Not To Be Trusted With Knives

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I’m a Frankestein’s Monster

So I got a gum graft this morning. I’ve been putting it off since forever ago when my dentist said my gum line was receding on the lower left side of my mouth on a tooth near the back. Basically, the root of the tooth was slowly being exposed and ultimately that would just lead to the root rotting and no one wants that. I looked into an alternative procedure, but then it turned out that the alternative procedure is pretty much what my periodontist does but using cadaver tissue instead of your own tissue (which is an option with my perio1 as well), but some guy gave it a fancy name and patented it. So anyway, after looking into that and deciding it wasn’t worth it, I put off booking the actual surgery for ages because (a) it didn’t sound that fun and (b) my insurance doesn’t cover the procedure (apparently Pacific Blue Cross is the only insurance that doesn’t cover it – lucky me) and I did not like the idea of spending $1400 on this rather than any number of other $1400 purchases I would have preferred to make. What finally got me to do it, though, was the realization that since I had to spend a bunch of money out of pocket for physio on my hip in the fall (as my physio allotment of my insurance got used up pretty quick), if I did the gum graft within 12 months of the physio, I could lump the receipts together and they will probably add up to a high enough amount that I can claim them on my taxes. And so I found myself in the periodontist’s chair this morning.

Not thrilled to be getting a gum graft

As you can see, I’m not thrilled to be sitting in this chair

The procedure was fairly quick and pretty much painless other than the needle to do the freezing2. They also put a blood pressure cuff on me, which inflated every 15 minutes during the pressure just to make sure it wasn’t going crazy – and I hate blood pressure cuffs! They make me feel all claustrophobic and when I can start to feel my blood pumping, I get queasy3. Ugh! Once everything was frozen, I could only feel a bit of pressure here and there, and it was weird to see someone sewing stitches in my mouth! Basically, they cut out a bit of tissue from the roof of your mouth, sew that incision up, then open up a little pocket in the receding gum and stuff the tissue inside there, and then sew that up. And that’s it. She did also put a “bandage” on the roof of my mouth to protect that cut – it feels like a little pack of putty. It sort of protects that cut – I imagine without it, I’d just be running my tongue on those stitches, like you do when you burn the roof of your mouth! Before the surgery, they gave me some Advil and Tylenol and then said to take an Advil every 2 hours today4, and then just as needed for any pain tomorrow. My jaw is a bit achy, but that doesn’t bug me too much. I was worried there would be sharp pain in the roof of my mouth, as I’ve heard from other people who have had gum grafts, but so far, knock on wood, I’m OK. I can deal with just achy (so I’m hoping it stays at just that!). The periodontist also said I might have a bruise on my cheek, but one hasn’t developed yet. I guess we’ll see how I look in the morning.

Today I had to take it easy and for the next week or so I have to eat only on the right side of my mouth. I can brush my teeth except for the ones where the graft was, and I have to swish around a special rinse after that to keep the wounded parts clean. The perio even said that I can play my hockey game tomorrow night5, so I should probably get a good night’s sleep!

  1. And, in fact, my friend Rick is getting a gum graft done using cadaver tissue, so he is going to be a real Frankenstein’s monster. Or perhaps a chimera. I haven’t been to periodontal school, so I’m not sure which of those is technically correct, though I’m sure it must be one of them. []
  2. The only painful part was paying the bill! []
  3. On the plus side, my blood pressure was good – about 109/60, which is a bit high for me (I’m usually around 90/60), but way below the normal of 120/80 and also I was having surgery! []
  4. Which I kept forgetting to do, so it’s been more like every 3-4 hrs. []
  5. I thought she would say not to, as the written material I got before the surgery said I shouldn’t engage in any physical activity for 48 hours, but she said that the written material is very conservative – she said that they don’t want you to raise your blood pressure in the first 12-24 hours while the initial healing is taking place, but after that I’m fine to play hockey!)

