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. 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 for me. It isn’t pleasant and many others had a harder recovery period, but I did OK. 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.
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)
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.
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
Hi Glen,
I am considering the surgery. I also live in Australia. Where did you have yours done?
Thank you,
Fernanda
I was not sure if anyone had been posting on this recently but I wanted to ask a question. I had the procedure done 8 days ago. The first 5 days were really hard. I followed all the instructions but my face was SO swollen and I had so much pain. At 9 days the swelling has gone down but still have some. I did 10 teeth, all upper. Now that the swelling is down, it feels like I can feel the strips in my mouth above my teeth? Did everyone’s look perfect the first week?
I had my check up at 7 days and he said it looked great. Although today it felt weird like something had moved. I took a tiny look at my front teeth and it looked like I can see tissue or a trip sitting on top, maybe not in place? If that makes any sense at all. I have not looked again, I know it is really important to not obsess, look or pull up your lip in any way. I have been very strict with what I eat so I do not cause any damage.
I agree with a few people that this recovery was way different than I was told. I was told it would be really easy, hardly any pain, immediate results, just no brushing for 6 weeks. After when I was leaving I got the list of long instructions saying no working out for 3 weeks, etc.
Did anyone get that feeling where you felt like you could feel the tissue or collagen? Or that something feels out of place? I figured maybe this is apart of the healing process? I know they said to not look or judge until 6 weeks, so why do they say results are immediate? It is a little confusing to me.
Hi Charlotte – I had the same experience with the pinhole technique. I had 9 upper teeth done in May and that feeling that your gums have stretched and you can feel tissue or collagen has not gone away even after 4 months. I can now see the gum pulling away again from 3 of the teeth – true, it is better than before the surgery – but I wonder what will happen in the next months if I am already seeing recession.
Expectations were not set for me either during my first meeting with the periodontist – I asked how soon I’d be back to normal and he said 3 days!! I ended up with 2 black eyes severe enough for me to have my ophthalmologist check them out, bruised lips and a face so swollen that I could not leave the house without worrying that people would stare at me. This lasted a good week and the black eyes and lips took at least a month to heal even with all the Arnicare and Vitamin K cream I applied.
And don’t get me started on how brown my teeth were from the Peridex mouthwash and no brushing!
That also lasted about 10 days and my taste buds were shot so nothing had any taste.
Note: in my opinion – Peridex is red and tastes worse than the generic Chlorhexidine which is blue ask for the generic version – I think it stains less as well.
I was also made to sign a form saying that I had the opportunity to ask questions!! How can I ask a question if I don’t even consider it to be something I might face – like no working out for several weeks! That never would have occurred to me. I think boards like this wouldn’t have so many negative comments if the doctors would just set realistic expectations in the first place.
It’s unfair not to allow people to prepare adequately for how much this surgery will impact their lives. Tell them not to plan important client meetings, social events or travel for at least a month – yes it might scare them off, but they will be better prepared, less scared when the see the results and will worry less that something has gone wrong.
Hi Glen
Where in Australia did you have this done as I am in NZ and cannot find anyone who performs it
How was your PST for both top and bottom? I t has been 3 years since your post from 201709.
I am planning to do the surgery soon.
Thank you!
Peter
My pinhole grafting was only done on my top gum. It has been successful with no further dental work needed, I am happy to report. Good luck with your surgery. Remember that any oral surgery is hard on the body so take time off post-surgery to fully recover and be patient through the recovery process. Take it day by day. I hope yours goes as well as mine did. Thanks for leaving a comment.
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
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.
I had the pinhole surgery done yesterday in Boca Raton, FL. I have read some of the comments on this post and am wondering why their experience was so horrific in some cases.
1). I asked if antibiotics were required or necessary. I was told they are suggested but considering my good health I should fill the prescription and be aware of any sign of inflammation/infection. I did this but I am using herbs and rinsing my mouth w Splianthes.
2). I could eat mushy foods straight away. Nothing hot till anesthetic wore off.
3). I was/am swollen but to be expected.
4). I brushed my teeth last night as doctor instructed. Why aren’t people brushing???you leave the gums alone to heal but yes I brushed and warm water rinse.
5). Today, day 2, warm salt water rinse / listerine. I’m using Spilanthes instead.
6). I’m taking 800 mg Motrin. I won’t need it later today. I feel better already. No pain. Just swelling.
7). Many of you were given that oral rinse that stains your teeth. I was told it was not necessary.
8). I feel great. A little tired but so happy I did this. I took my dog for a 30 min walk after surgery and ate a big bowl of lukewarm soup.
