My Experience With Less Invasive Pinhole Gum Grafting Surgery

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Wow…I must start this article out by saying that I had a good experience with pinhole gum grafting and you can read on to see how smoothly my surgery went for the most part.  BUT so many comments that have been left with this article are from readers who said that they did not have a good experience.  So if you are considering this surgery, read my article and all of the comments left and make a list of questions to ask your periodontist as you make your decision.  I am so disheartened to read all of the comments from those who struggled with this procedure.  I guess I was lucky.  Here is my story and the comments from others follow…

Need gum grafting for receding gums?  I did and I dreaded it.  I was able to try a new technique called pinhole gum grafting surgery.  This is something that you should know about in case receding gum treatment is in your future.  It is a common ailment.

First, let’s talk about traditional grafting surgery.  It is unpleasant, since typically, skin is cut from the roof of the mouth and then inserted into the receding gum area. Eek!

So, when my dentist told me that grafting was needed with a referred local periodontist, I instantly felt anxious.  My mother and brother had been through the traditional grafting and they felt for me, too.  I didn’t want to do it.  I wasn’t having any pain and my receding gums weren’t bothering me a bit, but I knew that they would at some point and if receding gums are ignored for years, the actual tooth could fall out.

I didn’t want that, so I bravely scheduled the appointment with Dr. Randy Fitzgerald at AZ Perio in Ahwatukee.  The AZ Perio staff is very nice to talk with on the phone and to work with in the office.  It is like they know that patients fear the word, periodontist.  And Dr. Fitzgerald was very nice as well.

And he had some good news for me.

I wasn’t going to have suffer through what my poor mom and brother endured because there is a relatively new procedure called pinhole surgical technique.  Dr. Fitzgerald explained to me that I would be numbed and then he would inject collagen strips under my gums, thereby filling in the receding spots to cover the tooth with the gums to the previously normal state.

He was also honest in letting me know that there would be a recovery period with some discomfort and that I would need to be on a cocktail of meds during the recovery time. I appreciated knowing that because if the words, pinhole surgical procedure is googled, words that he didn’t use come up.  Google searching said painless, no recovery time and no stitches.  That is not always actually the case.

Dr. Fitzgerald is very thorough and works to greatly reduce the chance that future surgery will be needed. Although only time will tell us that for sure.  So he does incorporate a few stitches into his pinhole procedure if he feels they are necessary.  In my case, a few were needed.

So how did my experience go?  Would I recommend this?  Here is my short gum surgery story.  First, a few pictures of my recovery stages as these photos will help reduce the fear if you end up needing this procedure.  I have read that over 50% of the population suffers from some sort of receding gums, so chances are, many of my blog readers may need this treatment in the future.

Day 1 and definitely swollen, but not too bad.

Day 3 and it is obvious which side had more surgery. My family called this my Joker smile! A sense of humor is good medicine when one is homebound recovering 🙂

Day 4 and a little more, but not too bad at all.

Peaking! This is as bad as it got. Again, not too shabby…or swollen, I should say.  Somewhat, but manageable.

A little over a week later and feeling like myself again. My lips are chapped from the recovery and, although I still feel like a cotton ball is stuffed under my cheek, the visible signs of swelling are gone. Happy me!

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Now that you see the pictures, you can see that the recovery with the pinhole procedure was not bad at all.  I will now take you through my pinhole journey.  Short and sweet, but with some stuff to pay attention to and remember when considering the pinhole technique.

On January 3rd, I drove myself to breakfast before my procedure.  My entire family was sick and I wanted to get this surgery over with, so I proceeded. I went to a restaurant first, as I had asked the doctor if I could enjoy a big meal and a mimosa pre-surgery, since I would be required to be on soft foods for two weeks following the operation.  He agreed to that.  He had offered me Valium to relax me for the procedure, but I turned it down since I would not be able to drive and would lose a day feeling loopy.  Good thing I chose that route since my family was too ill to drive me and to care for me that day!

After a big delicious breakfast and one enjoyable mimosa, it was time for my surgery.  I was lucky that I wasn’t going under, so I could fill up my tank first before heading to the shop, so to speak!

Pre-surgery breakfast with a raspberry mimosa that took the edge off!

The numbing shots hurt, as expected, but nothing too terrible. They asked to cover my eyes with a towel, so I decided to pretend like I was at the spa having a facial, as they worked away.  No pain, but unfortunately, I did have some sinus discomfort on the opposite side of my mouth as they worked.

Scheduling this right after the hectic holidays left me rundown and getting over a cold, which made my sinuses vulnerable, but I was OK and could deal with it.  I also knew that the antibiotic I would take, to prevent post-surgery infection, would also wipe out any sinus infection that was left over from the pesky holiday virus my family fought.  Tis’ the season!

So my first big piece of advice #1…don’t schedule surgery or procedures right after the holidays or an event that may have you rundown.  Try to be your strongest and healthiest self when preparing for any type of surgical procedure.

The procedure took a little over an hour. I had already purchased my soft foods, so I departed for the drug store to get a narcotic painkiller that the doctor prescribed for me, just in case my pain warranted that.

Great news.  It never did!  The extra strength Tylenol and prescribed ibuprofen did the job.  Which brings me to my advice #2…stay ahead of the pain when recovering from a surgery.  I kept a chart of the different meds I had to take and the times of day and night each one was ingested, with a list of the upcoming times as well.

My chicken scratch chart wasn’t pretty, but it did the job.

When recovering from a surgery, the body is tired and rundown.  No matter how minor, the body is messed with and it responds to the invasion and needs TLC.  So even if you think a surgery is common or minor, schedule time to recover.  Truly.

