Oral and maxillofacial surgeons are the surgical experts in dentistry. Often, the soft tissues inside the mouth require surgery to reshape or restore tissues around teeth or implants. Soft tissue surgery can include augmentation, reduction or reshaping. The goal of oral soft tissue surgery is to restore and maintain attractive and healthy tissues.

Reduction/Reshaping Procedures

Soft tissue reduction is sometimes necessary for such conditions as:
• Gum enlargement (due to medications or irritation)
• Excess soft tissue when full or partial dentures are planned
• Access to impacted teeth to attach orthodontic devices (braces)
• To allow your dentist to prepare teeth for crowns or place dental restorations
We will work closely with your family dentist or dental specialist when reducing and reshaping the soft tissues of the jaws.

Augmentation Procedures

Often, a lack of quality tissue around teeth or dental implants can be treated by soft tissue grafting. This enhances the look and maintenance of teeth and implants and is important for long-term health. Soft tissue grafts are often taken from the roof of your mouth and transplanted to the graft site. In some cases, soft tissue graft substitutes may be appropriate for your case. Your oral surgeon will recommend they type of soft tissue graft that is best for your care. Soft tissue grafts may take a number of weeks to heal. Since the final size and form of the graft cannot be exactly predicted, it may be necessary to do some minor recontouring of the grafted tissue after it heals in order to give the best result.

A gum graft (also known as a gingival graft), is a collective name for procedures that aim to cover an exposed tooth root surface with grafted oral tissue.

Exposed tooth roots can happen for many reasons. Common causes include gum disease, overly aggressive brushing, and trauma.

Reasons for gum grafting

When recession of the gingiva occurs, the body loses a natural defense against both bacterial penetration and trauma. Gum grafting is a common periodontal procedure. Though the name might sound frightening, the procedure is commonly performed with excellent results.

Some of the major benefits of gum grafting:

  • Reduced sensitivity — When the tooth root becomes exposed, eating or drinking hot or cold foods can cause extreme sensitivity to the teeth. Gum grafting will permanently cover the exposed root and thus reduce discomfort while restoring the good health of the gums.
  • Improved appearance — Severe gum disease will cause your gums to become inflamed and recede. Gum recession and root exposure will make your teeth look longer than normal and may make your smile appear very “toothy.” Gum grafting will cover your roots, making your teeth look shorter, symmetrical, and generally more pleasing and esthetic to look at.
  • Improved gum health — As gum disease progresses, it will destroy gum tissue very rapidly. The loss of gum tissue often weakens the seal between the gum and the tooth, making eventual tooth loss a possibility. Untreated, large amounts of gum tissue will be lost in a short period of time. Gum grafting these problem areas can help stop tissue and bone loss; preventing further problems and protecting exposed roots from further decay.

The most common types of gum grafting are:

  • Free gingival graft — This procedure is often used to thicken gum tissue. A layer of tissue is removed from the palate and relocated to the area affected by gum recession. Both sites will quickly heal without permanent damage.
  • Subepithelial connective tissue graft — This procedure is commonly used to cover exposed roots. Tissue is removed fairly painlessly from the outer layer of the palate and relocated to the site of gum recession.
  • Acellular dermal matrix allograft — This procedure uses medically processed, donated human tissue as a tissue source for the graft. The advantage of this is procedure is that there is no need for a donor site from the patient’s palate (thus, less pain).

What does gum grafting treatment involve?

Once the need for gum grafting surgery has been determined, there are several treatments Dr. Noori will want to perform before gum grafting takes place. The videos below can give you a better idea of the actual process. First, the teeth must be thoroughly cleaned to remove calculus (tartar) and bacteria. Next, your gum grafting procedure will take place. This can be performed either under local anesthetic or sedation if you prefer. The graft is usually slightly larger than the recession area, so some excess will be apparent immediately after your procedure. Sutures are often placed to further stabilize the graft and to prevent any shifting from the designated site. Surgical material is used to protect the area during the first week of healing. Uniformity and healing of the gums will be achieved in approximately six weeks. Dr. Noori will work closely with you and your general dentist throughout the procedure.

Frenae (plural of frenum) are generally minor strands or bands of muscle attaching the lips, cheeks, and tongue to the bone in the mouth. You can probably detect one of your frena by placing your tongue in the space between your upper lip and your upper front teeth. There are several different frena in the mouth and they can attach to the inside of the lip, inside of the cheek or to the bottom of the tongue. In certain cases a frenum can prevent teeth from staying in place after they have been orthodontically moved together. An excessively large frenum can prevent the teeth from coming together after braces are removed resulting in a gap between the front teeth.

While an upper frenum problem usually won’t affect speech patterns, the lower frenum, which attaches the tongue to the lower arch may interfere with speech if it is too large or fibrous. Generally, this will become apparent as the child begins to form words and phrases. If restrictions in tongue movement are noted, especially when the tongue is protruded, it is generally recommended to have the frenectomy and it may be required when the child starts developing speech patterns. Speech therapy may also be required.

A frenectomy procedure is simply the surgical removal of a frenum. This procedure can be performed with either local anesthesia or sedation depending on your preference. Dr. Noori will perform a complete examination and will work closely with your general dentist or orthodontist to ensure an optimal outcome.