9). This morning I went for an hour walk w dog. I’m going to take a nap and get some more healthy food.
Don’t be afraid of this procedure. Oh yes – I have stitches. No biggie. I am glad he used them. You won’t feel a thing. The novacaine is the worst part. I’m so happy I did this.
Where did you have it done in Boca Raton since that’s where I live and need a referral? And are you still happy with the results?
I used a saltwater rinse, heat a cup of water, and a teaspoon of sea salt. Move your head side to side and let it slowly drip out the side or front of your mouth. This is in lieu of mouthwash… anything with alcohol like Listerine is not good after gum graft or pinhole.
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?
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)
Glen, I just wonder how long it will be before my cold sensitivity completely goes away…..
Hi Bruce. My gum sensitivity has gone away, but we will see if that lasts.
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
I had this procedure done 4 years ago. DONT DO IT. I have scarfing of the guns about my upper teeth from being stryched and yanked to tighltvduring the procedure. It created tethering which is what happens when scar tissue shrinks. It is still uncomfortable after 4 years.
The procedure was a nightmare for me and the healing process difficult. The second day after the surgery I was puffed up and bruised so badly that I had to take prednisone and an antibiotic. Of course I could not Brody for 6 weeks and not solid food for all that time.
You never know how you will do with acprocrdure. I wish fir all the world I had not done this AND 4 years later my gums have receded back to the Pre op state. 4,000 dollars wasted. I had all upper teeth done at ince. Bad idea.
That is terrible that happened to you, Patty! I am the author of this article and one year in a half later I am doing well, no pain, no negative effects and my recession is fully healed. I will say that I only had several teeth done. It sure seems aggressive to me that an oral surgeon would do ALL upper teeth at once on you, Patty. Also mine was done by a peridonist who came highly recommended by my dentist and had all excellent reviews. For those considering this procedure, I would definitely take all that into account as well.
Patty, where did you have your procedure done? I am on day three.
Where did you have this procedure done? And with what doctor?
I agree! DO NOT DO THIS PROCEDURE!!!!!!!!!! I was talked into doing my upper gums which NO DENTIST ever mentioned that they had any recession. Now, I do not see any difference even though they were pulled down obviously with the tugging I noticed during the surgery. What I do notice is that one of my gums is now HIGHER!!!!! than is was and is now detached from the tooth. It looked like I had perfect upper gums before but the dentist just did the surgery to make extra money. My lower gums to look a little better but it was not worth the price, painful recovery, and I feel like my gums will always have this pain/tingly sensation that will go on for years!
Hi Party and Randy,
Did you find a way to get rid of the tingly, itchy feeling? My pinhole was 1 year ago and I still have this annoying, irritating feeling. Unsure what I can do as living with this is simply terrible.
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.
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.
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
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…
Wa
Hat were your dentist’s rules on exercise afterwards?
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
That’s infection. That is NOT normal
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.
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.
Yes, how did the alloderm graft go?
Hello Bruce,
I am wondering if you had the Alloderm gum graft and whether that technique was more helpful.
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?
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!
I get food stuck between my cheek and my upper gum. I had my upper arch done, so I am afraid to reach in there and push it off. It is driving me crazy.
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.
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!
Sudden swelling, throbbing, and itching are all infections signs. Swelling should peak at 3 days. By five days any new swelling is the body telling you something is wrong. For the love of god people, call your dentists when these things happen. The type of infections that occur can be life threatening, they are literally an emergency. Call emergency dentists, not forums.
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.
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!
need to have this done also what causes gum recession I was told tension i already have been told my gums were to thin to have the procedure this isnt a good problem..i have perfect teeth and bad gums
@ Donna Marie, I had both upper quadrants done via PST well over a year ago and overall things went really well. What you went through sounds like a real nightmare. Perhaps it was the practitioner and not the procedure that contributed to all the problems you went through. My dentist went through the PST training over ten years ago, then waited ten years to monitor the results of PST patients to determine for herself if this is a procedure she would want to offer her clients. I was one of a handful of her first clients doing the PST surgery and all went well throughout the procedure and the healing period. Sure, there were uncomfortable moments and the inconvenience of losing my usual dental care regimen for several months, and not being able to eat some of the foods I love, but I followed her instructions to a tee and actually have scheduled to do both lower quadrants done this January.
To me, it sounds like your dentist really wasn’t experienced enough…letting you walk out the door with collagen hanging out of your gums? Really?? That’s just awful! I am so sorry you had to endure all of that, it’s just not right. Perhaps not even ethical. I wonder what other reviews of that dentist are like, and if anyone has reported he or she to the dental board.