I had to take more pills than I like to endure as I recovered from this procedure. As I mentioned, for three days, I stayed on extra strength Tylenol combined with a prescription ibuprofen, that I kept scheduled to take at different times.  My least favorite item that I had to take for a week was the steroids.  This helped to reduce the swelling and I was required to start the pack one day in advance of the surgery. I didn’t like the side effects, which included an increased appetite, ironic when I couldn’t chew many foods.  I also had a cough while on those pills, but it cleared up as soon as I finished the pack.  The doctor has patients reduce the amount taken gradually each day, so that body comes off the powerful steroids gradually, which is good.

I was also given a powerful germicidal mouth rinse that I was required to start the day after surgery.  This stuff is strong and greatly reduces bacteria, which I found to appreciate since I was not allowed to brush or flush my teeth for two weeks following the surgery.  Sound gross?

I was afraid of just how gross that would be, but this rinse took care of any potential bad breath. However, it will be good to be done with with it soon, since it can stain teeth. I will be finished with this rinse in one more week.  The doc also gave me a special super soft post surgical tooth brush.  I got to brush very gently last night.  The things we take for granted…brushing teeth!

So I found my recovery to be almost be more about coming off the different meds than my swollen jaw.  The painkiller combo made me sleepy and the steroids made me feel rundown with a cough. As I finished each med, I gradually felt better.  Since it is winter, the soft foods diet wasn’t as challenging as I had imagined it would be, since soup is in season.  I had lots of soup, we juiced fruits and veggies and pals brought me yellow curry, homemade soup, smoothies and more.

My sweet pal, Julie brought me yummy yellow curry. It was soupy and I mashed the veggies inside while she had wine and gave me some great company. Both the food and her company nourished my recovery.

Juicing was so helpful and my sweet teen daughter did just that for me.

This brings me to my advice snippit #3….ask for and accept help.  Again, googling the words, pinhole procedure makes this surgery sound easy breezy with no recovery time. Not true.  Your gums are being messed with.  In my case, they were also cut a little and asked to accept injections of a foreign matter. My body is not used to taking in a bunch of new meds, all at once.  My gums were swollen and I was adjusting to a different diet.  So if you do have pinhole surgery, take comfort in knowing that it is way less invasive than traditional grafting with a shorter recovery time, but you will need to schedule some recovery time.

I was told that it would be two full weeks for me. Two full weeks on soft foods, too.  Well, I followed the long list of post-op care tips to a T…and I shortened my recovery time by doing so.  This piece of paper below became my bible and I followed all the instructions religiously.  Like most of us, I don’t have time to be down and I didn’t want any post-surgery complications.  So, my advice #4…do exactly what they tell you to do post-op, have a family member read it with you to help you keep track of it all.  Be sure to keep notes regarding what time meds are taken, unusual bleeding, etc.  I also drank healing herbal teas and ate as much veggies and fruits juiced as I could. I took my vitamins and added protein powder to my smoothies.  And I got extra rest.

These guys encouraged me to cat nap and get recovery rest 🙂

I did have a little unusual bleeding the day of my surgery.  The post op instructions failed to stop the bleeding, so my wonderful periodontist stayed open after hours to take a look at my gums.  All was good but the time I arrived, so that was a relief.

That would be my only complication and it was very slight.  So I do recommend the pinhole technique. If you live in the Phoenix area, I highly recommend AZ Perio and Dr. Fitzgerald.  I am very happy to be ending this experience and this article with that recommendation!

And one more thing…I have read in multiple articles that good dental hygiene and care can add 10 years to your life, so don’t ignore your chompers.  If surgery is needed, hopefully I just gave you some good news about the wonders of technology when it comes to gum grafting.  Remember the words, pinhole procedure if your dentist tells you that receding gum surgery is needed.

Comments

  1. Hi Rachel,
    It was great to read your personal account of your Pinhole Surgery experience, and very encouraging to read that it was very close to what I experienced. I have just come through the 6 week period of following the strict rules. Mine was done in Australia. Upper arch only, lower arch later this year. I had been googling for someone else’s experience I could compare to mine and found yours. Like you said lots of sites imply that it is a real breeze and almost nothing but the truth is it is more than that. It is surgery and it does knock you about a bit. Like you I had a few stitches – some mild swelling for a few days. I did have some pain during the procedure, got a top up needle or two, no bad pain afterwards – just took 2 lots of tylenol and was then OK. No steroids but one week of antibiotics. I followed the guidelines religiously. Found the mouth wash pretty heavy going but dentist insisted. Turned teeth brown after a couple of weeks but the dentist’s cleaning removed this, mushy food no real problem and even continued it for an extra week or so to be sure . In the early stages I had some pretty weird sensations in my teeth, but not unpleasant, almost like they were itchy and needed to chew something. Happy with the result. Lets hope the results are permanent. Once again thanks for your account. It was very helpful in that it collaborated my experience. Cheers, Glen. (Australia)

    • ManagedMoms.com says:

      Hi Glen. Thanks so much for sharing your experience. It is pretty similar to mine. So nice that you didn’t have to take the steroids. I have a friend who is about to go through this as well so I will tell her to read my article and your comment, too. Here’s to a smooth dental year ahead for both of us!

      • Hi Rachel, I thought I’d post a brief update now I’m at about three and a half months since surgery. The news is not all good. Everything was great up to about the two month mark but since then there has been some regression, in that the gum line has pulled back a bit and some degree of recession is reappearing., I’m still ahead of where I was, but whereas it looked fantastic post op, it is not as good now . I have to reiterate that I followed all the instructions to an absolute Tee, so I think this may be down to underlying bone loss which the dentist explained, does limit the success. Nevertheless I do feel a little deflated, as the result has not been as good as he predicted. (I was on a high at first!)

