Gum Healing After Dental Surgery: What to Expect

Dental gum issues

Hello Doctor, I had a significant portion of gum tissue removed from my upper left incisor two weeks ago for a graft.
I would like to know if the excised gum tissue will only partially integrate with the original gum around the incisor, and if part of it will not be absorbed and become necrotic tissue.
I had my stitches removed a week ago, and at that time, the wound appeared white and green.
Two days ago, which is two weeks post-surgery, while rinsing my mouth, a piece of the white and green tissue came loose, and I could see that the wound had healed.
Could you please clarify if the white and green tissue was a scab or if it was necrotic gum tissue that did not get absorbed? I'm quite worried, thank you very much!

Xu, 30~39 year old female. Ask Date: 2015/08/14

Dr. Zeng Guanghui reply Dentistry

A piece of gum tissue was taken from the upper left jaw to repair the gum of the upper front tooth, possibly due to severe recession of the gum around the upper front tooth.
As long as the blood supply to the gum tissue remains good and the gum tissue is healthy without inflammation, there should not be any necrotic tissue at the surgical site postoperatively.
If there is observation of white or greenish tissue loosening, it is recommended to return to the dentist for a thorough examination immediately.

Reply Date: 2015/08/14

More Info

After undergoing gum surgery, particularly a procedure that involves the removal of gum tissue, it is natural to have concerns about the healing process and what to expect. Your questions about the healing of the gum tissue, the appearance of the surgical site, and the potential for tissue integration are all valid and important for understanding your recovery.

Firstly, it is essential to recognize that the healing process of gum tissue can vary significantly from person to person. Generally, after gum surgery, the body initiates a healing response that involves inflammation, tissue regeneration, and remodeling. The area where the gum tissue was removed will go through several stages of healing, and it is common for patients to experience some changes in the appearance of the gum tissue during this time.

Regarding your specific concerns:
1. Integration of Gum Tissue: When gum tissue is surgically removed, the remaining tissue will typically attempt to heal and integrate with the surrounding areas. However, it is not uncommon for the newly healed gum tissue to appear different from the original tissue. Some areas may not fully integrate or may take longer to heal, leading to variations in height or texture. The healing process can take several weeks to months, and patience is key.

2. Appearance of the Surgical Site: The white and greenish appearance you observed at the surgical site could be attributed to several factors. In the early stages of healing, it is common for a fibrin clot to form, which can appear white or yellowish. This is part of the normal healing process and serves as a protective barrier. However, if the tissue appears excessively green or has an unpleasant odor, it could indicate an infection or necrosis (death of tissue). It is crucial to monitor the site for any signs of infection, such as increased swelling, pain, or discharge.

3. Tissue Necrosis: If the tissue that appears white or green is indeed dead tissue, it may not be able to integrate with the surrounding gum tissue. Dead tissue can occur if there is inadequate blood supply or if the tissue was not viable at the time of surgery. In such cases, the body may eventually expel this tissue, or it may require intervention from your dentist or oral surgeon to remove it.

4. Healing Timeline: The healing timeline can vary, but typically, initial healing occurs within the first few weeks. Complete healing and remodeling of the gum tissue can take several months. During this time, it is essential to maintain good oral hygiene and follow any post-operative care instructions provided by your dentist. This may include avoiding certain foods, using prescribed mouth rinses, and attending follow-up appointments to monitor healing.

5. Follow-Up Care: Given your concerns about the healing process, it is advisable to schedule a follow-up appointment with your dentist or oral surgeon. They can assess the surgical site, determine whether the tissue is healing appropriately, and address any concerns you may have about the appearance of the gum tissue. They may also provide guidance on how to care for the area to promote optimal healing.

In summary, while it is normal to have concerns about the healing of gum tissue after surgery, it is crucial to stay in communication with your dental care provider. They can offer personalized advice based on your specific situation and ensure that your recovery progresses smoothly. Remember that healing takes time, and with proper care, you can expect to see improvements in the appearance and health of your gum tissue.

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