My dentist took the approach of “learn the procedure, keep up on all professional publications and notifications pertaining to the procedure, watch…and wait.” And after ten years, she gave it her own “go ahead” and as of today, she is also an instructor teaching other dental professionals how to do PST and I honestly cannot say – overall – I have had a very positive experience.
I it’s been awhile since i posted i believe the dentist was extremely negligent. He kept me bleeding while tending to other patients .Came back and injecting me with more novicane. i have a thyroid condition i disclosed and i’m highly sensitive to novicane. I thought i was going to literally die. I never had recourse i signed off to get my money back. It was torture to this day and it has been 3 yrs my lower gums are numb i clearly have nerve damage. When i think back and how he wanted to redo my gums i told him i wanted to speak to my dr first. Then he gives me a firm for her to sign to clear it would be ok for me to get surgery . Something he should of did to begin with now he was worried but trying to involve my dr. I wasn’t going to redo this anyway. It was torture. Right now as it stands i’m looking into a gum graph with a perio . No longer will i get talked into having more teeth done then i need. have them look at my teeth and tell me i need other work done.upselling that is not legal . My experience with this dentist had left me so afraid to have another dentist touch me. I believe having this done on the lower gums aren’t as successful because of gravity . this dentist even told me after the fact after he got my money. your dentist sounded incredible doing case Study’s. This is only a weekend course to learn this teqnique. I urge others to go with a perio check them out with dental board . Go with your gutt unfortunately i didn’t go with mine .
Ooh and i remember as clear as day if he does the procedure again i will be the only one he will be working on . I regret getting a refund i am concerned about the safety of others and there is nothing i can do.
If you receive this email, can you please reply to me. I had pin hole surgery to repair gum recession and it ended in similar to your surgery. In fact, the doctor performed the surgery twice and then tried a graft. All failed. I am at a loss of what to do next. I have one tooth which has no gum covering the roots. My dentist told me to leave the tooth alone, but it’s very sensitive. I’ve been told I have bone loss due to the pin hole procedure. I’m very interested in hearing what you’ve done since your surgery failed too.
Hi Donna, I had a similar experience with pinhole gum surgery as you did. My gums are a mess and I have on tooth that the roots are completely exposed. NO one wants to touch it, but I have so much sensitivity, I don’ know how I can possible ignore this problem. I would love to hear how you made out following your failed surgery.
thanks for yiour coments,, I would seriously consider getting the tooth extracted, saves so much pain and money, after reading allthese comments I think that is the path I will be going down.. wishing you the best
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
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?
hi Tom I am also from the UK and considering this surgery- as far as I was aware there is only one periodontist in the UK who performs this. Can i ask where you got it done? And if the uncomfortable sensation has now improved?
Can you feel the collagen strips in place
Not at all. I have done very well with this surgery, I am happy to report 🙂
Hi who in n.y or n.j. is the top expert
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?
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!
I just had this done five days ago and asked about the collagen strips also. I guess it depends on placement and how far they had to pull up the gums. I even had a couple strips come out the first two days. Then there was a time that I could see a white area. I asked was told that was the college strips under the surface. So I guess each case is individual as to the amount they put in.
Debbie, did you end up healing okay? Could you feel the strips or something out of place?
Do you still have the feeling of gauze in your mouth?
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?
Hi Kristen,
I’m curious, did your dentist cut your frenulum on your bottom lip before he did the procedure? I haven’t had the pinhole procedure done yet because I had to have my frenulum cut to ensure it wouldn’t pull down on the gum line. It has to heal for at least a month before I schedule the PST. I only have 1 tooth that the gum has receded badly but my dentist says he has to loose the gun tissue from the 2 teeth on either side to pull the gum up. I’m nervous but there’s no way I could go through the traditional grafting.
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?
I would recommend the graft as a redo. Pinhole is tougher after a graft and in my opinion less likely to succeed.
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.
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.
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.
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.
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.
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.
I agree, take a week off! I was puffy and could not talk well either for a week. I am on week four… and my entire mouth done with grafting and pinhole combined. I am able to brush the insides of my teeth and brush the outsides with a q-tip and hydrogen peroxide.
WOW you are a better person than I could even think of being! I only had One quadrant done and it still hurts. I cannot imagine my whole mouth feeling like this. Interested to know after one year how you’re doing and how long it took you to recover? I’ve never heard of anybody having their whole mouth done! You are one brave lady!
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.
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.
How are you now?
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
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.
Where did you have it done? I’m 10 days post on entire upper jaw. Swelling mostly gone but still very sore. So far all looks good. Praying it stays that way. Done in Ormond Beach, FL.
