Any surgery can be a difficult choice to make. Bone loss prevention is a difficult reality for many, especially when it has begun to affect their face. Dealing with a protruding jawline or the loss of an adult tooth are signs that you may need to talk to your dentist about a dental bone graft.
What Is a Dental Bone Graft?
A dental bone graft is a method of strengthening the existing bone structure or replacing lost bone. This is often done when dealing with removing teeth, replacing them with dental implants, or a handful of cosmetic reasons. The procedure is relatively simple, with an incision in the gum tissue along the jaw and grafting (attaching) other bone material to what is already there.
Grafts are usually done when someone has lost one or more adult teeth or suffers from a severe gum disease case. Most dentists and oral surgeons prefer to use bone from the patient’s hip or jaw as the “golden standard” for grafting.
Types of Grafts
Using bone from the same person is called autograft. When the bone comes from another person, usually a cadaver, it is an allograft. A xenograft uses bone that does not come from a human, usually a cow, pig, or coral. As the modern world progresses, so does medical science, leading to synthetic bone material and supporting membranes. Alloplast is a graft using such material.
Reasons to Have One
One of the most common reasons to get a dental bone graft is to reinforce the existing jawbone to secure dental implants. Implants are artificial roots shaped like screws implanted in the jawbone and often topped with a crown matching nearby teeth. Having a bone graft can provide a strong base for those implants. Of the 800 dental implants performed and recorded in a study in 2016, over half required a dental bone graft.
Another common situation when patients need a bone graft is tooth loss or gum disease. The graft is to support the jaw structure. It helps provide stability to the jaw to prevent some long-term health issues from bone loss. Mismanaging gum disease can lead to further tooth loss or compound it into heart disease.
There are some more cosmetic reasons to schedule a dental bone graft. Patients who suffered an injury to their jaw may want to try a graft to change their appearance to what it was before the injury. Poor dental hygiene and infections can drastically change the nearby tissue and bone structure as well. With general bone loss, the overall appearance of the facial structure could look shorter or cause a protruding lower jaw. Skin can appear more wrinkled around the cheeks and chin. Lips and muscles around the area can change shape. In general, osteoporosis is a huge culprit for bone thinning in older adults and can affect any bone in the body.
How Painful Is It, Really?
Because the bone from the same patient can come from their hip or tibia, the harvesting of bone for a dental bone graft is a separate surgery. Grafting the bone orally is done while the patient is sedated. Post-surgery recommendations include over-the-counter pain relievers. If the pain is severe or the work was extensive, the surgeon or your dentist may prescribe pain relievers.
Patients usually feel discomfort for several weeks, although it can turn into months if they underwent the two surgeries in two locations. In general, the healing time for both is relatively short in comparison as the grafts are usually small.
For How Much?
While the procedure is commonplace, the costs can vary, and not all insurance providers cover dental bone grafts. Ranging from $400 to $1,200, you can get animal, cadaver, or synthetic grafts. Having to undergo two surgeries to use your bone increases the cost to $2,000 or more. If the graft is medically necessary, insurance may cover a portion of the costs, but it is unlikely they will provide any assistance for a cosmetic request.
Preparing for a Graft
Your dentist or oral surgeon will determine any surgical preparation. You will more than likely receive a walkthrough with them as the surgery date approaches. As an easy reference, it is vital to remember three major items: most procedures require you not to eat or drink anything for 8 to 12 hours before the scheduled time, will need to update your dentist on your current medications to make sure the anesthesia will not affect you negatively, and because the surgery is done sedated, you should plan to have someone pick you up instead of driving yourself.
There are three types of dental bone graft procedures. Block bone graft refers to the use of bone from the back of the jaw, usually to fill in the front. The graft can come from where a wisdom tooth is or was. A sinus lift refers to the upper molar area that has degraded, allowing the sinuses to fall. This procedure supports the sinus area and affixes it to the proper position. When you need a tooth removed, sometimes a graft is put in its place to avoid further bone loss. That type of replacement is a socket graft.
Recovering From a Graft
Again, your medical professional will give you instructions to ensure your recovery and aftercare and get you back on your feet. The incision is packed with gauze with instructions for the dressing over the next 24 hours. You will receive a prescription for antibiotics and, if the dentist or surgeon feels it necessary, one for higher dosage pain relief.
It is common practice to use ice packs on swollen areas during the first day or so. It is best to eat only soft foods for the next few days to prevent infection from lodged pieces. To prevent any blood pooling in the area, Dr. Dhiraj Sharma suggests elevating your head when you sleep.
You will also get recommendations on what to avoid after your surgery, including hot liquids, hard or crunchy foods, and physical activity that may cause the incision to reopen.
After one week, the dull pain turns into mild discomfort, a few weeks will have you feeling more normal, and a few months will mean you are ready to receive implants. Post-surgical visits are common, and often at least one of them will include an x-ray to check the progress.
What Do I Risk?
Some potential side effects resulting from having any surgery include swelling, pain, difficulty chewing or speaking, and risk of infection. Some other unusual but serious risks include your body rejecting the bone graft, blood clots, anesthesia complications, or nerve damage. If you experience pain that persists or worsens post-procedure, redness or increased swelling by the gums, persistent numbness or tingling, or an implant becomes loose, that may indicate your previous bone graft failed. Contact your dentist or healthcare provider if you notice any of those symptoms.
The More You Know
Dental bone grafts are a form of prevention regarding long-term health problems with tooth loss and gum disease. They are often used to support dental implants with sufficient bone material. Surgery is a common procedure that is usually safe. There are risks of side effects and complications with any surgery. Please refer to your doctor and dentist during recovery for any concerns.
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