        I’m scheduled to see my dentist again in a couple of months for him to do the lower arch and will discuss the situation with him then.
        I would like to know how your own case is progressing – whether you have managed to maintain your new gum line exactly as it was post op or whether you have experienced some loss like mine.
        Cheers, Glen (Australia)

      • I just had the pinhole surgery done for the second time. I had my lower front teeth done (10 in total). Immediately after surgery, the dentist claimed my gums were high and looked great. However, the first chance I was able to take a peek, my gums looked worse than before the surgery. They had completely fallen and it looked like slits were cut into my gums between each tooth. I had to wait six months to repeat the surgery. It’s been two days since surgery the second time and my gums look better, but the gum area is starting to pull away again from two of my front teeth. I pray the other teeth will hold up. I agree that the surgery takes a lot out of you. I felt very achy the second day and I have a constant tingling, itchy feeling in the gum area.

      • Heather Janas says:

        Hey! I just had the pinhole technique done on one of my front teeth. it’s been 5 days so far, there isn’t any visible swelling, however it feels like there is a cotton ball under my lip. how long does it usually take for that feeling/swelling to go down?

        Thanks!

    • Hi Glen,

      I am just wondering if you could give me the name of the doctor who did the Chao Pinhole Surgical Technique with you in Australia. I also live in Australia and would like to have it done.

      How is your recovery going? Do you still have some recession?

      Thank you,

      Isabel

  2. Hi Rachel! Thanks for the great article. I had this surgery on saturday and eating is a little bit difficult. It’s also difficult to not brush at all. I am surprised because my dentist does not allow me to use mouth rinse, is the one you used “damaged” the gum at all? Thank you for your advice

    • ManagedMoms.com says:

      Hang in there with your recovery. I wasn’t allowed to use the mouthwash until the 2nd or 3rd day…not right away. My gums are not damaged at all, I am happy to report.

  3. Bruce Howard says:

    I had the pinhole surgical technique done on me on March 18, 2017. My doctor is saying that I cannot start brushing until 6 weeks after the surgery. I notice that your post-op instructions state two weeks. I wonder if there is even an exact timeframe since everyone recovers at different rates and as long as the gums have become set in their new position and the swollen has disappeared, then the brushing can resume right? What have you heard?

  4. Hi Bruce,
    My dentist gave me a sheet of instructions saying no brushing for 6 weeks which I observed religiously, and then only with a very soft brush. its a long haul!
    Glen (Australia)

  5. Bruce Howard says:

    Glen,

    It is unfortunate to hear that there is already gum recession a few months after your pinhole procedure even though as you say you followed the recovery procedures…

    Bruce

  6. Bruce, I hope your new gum line is holding up well. As mentioned mine has relapsed somewhat, but remains improved over how it was. I can’t say I’m not a little disappointed though, as things looked so promising initially.
    As for sensitivity, I had it before the procedure and still do. I don’t think you will ever be free of it, because with PGR only the front gums are lifted, behind the teeth remains unchanged (as far as I know).
    Sensitivity seems to be something we just have to learn to live with.
    Glen
    Rachel – can you let us know how you are going now, after X months.

    • ManagedMoms.com says:

      So sorry to hear that you are having some challenges now, Glen. Hang in there and I hope the improvement continues. I have done well, although I haven’t had my 6 month post-op check-up yet, so I will post how it goes.

    • Jordan Marks says:

      Hi Glen,

      I’m contemplating having this procedure.Can you let us know how you are getting on now since the procedures been done? Overall how have the results been and have you tried any other procedures?

      Thanks

  7. Michael says:

    I had the PST in Feb and had all of my upper teeth done. To be honest I have really struggled. Of the 10 teeth, I will probably get 2 done again as I still have 2mm on those however the rest do actually look aesthetically pleasing. The problem is the way they feel. I relate to the earlier comment RE itching and getting relief from chewing. I have also noticed very slight movement of my teeth which worries me. Over all it is better than it was, however the sensitivity has been replaced wirh this dreadful itching feeling. The dentist claims that she can see nothing wrong. My wife is a doctor and claims that the only way to pull the gums down effectively would be to reveal tissue that was previously not exposed so it may be that. However I am really struggling…

  8. Carey Stumpf Largent says:

    Wa
    Hat were your dentist’s rules on exercise afterwards?

  9. I had the pinhole procedure done a week ago yesterday. The bottom of my gum has turned completely white and I feel like the stench would kill a bird. Is this a normal experience? Or should I be worried with infection?

    • Yes it happened to me. It’s normal and goes away. I also had horrible itchiness of the entire mouth that antihistamines helped with. I need to het two teeth redone as well

  10. Bruce Howard says:

    Hi everyone, I am back now.

    Overall, the results of my pinhole gum surgery were quite disappointing. On 3 of my teeth, there was complete relapse. Only 1 tooth had partial coverage. I read further on the Internet and found that a major weakness of the PST is the lack of any mechanism holding the newly repositioned gum tissue in place. This stands in contrast with various types of grafts, which uses sutures to hold the tissue. I am still determined to ensure complete root coverage and will elect to have an Alloderm gum graft done on my teeth instead.

    • Denis Bayle says:

      Bruce, you made a remarkable discovery! Yes, there are no sutures to hold gums in place. Due to knowing this beforehand I decided on not using this method for receding gums. A free gingival gum graft is another method. I tried it but there are 2 wounds post op. one where your own tissue is taken from your palate and then sutured to gum recessed area. I will never go through this again. I decided to have alloderm matrix used on 2 teeth today. Only one wound! And, alloderm can be used with multiple teeth at one time. Sutures but this is the benefit. Check with insurance company for coverage.