Now 17 days in and things are going really well. Swelling gone. Pain for the most part gone as well. Gums still feel enlarged (due to the intentional over correction but i think this is a good thing). I was allowed to start brushing my affected teeth/jaw after 1 week which is great. Still can’t bite into anything and no hard/sticky foods. Very happy so far. I believe this was a good choice and i had an awesome doctor. I fully trust that my results will continue to get better with each passing day.
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.
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.
Good comment. Mine was definitely mild, so that helped my situation.
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.
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.
I am glad that this has been better for you than grafting. I completely agree! Wishing you a speedy recovery.
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.
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.
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?
Check out Dr. Ariel Trujillo the cost is much less ( about half of what you posted) and the office is very nice.
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.
I was considering this procedure but have changed my mind based on all the failed results. Thanks!!
Ditto.
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?
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
I was told only moderate exercise for 3 weeks, then anything is fine.
I started exercising after 3 weeks.
I too was thinking about getting this procedure done.
After reading these reviews, I think i’ll pass.
I had a graft done to one of my bottom teeth 20 years ago, and it still looks amazing (they took material from the roof of my mouth). The verdict for me is still out on my recent pinhole with my top teeth.
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.
Naproxen is aleve.
How did the bottom turn out?
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.
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.
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….
<3 Finally someone who sounds like a real doctor! Perfectly reasonable!
Have been considering gum surgery. Thank you for your remarks!
thanks so much for your kind comments and learned too.. it sounds far too much likea money grabbig exercise for general dentists and Dr CHao than anything else,braces take 3-5 years to reposition teeth and often don’t last anyway, so a quick fix with nothing to hold in place seems unrealistic.. thanks again
Hi,
first of all i’m shocked this is the only place on the web that i have found honest information about pinhole needle technique.
i am six months post op from having pinhole to my upper and lower mouth.
i would NEVER, EVER recommend getting pinhole. Almost all of my gums have receded again. Dr. Chao and his cult clearly do an excellent job marketing this procedure. I educated myself on the procedure, and only found promising information. Its only now that i’m dealing with the devastating results that i’ve come to conclude that if you’re going to receive gum surgery it should only be done by a periodontist.
Thanks for your valuable feedback doctors. I have been to Dr. Chao’s and “Dr.” feedback rings true. Thanks for honesty and truth. This is a teaching moment <3
I´m glad to know there are still doctors left over who can make use of their brains ! Honestly, I´m scared to life in this fast forwards generation with the gloves off
I agee with you dr thank you for speaking your honest mind. I did this surgery because no pain back to work the next day no stitches no bleeding . I had all of this the best part was my gums came out worse then when i went to this dentist . It is very deceptive I m looking into a lower graph with a perio.
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.
Thanks for your honesty. We need more professionals like you two.
Not sure why you would receive negative feedback. Did not pick up an ounce of negativity. What you are saying is reality. I am a Psych NP and while I believe that I and others do a good job, I also recognize the disparity between a 3 year part-time masters program versus med school followed by a lengthy residency/internship. Your post makes complete sense. Seems like that happened with Invisalign but with more risk. Ok, let that stuff roll. Am on the receiving end of of severe hostility over benzos on plenty of days so have learned to develop a thick gum, I mean skin! Wow, so bad. Trying to decide between graft or pinhole. Not sure yet.. Keep posting!
Meg, please remember that they are all grafts. So your decision as stated may not be based on good clinical information. In order to obtain tissue thickness and cover the roots as much as possible, a soft tissue graft may be needed in conjunction with other treatment.
Depending on the nature of your problem, a variety of different procedures could be indicated. If you have good anatomy on the roof of the mouth, your own tissue may be best. There are a number of ways to do the grafting depending on your anatomy. One of them may involve a tunneling procedure. The pinhole is one of many tunneling approaches. It happens to have the most marketing and uses pig collagen. You could also use a human derivative So if you are having a pinhole procedure, you are having a graft done.
Find a good experienced periodontist who can do a comprehensive evaluation, can perform any procedure, then you decide what is in your best interest.
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!
SO glad that yours went well, like mine did. I know that doesn’t happen for everyone.
Hi Tom- I live near SF and I am considering the pinhole procedure. I found a website for Dr. Kelvin Hall. Can you confirm this is the same doctor? http://www.kelvinhalldds.com/
-Vivian
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.