    Sadly, I didn’t get any gruesome photos like I did that time I got crowns and veneers done, because there really wasn’t anything gruesome to see. I kind of wish I could see what the stitches look like, but the periodontist said not to try to pull at my lip to look at what’s going on with the wound (like many people do) as it will only disrupt the site and delay healing/screw up the graft and after $1400, I’m not risking that, no matter how many cool looking stitches I’m missing out on seeing.

    Anyhoo, I suppose I should take my last Advil for the day and hit the hay. Tomorrow is my first day back at work after two weeks of holidays ((Which I’ll blog about soon! []

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To Gum Graft or Not To Gum Graft?

ToothSo the verdict is in from my dental insurance company and they are not going to cover a gum graft because apparently they want my teeth to fall out. As I was pondering on The Twitter (and consequently The Facebook, since all my Twitters go to my The Facebook)about whether I shoulddrop $1400 out-of-pocket on this apparently painful procedure, a friend of mine suggested looking into something called the Pinhole Surgical Technique (PST), which is apparently a new alternative to gum grafts.

So I googled and found the website of the guy who invented the Pinhole Surgical Technique, which I learned involves making a hole in your gum, shifting the existing tissue around a bit, and inserting some collagen strips to promote the gums to grow some more collagen and then you end up with your gums being in the correct place. It’s less invasive (you don’t have to have tissue cut out of the roof of your mouth, have your gums cut to have that tissue put in there, and then have a bunch of stitches holding it all together.). The guy who invented it has been doing it since 2006 and published the procedure in a dentistry journal in 2012.

So my problem now is – how can I tell if this really is as good as it sounds? Obviously the inventor of this procedure is trying to sell it – both to clients (to create a market for it) and to other dental professionals (to pay him to train them). I don’t know anything about dentistry, so I don’t even know if the journal in which that study is published is really “one of the most respected journals in dentistry”, as stated on the PST website.

Through further googling, Ihave discovered that there are some people locally who do this procedure, so I suppose I could go to one of them for a consultation, but I feel like they are just going to say I should do it, since they will make a bunch of money if I do.

Does anyone know any good dental professionals that would be able to provide some unbiased advice on this?

Image Credit: Posted by Luke Siemens on Flickr with a Creative Commons license.

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Perio

At my last dentist appointment, my dentist gave me a referral to a periodontist because apparently my gum is receding on one of my molars, so she thinks I should get a gum graft.

I went to the Perio appointment yesterday morning and as I drove up to the office I had an uncanny feeling I’d been there before. But it turns out that it was a canny feeling, because I *have* been there before. In 2012.  Apparently when I had my braces, my orthodontist referred me there for an exam just to make sure my gums were OK during the ortho treatment. I had no recollection of this and even after seeing my original patient intake form (which they had me update in case info had changed, which it totally had) and the Xrays they took while I was there, I still have only the vaguest recollection of this. Apparently my memory is receding along with my gum line.

Anyway, the perio’s assessment was that my gum on the molar my dentist was referring to is receding, slowly but surely, and the molar behind it is starting to as well. She stressed that it was nothing I was doing wrong, my mouth is super duper healthy and well taken care of, just a result of anatomy and the unavoidable wear and tear of living. Her recommendation is to do the graft, though she said it’s not an emergency – everything is stable now, but it will continue to recede, and even though it’s a slow recession, eventually it will be problematic.

So I’ve asked them to do a preapproval with my dental plan – the receptionist said plans don’t usually cover gum grafts, but mine says something about covering a periodontist doing a tissue graft, which sounds like the same thing to me, so I figured I’d get them to find out for sure. Especially because it will cost more than $1300 and I’d pretty much rather do anything with $1300 than spend it on mouth surgery. $1300 would buy a nice holiday. Or would look really good coming off my mortgage. Or would be fun for the cats to play with. Seriously, giving my cats $1300 in cash for them to chew up seems like a more enjoyable use of $1300.

Anyhoo, I guess I’ll find out in a few weeks if my insurance company will foot the bill for this. And if I end up getting it, perhaps I’ll post some gross photos like I did when I had my last dental surgery!