  11. I had the pinhole dental procedure on Monday and have no pain. My biggesr problem is having food on my teeth, even the cottage cheese seems to stick to my teeth at the gum line. Am I the only one to have that problem? If so, what did you do?

    • ManagedMoms.com says:

      Sorry for my delayed comment. Have been traveling. I swished the mouthwash the dentist gives you post-op to loosen the food off my teeth. I was so happy when I could brush again!

  12. Catherine King Ward says:

    I had the procedure done June 28 (5 days ago) on both sides of my upper teeth, and everything went well. The dentist took before and after pictures to show me so I wouldn’t feel the need to peek. I was doing very well until yesterday afternoon when my left cheek swelled and became very uncomfortable. I took more medication and used an ice pack which seemed to help. Today I woke up with a very swollen and throbbing cheek right up to the side of my nose. I took more medication and am using an ice pack. Yesterday I felt weak and unwell. Today is Sunday, and the dentist won’t be available until Tuesday as this is the Canada Day holiday weekend. I don’t think it’s anything serious and I may have contributed to the problem by not taking the ibuprofen on a regular basis as I didn’t have any pain or discomfort until now. In hindsight, the ibuprofen would have kept the swelling down. On the swollen side, my gums feel swollen, slightly throbbing and are itching and it feels good to bite down gently. My dentist made this procedure sound like it was no big deal and recovery was nothing, until the day before surgery, my pharmacist handed me a bag of bottles. And then the dentist emailed me pages of instructions and forms to sign.
    My dentist is the best, and I completely trust her. So now that I have shared, I want to thank you for this blog as it has been very helpful. I will check in again to see if there are any updates from anyone and will let you know how I make out over the next day or two. Thanks again.

    • ManagedMoms.com says:

      Hi Catherine….I sure hope you are doing better. You perfectly described what I felt…that the procedure would be no big deal…but then, like you, when I was handed the big bag of meds, I decided to schedule a few extra days off for myself to recuperate. So glad I did that. I am sure hoping you are better now. Let us know!

  13. Donna Marie says:

    This surgery was a nightmare for me . The gum under one bottom tooth was alittle Lower then my others my gums were not bad. I was convinced to do my gums on 5 teeth. I bleed a lot after the surgery and left with collegian strips hanging out of my gums. My gums had stitches , bleeding for months . I was out of work many days . I couldn’t eat for months I lost 10 lbs and I’m already thin. At one point you could see all the way down into my roots on perfectly good once gums. I went to my general dentist who told me my gums were to thin for this procedure . So now I have to go see a perio dentist to repair everything this dentist did. It’s going to cost me so much more money and I’m so afraid of anymore surgery . I was thinking maybe a deep cleaning would help? I was also thinking of getting bonding done. Thanks to this procedure.

    • ManagedMoms.com says:

      I am so sorry to hear that, Donna. That is the pits. Wishing you a successful follow-up as you work to get this chapter over! Hang in there!

  14. Hi everyone, I’m new to this chat group but maybe I can offer some insight and ask a couple of questions. I had the pinhole procedure carried out in April 2017, the procedure itself was mildly uncomfortable but the recovery was fairly quick. I got ok coverage on the complete upper arch which I had done. I’d say I’m 70% satisfied. Now that I’m almost 4 months post opp I continue to have a strange feeling over the area. The feeling is almost like a slightly bruised feeling. There doesn’t seem to be any swelling and no bleeding but just a strange bruised sensation. I’m putting it down to the disturbed tissue in my mouth and possible nerves? I brush now almost as normal but a lot more carefully and have no problems other than this strange feeling. It’s not uncomfortable but I feel it mostly when I smile. Has anyone else had this? I have absolutely no sensitivity to hot and cold so I don’t thing it’s a sensitivity issue. Maybe it’s the tissue settling? Any comments would be appreciated and if anyone need to ask about my experience I’d be happy to help. Thanks for reading, Tom – UK

    • ManagedMoms.com says:

      I haven’t had this or any other post-procedure issues or complications. I would definitely check with your oral surgeon about it. I hope you get this resolved and thanks for writing in.

    • Hi Tom, where snouts in the UK did you have your surgery?

  15. Can you feel the collagen strips in place

  16. I had this procedure done last week and I still feel like I have a tube of gauze left in my mouth (all the collagen strips). Anyone else feel that way? I look like a who from whoville haha and can’t smile normal at all. How many strips of collagen did your dentist use?

    • ManagedMoms.com says:

      I would definitely call your dentist to be sure that you are healing properly. My dentist did two areas on my upper left and one area on my upper right. I do think any time oral surgery is done, is traumatic to the mouth and takes time to heal, but I would still have your dentist check you to be sure. Hang in there!

  17. Hi all,
    I had the procedure done about 6 weeks ago on my bottom front teeth and unfortunately it has receeded back to how it originally was. I followed all the instructions- no brushing, no straws, no gum, no balloon blowing, etc!! I’m very frustrated. My dentist wants to try the procedure again, but like you all said above, it’s not as quick and painless as they make it out to be. Have any of you tried it a second time and had better luck the second time?

  18. I am 2 weeks post op of a full gum graft on 4 bottom teeth. One of the grafts on one of the teeth failed. The other 3 have held.

    So now I am faced with having to address the tooth where the graft failed. The Perio is thinking that she will raise my gum there. However, I’m a bit reluctant because based on what I’m researching, the pinhole technique, etc. may not have the best results (my gum may regress after).

    I’m willing to do another graft at that site… and thinking of getting a second opinion. Anyone have any insight?

    • Alex Abernathy, DDS says:

      I would recommend the graft as a redo. Pinhole is tougher after a graft and in my opinion less likely to succeed.