Thanks for your valuable feedback. I wish you were my hygienist…when I read your post, I felt you were reading my mind. Indeed, and so sad, my dental issues started by a malocclusion caused by a holistic dentist I had trusted…this dentist was working on a crown when in the midst of treatment he said that my bottom teeth were being hit hard by my top crowns…unfortunately, he didn’t do any testing to verify, (and I was kind of spaced on the treating table…) so he proceeded to reshape my natural bottom teeth, taking away my natural healthy enamel…One of the worst mistake I have experienced. Right after that, I felt like the rug was pulled from under my teeth…When he tried to fix the problem, he ended up creating more problems…Moving forward, I have tried to explain my issues to other dentists, most didn’t buy my story and some had elaborate procedures they recommended. One good dentist said that bonding to the bottom teeth would not last, which sounded honest and reasonable. He also helped correct my “bite” a bit. At any rate, I’m still searching to find answers; so I find comfort in correct diet with emphasis
in re-mineralization…and in posts like your and others.
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.
There are so many more factors related to recession than simply oral hygiene. Medical conditions, gum thickness, medications, and more.
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.
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?
At first the results looked great, but after about 6 weeks the recession came back, and it is now much worse than before the procedure. My teeth don’t hurt but my gums still hurt when I brush and floss. I am very disappointed I have a lot of bone loss which affects the results.
I hope you found another alternative i am in the same boat as you. This isn’t for everyone there a lot things i should of considered but i learned from this experience . Have you looked into gum graphs?
Does grafting give better results?
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.
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.
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!
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?
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!
Hi..I had procedure 3 weeks ago and my gums are still swollen from the collagen strips. Is it normal? How long it takes for the strips to get dissolve?
Two months later, I have to rate this as a failure.
Had a recessed gum at an old crown. The gum had fallen well below the crown margin and some amount of tooth had been worn away by over-brushing.
Had the PST work done on March 14, 2018. Procedure seemed to go well, dentist made two pinholes and seemingly stuffed the gum with an abundance of collagen strips.
Swelling set in 2 days later. The gum line had been lifted up well above the crown line, but this was an unrealistic perspective, for the side of my face was swollen like a chipmunk.
I followed the periodontist’s instructions perfectly. Soft food only for four weeks. No chewing on that side. No brushing on that quadrant. No Water Pik.
First day was ok on Advil, followed by nothing at all. Then the headaches set in. I began suffering “ice pick” headaches behind my right eye (same side as the procedure). First return to my dentist, he basically ignored my complaint.
After two weeks of blinding pain, went to my md, who prescribed gabapentin, to lessen the nerve inflammation. This did nothing.
Upon my return to the perio, he took x-rays, to make sure there was nothing the matter with the tooth – there is not. He offered to refer me to another doctor, clearly having no idea as to the problem.
The problem is this… after two months, the gum area still feels enlarged. My gum is sore & occasionally painful. I am naturally clenching / holding my jaw, which is putting pressure on the entire side of my face. And hence the headaches. As remedy, I am staying on Advil – self prescribed – to break the pain cycle.
Worse, little by little, the gum has recessed to the original position. So, I have spent $1700, gone through several months of significant pain and have not accomplished a thing.
My general dentist wanted to remove the crown, lower the tooth and put on a longer crown. This is what I should have done and may end up with this eventually. For now, I am trying to get back to normal. If providing advice, I would not recommend the Chao PST and encourage interested parties to investigate other doctors (dentists) and approaches.
I’m convinced.
I had this surgery four days ago and I’m in a significant amount of pain. I’ve had extensive dental work so I wouldn’t consider myself as pain intolerant. This pain rivals having six wisdom teeth removed and requires constant management with more ibuprofen, etc. than I would normally be comfortable taking. I can’t help but feel angry that this procedure is marketed as “painless” and generally, as no big deal. I’ve had to take unanticipated time off of work due to pain and difficulty speaking. I wish someone would have told me beforehand that it could be incredibly painful, that someone with thin gums as myself may see the gum recede back anyway, thereby wasting my time, effort and $1700 out of pocket in addition to whatever balance was paid by insurance. I now am losing time from work, can’t exercise, brush or eat normally for six weeks and fear that my recession will be worse for having this done. My thin gums don’t appear to be adhering to my teeth and instead are falling down, with bits of white who knows wha lining my gumst. Now I’m wondering how necessary this surgery really was, I wasn’t told my teeth were at danger currently of falling out. I’m hoping that I feel differently in a few days but I’m just frustrated at the weird, wildly inaccurate marketing around this. I’m mad at myself that I didn’t research it more thoroughly on my own. I trusted my dentist too much and should have delayed this procedure until it was truly necessary and had it done by a periodontist. Thank you so much for this forum, I noticed there’s not much on the internet about this from patient perspective so I appreciate being able to share.
