I recently made the decision to tend to my receding gum problem I have had since I was a teenager, resulting from my excessive teeth brushing. I only decided this after recently speaking with a Dentist friend of mine from Tampa, Florida in December 2017. Until she introduced me to the Pinhole Surgical Technique, I had never heard of it. Based on many friends’ experiences before me, the previously popular gum procedure of connective tissue grafting was never an alternative for me.
Between my friend’s discussions and my follow-up research, I was intrigued by the procedure as it appeared to be a less invasive treatment, less painful overall (as I have a low tolerance for pain), and a quicker healing process. I am posting this information in hopes it will assist others when deciding the options for gum recession remedy. The information online is minimal and is similar from site to site, perhaps due to a patent held by Dr. Chao for this procedure. Information does not speak to the procedure in depth, the post-operative restrictions, real-life experiences or probability of failure. For me, knowing what to expect was important.
I first requested a list of certified Periodontists in my area of Tucson and found a list of five. You will find many who have performed one or two procedures; therefore, it is important to assess your own personal risk. The one I selected was Dr. John Rosenberg at Hillside Dental in Tucson Dentist In Tucson |Cosmetic Dentist in Tucson. My selection was based on Dr. Rosenberg’s level of experience with this relatively new procedure and the staff professionalism during the consult.
My personal stats — I am a healthy 55-year old female with fairly good teeth other than recession which has occurred in my upper primary teeth. My receding gums were not visible when smiling. Prior to this surgery, my primary Dentist had been replacing composite fillings that covered this recession (called abfractions) on multiple occasions. Composite fillings do not adhere to non-enamel surfaces for any length of time. The cost associated with these fillings over the years is considered cosmetic although it is necessary to reduce sensitivity to open root surfaces. I rationalized the ultimate cost of the Pin Hole Surgery (approximately $500/tooth) based on the fact that I have paid for these teeth many times over replacing fillings. If you have insurance, a portion of this cost will be covered.
From what I understand now, this procedure is not as successful on lower teeth due to gravity working against the tissue staying in place. Also, there is less room between the teeth to hold collagen that holds the gums up in place. It is also not recommended for molar teeth due to less tissue available to loosen and move up into place, so it pulls the gums back down to where they were more easily. Multiple teeth can be corrected in one procedure. There is no guarantee that your gums won’t revert to their original receded position if attachment to the bone in the new position fails.
So, the procedure… you are given lots of Novocain as this process is not as simple as it sounds, and they are working on exposed roots. After making me very comfortable in the chair with music, Dr. Rosenberg first had to remove all composite fillings protecting my recession. No incision is made with a knife or scalpel. A (pinhole) is made through the gums to the bone with a large gauge needle, then the tissue is separated from the bone attachment by scraping and lifting it free. Collagen strips are placed between the gum tissue and bone behind your gums, through this pinhole, to help cover the facial surfaces of previously exposed roots. The strips are white and when pushed through the pinhole, they appear as little baggy sacks between the spaces in your teeth (Dr. Rosenberg showed me the completed surgery since you cannot lift your gums or lips to look at your teeth for several weeks). The collagen strips and your own tissue collagen will blend during the healing process, turning from white to normal fleshy coloring. I freaked out when I woke up on day 3 and had white gums. I didn’t know if I had a disease or if this was normal. It is! I also had about 2 days of bleeding after surgery. This, too, is normal. My face swelling was not as bad as anticipated, but the area around my nose was very bruised for a few weeks (apparently from pooling of blood during surgery with head back). You meet with the Dentist on day 1 after surgery, Week 1, Week 3 and Week 6. Within a few days, the Dentist saw that 2 of my teeth (canines) experienced some recession as these two teeth were very deep. My teeth look shorter as I have been looking at my “long” teeth for years. The gum apparently takes 6 months to completely heal. Any further work on my gums will be decided at this point. They say to expect sensitive teeth. I had this procedure done as a result of excessive teeth sensitivity and was surprised that I have not experienced the sensitivity that I had previous to surgery.
If you read nothing else, know this:
-Find a Periodontist who has acquired this certification, has experience performing the procedure and has steady hands. It is a delicate surgery;
-If you cannot tolerate up to 2 hours of hard pulling and scraping during surgery, ask to be placed under general anesthesia;
-Although blogs indicate no pain medication was needed after a few days, you will probably experience a dull “teeth ache” for up to 2 weeks after surgery. And, your nose will experience bruising which may be more painful than the teeth.
-Know you cannot eat normally for 6 weeks following surgery. Soft foods do get caught in your teeth (especially if you have tightly spaced teeth); therefore, plan your menu in advance. For example, cottage cheese and scrambled eggs are on most published lists of “soft foods” for gum surgery. Don’t believe everything you read. Try foods out before surgery. If they get caught in between teeth, you won’t be able to remove them for 6 weeks. I purchased Costco protein drinks, applesauce, lots of broth, sweet potatoes and then pureed many foods in the Vitamix machine. I did not eat bread, chips and crunchy food, steak, fruit with seeds and other foods that require you to chomp and use your gums. By week 3, I was breaking food up into small bites and placing them in the back of my mouth at the molars for chewing.
-Know that you cannot brush and floss the affected area for at least 6 weeks; this is a big deal for those of us whom love to brush our teeth.
-No alcohol the 1
week after surgery; no straws for drinking those shakes; no traveling in an airplane for the first 2 weeks;
-No sleeping on your side as it can move your new gums; I found this difficult as I cannot sleep on my back.
-No exercise is allowed beyond walking for 6 weeks after surgery as this can move or damage your gums from movement and/or falling; don’t take this lightly if you are as athletic as I am.
-Don’t ignore the importance of icing your face for the first 72 hours; it will help reduce swelling and pain and hasten recovery;
Overall, the procedure and Dr. Rosenberg’s performance have been exceptional. I would recommend this procedure if you have multiple receding teeth that require fillings, you want to reduce sensitivity of exposed roots or recession is visible when you smile. The outcome is absolutely worthwhile.