  19. Just had this procedure done on my whole upper arch 3 days ago. I am still SUPER swollen and in enough pain and discomfort that I called my periodontis asking for better pain relief. He refused to offer anything other than his initial post-op recommendation of OTC acetaminophen and ibuprofen. I’m quite upset as I’ve been unable to sleep well or get through the day without being run down by the discomfort. I need my lower arch done as well but am seriously reconsidering since the recovery is not what I expected at all.

    • ManagedMoms.com says:

      So sorry to hear this, Shana. That is terrible. I would reconsider having more done, too if your recovery doesn’t improve. Hang in there.

  20. My periodontist charged me again when my traditional graft had to be redone after about a year. Have those who had the pinhole graft been charged a second time when it had to be redone? I’m hesitant to jump into this after reading some of these experiences.

    • This is a very good question as I am most curious as well. I think I have at least 2 teeth that have regressed (whole upper arch done almost 2 weeks ago). I see my perio tomorrow so I’m definitely asking if he is going to charge me again for any necessary revisions.

  21. I am following this blog closely as my dentist has recommended this surgery to me, explained it as almost painless procedure with great success. Will continue to follow this blog prior to making my decision to proceed.

    • ManagedMoms.com says:

      Good luck Jeannie. My experience was good, but I wouldn’t call it painless. I stayed ahead of the pain by staying ahead with my pain meds and that made a big difference. I am disheartened to see how many folks leaving comments here had a hard time. I guess I was lucky. My periodontist came highly recommended and I didn’t need as much as work as many of the readers here did, so that may be why mine wasn’t as bad, but any time anything is done to our gums and mouth, it is traumatic to the body, just like most surgeries. Good luck and keep us posted.

  22. I am having the surgery on Friday (Nov. 3) and I know that I will not feel too great for a few days, but I am wondering how soon people went back to work after the procedure. I am a trial attorney and my perio told me that I will want to stay out of court the week after the procedure b/c he expects a fair degree of swelling (I can’t take any anti-inflammatories) and bruising. If anyone would share when they went back to work I would really appreciate it. Tx!

    • I had my procedure done on a Thursday so I took that day and Friday off. I had 4 days total to take it easy. I had issues that weekend with pain, swelling and bruising. Honestly, I would have gladly taken the next whole week off if I could have simply because of the swelling, bruising and awkwardness of speaking (pain was better by Monday). Being an attorney where speaking is essential, I’d say take at least a week if you can if you are getting an entire arch done.

      • Thank you Shana. Your advice makes me feel much better; I thought I would be coddling myself if I didn’t go back to work on Monday. The procedure was yesterday (full mouth–top and bottom), and although the gum pain is controlled w/extra strength Tylenol, my jaw is really sore; I’m guessing it was b/c my mouth was held open so long during the surgery. I also needed to have some stitches which I know is contributing to the discomfort. I have followed the advice on this blog and have taken it easy today, but like almost everyone else, I am really tired and feel like I was put through the ringer. I am definitely taking Monday and Tuesday off and I’ll just see how I feel after that.

        Thanks again for your response.

  23. I was just informed by my dentist about this kind of procedure and I must say reading this blog and comments have been very helpful and will help me ask the right questions when I have a consult and in making an informed decision.

  24. Can anyone share some insight on how long it takes to feel “normal” and back to your regular self? I’m having this procedure done tomorrow and very concerned about the down time..

    • It will probably depend on how many teeth you are having done. I had my entire upper and lower done and I was miserable my first week. Absolutely needed pain meds. Two weeks out now and I’m feeling much better, but not normal. Gums are still a bit swollen, diet is restricted, no exercise, and I still have busing.

  25. I am only 33 and I had major recession on my uppers AND lower mouth due to braces (as a child) and years of aggressive brushing. The first perio I went to wanted almost $5k to graft 3-4 teeth (Socal). He told me I would be on the “10 year plan” as I would need multiple grafts over the next few years.

    I went to another perio (SoCal) who told me what I wanted to hear…that I would be a candidate for the pinhole procedure. This perio gace me a great price on a full pinhole procedure for my uppers and lowers. I expressed concern that my recession might be too bad for the pinhole and he told me the pinhole procedure was the only procedure that would be cost effective.

    Truthfully, I regret not going with the graft. While I did have recession in my entire mouth, I was only at risk of losing my bottom teeth. I should have just grafted them as I’m only two weeks out from my pinhole procedure and my lower area has already fallen back to where it was. The doctor did stitch this area to my teeth to try to keep it to hold AND I followed all instructions religiously. But still, it looks like I will not be getting the result I wanted. My gums were just too thin in this area. I wish he had told me this upfront.

    Right after surgery, the coverage looked perfect…PERFECT. But now I’m only 2 weeks out and with the swelling down, my recession is coming back. I’m really worried what it will look like in another 2-4 weeks.

    Recovery is awful. 6 weeks of soft foods, no brushing, and no exercise. I’ve been through multiple surgeries and this list of restrictions might be the worst combination yet.’

    I’m hoping some of my recession is improved. Otherwise all this money and down time has been a waste. And even with some improvement I’ll probably be back to square one and need a graft on my front lower teeth anyway.

    I’ll update this post if recovery makes an unexpected turn for the better, but right now, I’m upset and angry. Lots of money down the drain, 4 more weeks of a restricted diet, and 4 more weeks of being paranoid every-time I lift anything that has weight, cough, sneeze, or even smile. The post op restrictions are just ridiculous and show you how fragile this procedure is.