Bless your heart! That is awful! Hang in there, Kara. I am glad you are sharing. According to the many comments on this post, you aren’t alone with your post procedure struggles. I had a good experience, but there sure seems to be way more negative feedback shared here since I wrote this article, so I hope this helps all in this forum to really research this procedure (and really any dental/medical procedure) extremely thoroughly, find the correct doctor and type of doctor (as you say) and also assess the risk with procedures that are “new” and “cutting edge”…ugh. So much to navigate through, I know. I do think that any surgery, no matter how simple the docs and others may say it will be or how common a doctor will say it is, always requires a challenging recovery time. I have yet to experience a procedure (myself or my family) that was an easy recovery time. My husband’s surgery for carpel tunnel syndrome, his leg surgery, his gallbladder removal surgery, my two C-sections, my son’s wisdom teeth removal and my son’s biopsy…all a tougher recovery experience than what we expected. I sure hope things improve quickly for you, Kara. Hang in there. I sure feel for you. Thanks for sharing your story and I sure hope you get better soon!
Thank you, I really appreciate it!
It doesn’t sound like my pain was as bad as yours but I was still very surprised at my level of discomfort when just about everything out there talks about how painless this surgery is. I’m over two months post-op (entire upper arch was done) and my teeth and gums on the front 4-6 teeth still don’t feel right. It makes me wonder if this guy Chao makes people take down anything negative about the surgery and this site just hasn’t been found yet. The procedure seemed to work for my mild recession but the one place it was really bad it already receeding again.
I do hope you are feeling better! How is it going? As I am right behind you in all the same thoughts…I was told 1.5 days to recover and of course, made plans to go to exercise…hahah…still on the couch 9 days later…
I would like to know if any of you used Peridex mouth wash for 6 weeks instead of brushing or doing something else. If you did use Peridex or another brand of chlohexidine, exactly how stained were your teeth by the end of the 6 weeks. I have a job where I am presenting to the public, and I can’t run around with brown teeth. Thank you for your reply
I used the Peridex twice a day for four weeks, the fifth week I started to notice the staining and started only using it once a week and then switched to Listerine after that. Luckily my front 4 teeth are really smooth and this prevented them from staining but there was some light brown staining on most of my other teeth that was removed at the end of six weeks when they cleaned them for me. Also, I cut out coffee and red wine for six weeks.
I cut out coffee and red wine just like Jenny. I also researched an alternative to Peridex called Oracare. it is only dispensed by dentists. The Oracare website will provide a list of dentists where you can buy it. It was $44. It tastes like pool chemicals, but it promised not to stain and the research shows better effectiveness than Peridex. I wrote to Dr. Chao about his opinion but did not hear back. So I did the Peridex for 3 weeks and now switched to the Oracare. My teeth were starting to get a gray tinge on the Peridex after 3 weeks.
I just made the 1st consultation appointment with Dr. Chao but after reading these comments, I think I will pass on his method. Thanks, one less person to feel your pain!
Wow, I agree. I saw Dr. Chao earlier this year…but was suspicious and not in a hurry to jump-the-gun…I did not like the Conniving strategy. Now I am full of gratitude for this forum.
Hi-
I had this done on one crowned tooth a week ago…and have been couch bound ever since with pain that is higher than what I was told to expect. My oral surgeon irrigated the site yesterday and I am hoping that this will subside as he says the surgery went well. After reading these posts, I, too, wish I would’ve waited until absolutely necessary as I know guess my dentist will want to replace the crown fearing that I have developed an allergy to the alloy this old crown was made of….anyone heard of that? I have 2 other bridges and those gum lines are fine! Oral surgeon says over brushing was the cause…I am on pain meds and Aleve and am very disappointed in this procedure also. I was told 2 day recovery and back to life except for soft foods for only 2 weeks….Any advice? Anyone think there was nerve damage causing this pain?
Thank you!
Managed Mom, thank you for this forum. I am a general dentist trained in the Chao Pinhole technique. I took the course twice to ensure my skills would be appropriate for good care for my patients. The Perio specialists make good points. Provider skill and treating patients that have the right recession make all the difference. The lower front four teeth are the most difficult due to the lip muscle pushing and pulling the treated area., Combine with a shallow fold and success is much less predictable.
For anyone with gum recession on the lower front teeth considering this technique I recommend looking in your mouth for a few things and it will help predict how much root coverage you will gain AND keep.
