Gum Graft Failure Symptoms: Signs You Shouldn't Ignore (pictures)

Gum grafting has a high success rate. After receiving your graft, the results will gradually improve over the following days and weeks.

After about a month, you will notice that the recessed areas will be regenerated and covered.

However, there are a few symptoms you should be aware of that may indicate graft failure. In general, the first few days after the procedure are the most critical, during which time you should follow your surgeon's advice and instructions for optimal recovery.

We will discuss in this article the most common situations of graft failure, the symptoms, and how to manage them.

The Most Common Causes of Gum Graft Failure:

The first few days following the gum graft are the most critical. During this time, the graft must attach to its recipient site and form its blood vessels to survive. Therefore, you must be careful not to injure or touch it with your tongue or other objects for the first week. Otherwise, you risk dislodging the graft, which may not attach properly and fail.

When the blood flow inside the graft is not properly established, the tissue may die. You may also hear about necrosis. Note that this can also affect the donor site (the roof of your mouth). The most common causes are:

1. Technical mistake:

The technique is a major factor in the success and integration of the graft with its recipient site. So, find a periodontist who has a great deal of experience in this field to maximize the chances of a successful procedure.

2. The graft did not take hold properly:

Once the graft is placed and sutured, it must not shift or change position. This may disturb the blood clot, which is an essential element in healing. In addition, during the first few days, the graft receives nutrients from the underlying recipient site as the blood vessels have not yet formed. So be careful not to touch or dislodge the graft, especially for the first three days.

3. Smoking and diabetes:

Both smoking and uncontrolled diabetes (high blood sugar) can disrupt blood flow to the graft, decrease the immune response and increase the risk of complications. Smoking has also been shown to significantly increase the risk of pain and bleeding after surgery. So, ensure your blood sugar levels are balanced and stop smoking, especially during the first two weeks.

4. You have injured the surgical site:

If you injure your graft with a blow or rip the dressing off its site, not only can it be painful, but you may remove a stitch, mobilize the graft from its site, and trigger bleeding. This can detach the graft from the recipient site and lead to necrosis.

Symptoms of Graft Failure by Necrosis:

Symptoms of graft necrosis often include whitish discoloration, persistent pain, foul odor, and longer-than-expected healing.

However, these symptoms should not be confused with the whitish discoloration that can occur in the first week. This is normal as the body first needs to remove the outer layer of the graft to form a new, well-fitting one. The graft will gradually take on the natural color of the gum as it heals.

However, if you notice other symptoms are associated (redness, swelling, persistent pain, and prolonged healing), it may mean that the graft is failing. In this case, you should contact your surgeon immediately to manage the situation.

How is Gum Graft Failure Managed?

If the graft has become necrotic, your periodontist will first clean the site with an antiseptic solution. This will help save the healthy part and remove dead tissue. Then, he may prescribe painkillers and an antibiotic.
Once your gums have completely healed (about 3 months), you can discuss the option of a second graft with your dentist.

Infection After Gum Graft Surgery:

Gum graft infection is a rare occurrence. It results from bacteria getting into the surgical site and triggering acute inflammation. This can also lead to the failure of the gum graft.

The risk of post-operative infection is higher if you have a medical condition that weakens your immune system, such as diabetes.

Symptoms of Gum Graft Infection:

The telltale signs of infection are persistent pain, swelling, and redness around the surgical site, with a discharge of a pale-yellow fluid (pus).

How is Infection Managed?

The best way to deal with infections is to prevent them from happening in the first place.

You should follow your surgeon's instructions and follow-up appointments to monitor the healing progress and to remove sutures in time. If the sutures are not removed, they can promote the accumulation of plaque and food debris.

Rinsing your mouth with salt water from the second day onward can also help you prevent this risk.

Now, if an infection has already set in, the dentist's treatment consists of rinsing the area with an antiseptic. An antibiotic may then be prescribed.

What if You're not Satisfied with the Aesthetic Appearance of the Graft?

One of the main reasons for having a gum graft is to improve the look and appearance of your smile. Therefore, a graft that does not meet your aesthetic expectations can be considered a failure.

The main requirement is root coverage. The graft should cover as much of the receding area as possible, especially on the front teeth that are more noticeable. Other factors are just as important, such as color, contour, and texture.

How is aesthetic failure managed?

In case of incomplete root coverage, a new procedure may be needed. If the gum contour is irregular or if there is a surface defect, your periodontist can reshape the gum with an instrument. This technique is known as gingival recontouring or gingivoplasty.