    • Eric, I completely agree with you. I had my procedure done on Thursday the 16, and I have three holes in my mouth with collagen strips falling out. I only had half of my lower arch done on the right side and I’m swollen and still in massive discomfort. I am regretting this procedure, and feel i should have gotten other opinions. My dentist told me the “pinholes” would heal in 24 hours, not the case. I have incisions in my mouth, three of them that are still open with collagen coming out every time I brush my upper arch. My dentist said not to look, and to follow post-op instructions and I am. Any one else have a similar experience? This swelling is ridiculous.

      • Catherine hi, great posts here. I am in my 50’s and had 1 tooth done 3 weeks ago – still tender a bit, but much better the first 10 days sucked. I am looking at doing two more bottom teeth gums at my own discretion because tenderness really is kicking down there. Perio said OK maybe, but recession is kicking in, so I am pushing it through. I stopped in to see him this week to schedule a post opp and pushed him on the recovery topic, he said that realistically it takes some times 4 to 6 months for complete healing, and comfort. that surprised me but it is real. I am going forward with the next round of grafting in a month or two – going with my gut here.
        Rm

  26. 5 weeks post-op, upper arch and I am so disappointed! I was told, with a fair amount of enthusiasm, that I was a perfect candidate for PST. I was sold on the procedure since the traditional grafts I had were so much more expensive. I thought my recession would be remedied as well as the pain and discomfort I regularly experienced with my severe condition. Well, my worst areas are not improved and the discomfort I had intermittently before is nearly constant now. My perio addresses my concerns of wasted money and effort by telling me that it’s because of enamel loss from years of recession that my gums no longer have adequate areas to attach to so the divets and grooves I feel and see can be covered over (again) with filling material. So, in essence, thousands of dollars later I only have about a 40% improvement in root coverage. My gum pain/discomfort has been increased instead of alleviated and honestly my teeth themselves look awful. I’m not sure I can recommend this procedure to anyone with even moderate recession.

  27. I had 6 teeth done, 4 moderately successful two total relapses. My question is: If I elect traditional gum
    surgery the second time (on the two that failed), is having had the pine hole technique in any way negative…does it weaken, interfer with the traditional?

    • hi i had a similar experience my surgery was elective no dentist ever said i needed it’. when i left the office after my procedure collegen strips were hanging out of my mouth too . the dentist also told me not to look! suffered with inflamed gums for months . it’s been two yrs the way it stands now i just went for x-rays and i have a lot of bone loss . i know it’s due to this surgery it’s the same area i had that pin hole done. i’m going to have la nap surgery to build bone. back up. this surgery cost me more money.! i don’t have a dental plan . it’s all out of pocket. How are you donning? i know a few people that had this done and they are worse then before.

  28. Had the procedure almost 3 weeks ago end of November. Paid $11k for full mouth over 20 teeth. The doc seems very competent and showed me pics with Dr Chao, and I had full sedation. He combined multiple techniques with the pinhole; he used my stem cells and mixed them with collagen and injected it all into my gums and used a bunch of stitches as well. Post op was very unpleasant with major swelling. I was only on antibiotics and mouthwash after. I still can’t brush except for top and behind and can pretty much eat normally. The top looks perfect but the it appears the bottom arch didn’t hold fully I can still see many of the roots exposed. Will likely need to redo or have a different procedure done. Going in to see him tmrw. Not sure I would recommend this procedure except for very mild cases.

  29. Very happy to read your experience with less invasive pinhole gum grafting surgery. This post will help many people to opt for pinhole gum grafting surgery over traditional grafting techniques.

  30. I wish I had found this one week earlier. I had PST done on 12/28 but with IV sedation. I am the biggest wimp on the planet. My post surgical experience has been similar to your, minus the steroids. I have diabetes so they will not allow me to take them. It is almost a week and the swelling is fading. The bruises are almost gone too. I had sutures put in. I think that is the most annoying part. This was much better than grafting.

    • ManagedMoms.com says:

      I am glad that this has been better for you than grafting. I completely agree! Wishing you a speedy recovery.

  31. I had 6 teeth done in late November 2017. Not worth it. Three are back down to about where they were, and the other three are half way back down after 6 weeks. A complete waste of money, time and pain.

    • ManagedMoms.com says:

      That is terrible, Leslie! I am so sorry that happened to you. My 9 month follow up checkup showed that mine worked, but from the many comments left with this article, it works for some and not for others. Wishing everyone good luck out there with this procedure and any other gum surgery.

  32. I am also in the Phoenix area. I saw a periodontist who told me I need both the upper and lower arches treated with PST and that it would cost about $20,000. I expected it to be expensive, but was shocked by this price! Would you mind sharing how much your treatment cost? Did you need your full mouth treated?

  33. Erin Hammond says:

    I am just 2 days post-op. I had 3 teeth done on the upper right side, although I feel like it’s the whole upper quadrant by the swelling. I need the same on the left but will do it in a year hopefully. I would say my recession is mild to maybe moderate. I only took Ibuprofen 800 twice after surgery and then no longer needed it. I do have swelling and it feels like a gauze roll is stuck up between my teeth and cheek. I took Friday (yesterday) off and Monday is a holiday so I will have 4 days off. I actually feel pretty good and hopefully it will be a success. After reading all the comments, I wish I would have asked the success rate. I did not have sedation (Valium) this time but I will have it next time. The pulling and noise bothered me and I don’t think I could do that part again. The surgery was pretty painless and if I felt any little thing I told my periodontist and I think she numbed it more but not sure. Like everyone else I have a list of do’s and dont’s. I am on antibiotics for a week and rinsing w8th Closys. I was told my teeth could be sensitive to cold for months.

  34. I was considering this procedure but have changed my mind based on all the failed results. Thanks!!

  35. It has been one week since I had the pinhole surgical technique. My gum tissue is so swollen that my bottom lip is protruding and I have constant pain in the surgical area. Has anyone else experienced these symptoms 1 week post op?