1) put your finger gently on your lower front teeth and use your lip to push off your finger. If you can easily push your finger off your teeth you are less likely to get good results ( you probably have heard your dentist or hygienist say you have a powerful lip)
2) Look behind your lower front teeth for two things> Do you have recession on the tongue side and do you get a lot of build up ( tarter and calculus) between dental visits? Both of those are negatives.
3) Do your gums fill the space between your teeth or are there black triangles? Lack of gum between the teeth indicates bone loss between the teeth. No bone to support the graft pinhole or traditional means after treatment gums will end up close to where you started.
4) When you look at your gum in the recession area is it see through and all the little blood vessels visible ? Is it thick and has the texture of an orange peel? See through gums are very delicate and much more likely to be damaged in the surgery ( ANY surgery).
So for those that have had the Pinhole treatment follow the post op instructions carefully! Anything that moves the gum will detract from the success. Traditional gum surgery depends on sutures to hold things in place. Pinhole depends on the collagen acting as glue and filler between the teeth to stabilize the loosened gums. Picture using lots of padding on your shoulders to hold a v neck shirt tight against your neck ( The 80’s style for women!)
Minimize swelling by lots of ice for the 1st 48 hours.
Swelling that shows up after 3 days or smells bad is most likely infection and antibiotics will be needed in addition to the antibacterial rinse.
I wish I had read this BEFORE having the procedure done! I can answer YES to all of the questions. And so I suppose I should not be surprised that my gum has receeded back to where it started. I had the procedure done about 1 month ago and the periodontist now wants to push the gum back up and suture it in place, hoping that will help.
Openplzdds thank you for your post! I met with a highly recommended periodontist yesterday to evaluate my badly receded gums. I had grafting done on one of my lower quadrants 30 years ago (I think it was a cutting edge procedure back then) and it was so traumatic for me that I opted not to return to get my other lower quadrant grafted. Fast-forward 30 years and my other lower quadrant has BADLY receded. I went in to my appointment yesterday expecting to hear about grafting procedures I would need and instead the periodontist talked only about the pinhole procedure and was ready to schedule mine right away. Since I had never heard about this procedure I told her I wanted to think about it (research) over the weekend. It was so hard to find any info on the internet until I found this site and your post in particular has solidified for me that I will NOT be getting the Chao pinhole. I answered yes to all of to all of the questions in your post!! Thank you for helping me dodge a bullet on this one!
Hi everyone… I’m 4 days post op of the Pinholes surgery. I saw some comments regarding feeling like there’s a cotton ball under their lips. I have this feeling as well. Can someone let me know if the gums will shrink down to looking close to normal again or is this permanent? I’d appreciate it.
I also had the Pinhole surgery. My dentist did the left side of my mouth first . This allowed me to chew on one side during recovery. My gums look great – no receding so far. I only took Advil and an antibiotic and was back to work the following day. I was eating a normal diet 3 days after the procedure. The worst part was the swelling because I had to walk around looking like a chipmunk.
Yes. I am nearly a week out from surgery and the pain rough! I am trying to remain hopeful – results looked great after surgery but after reading this post I have Become concerned.
how long did it take for the swelling to fully go away?
Three weeks post surgery and some days the gums swell to where I feel them when puckering my lips, but then there might be a few days they feel fine. Is this normal?
Interesting and concerning exchange. I had the PST done on my upper arch 4 days ago. Although I would like to discontinue the Ibuprofen fearing gastrointestinal side effects, due to the pain, swelling and bruising will not yet. The restrictions involved with this process are tough, but I am assuming they mirror those for conventional grafting. With deep recession my greatest concern after reading this exchange is the stability
of the process; this was way too expensive and too much trouble to have it fail. I’m encouraged by those who have had good results and sorry about those who have not.
Perhaps I will be able to judge the success of the procedure within 2-3 months after which time Ian due to have my lower arch done. I’m not too sure now if that is such a good idea. We shall see.
Best to you all, Nan
Hi, how are you doing now after almost 3 months.
I will have the procedure done next week, and as anyone here I am looking for positive comments. Still I am scared.
Hope everything is going good for you.
Mary
I had the Pinhole procedure done in March 2018. I was totally sold by doctor John Chao by his online videos and that it was a lunch time procedure. Bullshit! I am so upset and I’m so disappointed. This has been the biggest waste of my time and money. No dental insurance. I paid for this out of my own pocket. I am now suing my dentist and I’m considering suing doctor John Chao.
Mine was no lunchtime procedure and my oral surgeon told me to factor in recovery time and I have done well. I wish your experience would have been like mine, bless you. Wow…I see why you are considering suing.
