, insist on an inexpensive custom night guard to totally cover the surgical area in order to protect the site from the tongue’s movements while you are asleep. To be extra safe (as I did), wear the night guard 24 hours a day (except for cleaning) and go to a liquid diet only for the first seven days, then only very soft food for day 8-14. The less you talk the better. Finding a periodontist as good as Dr. Soolari won’t hurt either!

Having done some research on the use of antibiotics, infection, and dental surgery, I decided to go against doctor’s orders and not take an antibiotic during or after my surgery. I had, as usual, no swelling at all and very little post-surgical pain and absolutely no infection. Antibiotics kill off most of the beneficial bacteria in your body, and more diseases are being traced to inadequate gut bacteria, so using antibiotics is something I don’t like to do unless there is no other alternative.

If the custom night guard covers too much of your exterior lower gums, it may produce uncomfortable pressure. The solution is to take a sharp knife or scissors and make a small cut in the center where it covers the exterior gums; that will significantly relieve the pressure on your gums.

Key Search Terms: gum graft, lingual, interior gums, custom night guard, antibiotics, gut bacteria, dental surgery.

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