  36. Hi, I just scheduled the pinhole procedure for my bottom four teeth. I noticed one person said they were told not to exercise for 6 weeks!?!? I’m curious how many people were given the same instructions. I’m already trying to wrap my head around not brushing for several weeks but no exercise is really a bummer.

    Thanks!
    Genevieve

  37. I too was thinking about getting this procedure done.

    After reading these reviews, I think i’ll pass.

  38. So far, so good! I had my whole top done in October, and just had my bottoms done 2 days ago. Some of my recession was pretty severe. My post op wasn’t bad. The mouthwash, amoxicillin, and naproxen (prescription strength Advil?) Needed that for only 2 days. Definitely some swelling, but it’s going down nicely. The tops look great, huge improvement. I am still brushing them only with the very soft toothbrush. Not allowed to look at the bottom yet. I will follow up in a few months.

  39. After reading all these comments, I am wondering if my recession is too bad for this procedure. I had donor graft on upper left; some of it took and some did not. Having issues with upper front and lower front really scares me if it turns out looking worse than it does now. The comment about thin tissue is an issue for me also. I will get a second opinion. My first periodontist never mentioned this procedure.

  40. Here is the deal— PST rarely works for the lower front teeth specifically especially if you allow a general dentist to perform the procedure. Yes experience helps but they don’t perform surgery daily and there’s just something to be said for the training one undergoes to become a periodontist or any of the specialties. Yes some general dentists are great at PST but I’ve seen too many cases posted on Facebook to know of what I’m speaking. It scares the shit out of me and if the general public had access to the forum, it would scare them as well. I have no qualms about placing sutures or implementing adjunctive techniques I’ve learned in my training but the procedure is marketed to patients and dentists as “no scalpel, no sutures.” This simply restricts the options for the treating dentist but also is appealing to the patient and for the dentists who may be averse to surgical therapies or not really qualified nor confident to perform surgery. There are so many variables and nuances in the bone and soft tissue involved with surgery and this IS surgery, that can only be gained with the experience of performing surgery daily. I regularly deviate from the instrumentation and technique taught by Dr. Chao. Much of what he teaches is counterintuitive to how I and really even every dentist is trained in surgery. Ask your treating dentist about “full thickness vs partial thickness” and then “sharp dissection vs blunt dissection” and the demand about sharp instruments where it is not correct and in fact in my opinion wrong and damaging when overly sharp instruments are used.

    The course is taught over 2 days on a weekend whereas a periodontist trains for at least two years and usually 3 yrs — AFTER dental school. I know I’ll get pushback on this but it’s true. Dr Chao markets this heavily to every dentist but in my experience, it’s seems general dentists are targeted particularly as a way for them to get a new source of income and keep from having to send cases out to a periodontist. If one wants to be a periodontist get the grades during dental school and excel! Then apply and do the extra training to be a periodontist and not stay in a hotel for two nights and now be called a “Pinhole Surgeon!!!” The Facebook forum is filled with “experts” giving less experienced clinicians advice and this scares me equally perhaps even more. What really pisses me off is that prior to taking the course I was required to sign a document stating that I would not teach anyone how to perform the technique under the threat of a lawsuit since he has patented the procedure. As a healthcare professional, we are always taught to share our knowledge or findings with fellow professionals to help people, not line Dr. Chao’s pockets. A large part of the course are the sale of marketing tools and website enhancements for Dr. Chao. The cost of the instruments are obscene as well. This has become a huge source of income for him and the PST “Academy.” Enough ranting but this needs to be said. We’re called specialists for a reason.

    Back to the results or common failures I should say. There is simply too much musculature in the lower front to have predictable results. I have had very nice results with some lower anterior cases and truly what appears to be ABSOLUTELY no change in just too many to perform the procedure in that area exclusively any longer. I took the course to learn the technique but as an addition to my arsenal not as a primary treatment option. I perform connective tissue and free gingival grafts in the lower anterior but I still will treat that area but only if I’m treating the entire lower arch. Yes it involves scalpels, sutures and tissue removal from the palate (or use of cadaver tissue) but it works and is predictable. I’ve had to do too many revision surgeries on the lower front teeth. It seems to work somewhat better in that area when the entire lower is treated probably because of the larger release of the gingival tissues. I know for sure that there are other periodontists who feel the same way as I’ve talked to three of them about this.

    The technique has great value in most of the other areas particularly on the upper arch. This is an esthetic area and expectations are high and PST can deliver here.

    Gain knowledge and have the treating dentists show you results of their cases. Plenty of pictures are taken and in fact Dr. Chao really pushes this concept on the trainees. It does help with learning but also can be a resource for patients. Do you research and then make an informed decision.

    • Peter Cabrera says:

      As a practicing periodontist for over 35 years I am somewhat alarmed by some the comments on this site, as many of you are asking the wrong questions.

      What is commonly called “gum recession” is really the visual appearance of an underlying set of problems. The visual appearance is NOT a diagnosis. There can be a WIDE variety of contributing factors to the visual appearance; ranging from disease, to skeletal makeup, bone and tissue thickness, position of the teeth in the bone, etc.. etc.. etc…
      The key is understanding and addressing all of the underlying factors, understanding the specific anatomy of the patient and performing the most appropriate procedure for the specific patient. The grafting is ONE aspect of treatment. Many times other types of treatment are indicated in conjunction with grafting.

      Depending on the problem, the treatment can vary from monitoring, to no treatment, to using the patient’s own tissue to a wide variety of what are called tunneling procedures of which the so-called pinhole is BUT ONE. All tunnels are performed through small openings, but that does not mean they are necessarily less invasive. In some cases, a blind dissection can be quite risky. Especially in untrained hands.

      The roof of the mouth often gets a bad rap. In reality, the risks and complications are minimal if you have the appropriate patient. If the patient’s mouth cannot safely provide the tissue needed, you simply do something else. The main complications that I have seen over the years have to do with clinicians who did not properly diagnose where they are taking the tissue from.

      I would be INFINITELY more concerned about the provider than the procedure. A well trained, skilled specialist can make many things work with minimal problems. Would you have your family doctor take a weekend course and then do your knee surgery the next week? Probably not.

      Three concluding thoughts:
      1. UNDERSTAND your diagnosis and contributing factors. ALL of them!
      2. Know something about the surgeon. Are they well trained in all aspects of periodontal surgery so that they can recommend the best procedure for YOU? or did they receive a weekend certification? If you only have a hammer, all problems look like nails.
      3. ALL procedures have pros/cons, possible risks and complications. If something sounds too good to be true….

  41. Peter Cabrera-
    Well put and much more diplomatic than my post but nonetheless true. I probably went overboard but the culture developed with the PST practinoners is cultlike. Peter Cabrera is correct. He obviously knows the concept of Maslow’s hammer or has read all of the PST forum posts. Well stated Dr. Cabrera and your 3 concluding thoughts are a blueprint for better results. I’ll not comment again. I’ve said my piece. Sadly because of the blowback my name will remain anonymous for several reasons at least for the time being.

  42. Thanks for all the experiences. I went ahead with a pinhole procedure to deal with recession on gums above a row of four teeth on one side of my upper jaw. My experience with Dr Kelvin Hall in San Francisco was great (well… relatively speaking). Pain was pretty mild. I never used the pain prescription he provided. Ibuprofin – full dose of 4 pills – was sufficient for the immediate post op pain as the injection pain killers wore off and for the intermittent problems for the next 36 hours. After that there was minor swelling and dull ache for a week or so, but nothing bad. I was pretty wiped out by the surgery and pretty much lay around doing little for the first 48 hours but was back to work after that. The careful eating (cutting everything up like feeding a baby and chewing only on the opposite of my mouth) and brushing kind of drove me nuts, but I stuck with it and have now made it past the magical 6 week mark with no fall back recession. I’ll continue to try to be cautious with my eating for the next 4 months and have a special super soft brush to use on that area for that duration. Hope I can keep it all in place while it solidifies!

  43. Dent Hyg says:

    I am a practicing dental hygienist going on 26 years. Before having any gingival grafting done, your occlusion (the way your teeth fit together, top teeth to bottom teeth) and occlusal habits (grinding, clenching) should be evaluated. If your gingival recession is caused by occlusal trauma (hitting on one tooth or certain teeth harder than other teeth) or malpositioned teeth (crooked teeth), the results from your surgery will be temporary at best. If your general dentist can’t tell you (although he should be able to), then I’d consult with a reputable orthodontist to determine if your bite is contributing to your recession. It’s an extra step but one that could prevent issues and save you money in the long run.

  44. Works in Dental Field says:

    You can protect and save your gums by brushing twice a day (but not too hard), flossing, eating healthy foods (avoiding sugar) and seeing your dentist twice a year. Ask your dental hygienist or dentist to show you how to brush and floss, many people do not do it correctly. They can also help with dietary suggestions. Periodontal (gum) disease is not a normal condition, you can prevent it.

  45. It has been 3 months since I had the pinhole technique done to 4 of my bottom front teeth. Not only did the procedure not work, but my recession is a lot worse. I’m very disappointed, and worried about my teeth.

    • Jenny Aprile says:

      Gail, Was the recession better at first? I had it done two weeks ago on my top arch and I’m happy with the results so far but I’m surprised and a little worried because my front teeth are still pretty sore. We’re your teeth sore after the procedure?

  46. Does grafting give better results?

  47. Just had my surgery yesterday, all my uppers. Fortunately, my experience is the little pain the dentist said to expect, not what people are reporting here. Just wanted folks to know it happens. Right after the surgery it hurt a lot . I took the maximum Vicodin dose once, and now not even ibuprofen. My greatest discomfort is having to sleep on my back so I don’t rest my cheek on my hand. I went grocery shopping after my checkup today (walked slower and hubby did all the lifting) and feel energetic enough to take my dog out for a stroll in the woods. Still, i think I’ll start with 1/2 day work on Monday.

    Based on what I read here, I went to my regular perio dentist to see if I’m a good candidate. He’s no fan of Chao because he keeps his technique so proprietary and expensive, but said the technique itself was fine and my gum tissue was thick enough that he recommended it. My gums weren’t so bad that he thought I needed him to do more grafts. At my checkup today they said all looked good (would they tell me if it didnt?). They were straightforward that on two of the worst teeth I might not get full coverage, but enough to protect the roots some.

  48. Pete Newnon says:

    Great advice from many sources…thank you! Nobody has mentioned cost which is important to me. WOuld you all be so kind as to tell me what your financial obligation was for this procedure?

    I really appreciate the guidance and advice.

    Sincerely
    Dan K.

  49. Heather Janas says:

    Hey everyone! I just had the pinhole technique done on one of my front teeth. it’s been 5 days so far, there isn’t any visible swelling, however it feels like there is a cotton ball under my lip. how long does it usually take for that feeling/swelling to go down?

    Thanks!

  50. Hi. Im 5 days out from procedure. Minimal pain, just a throbbing on the bottom gums. Biggest concern is a slight smell and whitish discharge from one tooth. The dentist assured me i had no infection, so what coukd it be?

    • Heather J says:

      I have a little bit of white discharge from my tooth too. I haven’t touched it because I’m positive I’m not supposed to. I am going to the dentist tomorrow for the first cleaning, I will let you know what he says it is!

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