So sorry Kristin. I was at Dr. Chao office earlier this year and did not like his tactics… They did manage to sell me on the dental cone beam CT which I regret doing. I hope you stay brave. I admire you, since I too wanted to sue a dentist who messed up my perfect bite, but became overwhelmed…in addition, my lawyer informed me that in California the statute of limitations is one year. Stay strong.
I just had mine yesterday and wish I would have read all this of before hand. I was not told how painful and how much swelling. I wish I had never done the procedure. They are calling in an antibiotic just in case. I was sold that this was nothing and people go back to work the same day..Not the case for me. Really consider if you need to do this or not.
That is frustrating that you are having a hard time, Joanna. As you can see in the comments, a lot of people agree with you. That is why I wrote this article to challenge all the online discussion that call this procedure simple…not the case. In my article above, I stated that my periodontist told me to take time off to schedule a recovery period and to take the meds he prescribed me. He never ever told me that I could return to work the same day. You can see the box of pills that I had to take in my photo above in the article. Thanks for leaving your comment so others can know that what you were told is incorrect. Hang in there.
I’m sure I’m having Internet problems since doing this through my phone. Not receiving a reply, so I won’t be posting anymore. If you can read this, I hope you all have positive outcomes and continued luck in the future.
Hi Tara. I am the author of this article. It has been over a year since I had the procedure and I am well. My gums did great. I did have to go through a recovery period and I think I felt back like myself again for the most part after about 5 or 6 weeks later. If you are still having problems, I for sure would check with your oral surgeon. I am wishing you a positive outcome, too. Thanks for reading this article and for leaving comments. Oh and my gums are totally back to normal and did completely shrink down with time. I had the cotton ball feeling for about a month.
I found this site by searching for PST reviews and this is the first site that popped up. I have my procedure tomorrow but a little worried since most of the reviews on this page have mix views. My procedure only involves two tooth which should be a quick according to the dentist but as I am typing this, I am just worried if something goes wrong. It’s definitely pricey but hey, if this is for a better smile and to take care of your teeth, why not? Hopefully, I can provide an update this week and how everything went. Any advise on pre/post procedure? I hate the fact that I need to wait six weeks until I can brush that section and eat soft food for a few weeks as well. Does anyone know if it’s a bad idea to at least wait a week to hit the gym?
Hi Dave, by now you have had your procedure. I hope that it went w
Post surgery (of any kind) it is best to avoid overt exertion because raising your blood pressure effects inflammation and deters healing. Your dentist should have given you a list of does and don’ts and that should have been one of them. My best to you for your PST.
For the record and to whomever reads this I am nearly at the 4 week mark post surgery, having had my entire top arch done by an experienced periodontist. Even following the many strict rules as best as I could, I am already seeing recession on several teeth. Darn. I will have to see what my periodontist thinks when I see her in two days. This process has been quite rigorous and quite frankly no fun. I’m still hoping for a satisfactory outcome.
Hello,
So yesterday was my procedure and gotta say, so glad that it’s over!!! I was really nervous and sweating before the procedure started but my dentist reassured me, that it’s a quick procedure which I believe lasted about 40 – 45 minutes to do just two teeth. There was some discomfort during the procedure which I said to myself “Why am I doing this, please GOD let this be over”. I had no pain after the procedure and even today have no pain whatsoever. I was given Ibuprofen (800 mg) and Motrin (250 mg). I took the Ibuprofen an hour after the surgery in case any pain was coming down the tunnel and today morning. I feel my gums a bit fuller which I believe (where the procedure was done) is filled with collagen (I think she used membrane). One complaint is that you must accustom yourself to eating soft food and no hot liquid for a few days and also, no brushing that area!!! I will keep reporting on my progress.
Wishing you a good recovery!
Hi! I just had my PST surgery on August 17th by my friend that is a periodontist. I have had 2 failed traditional gum grafts on my upper canine tooth earlier this year by a different periodontist. The last one was in April. My friend who is a periodontist did 4 teeth (for free!!)including the canine tooth that previously had failed. I am now 4 days post op with the PST and I have had a ton of bruising and swelling and pain and when I went in for my first post op, my periodontist said my gums looked good except a little bit of old blood on the gums above one of my canine teeth. Now I am getting some old blood leaking at times. Has anyone had any bleeding a few days post op? Just wondering if this means it is failing Thanks!
I did have a little bleeding the next day, so I went to see my oral surgeon to be sure that all was normal. It was but I always go in to see the doc to be sure! It did not mean that my procedure failed as mine was successful. Wishing you success and a good recovery.
Thank you so much! My fingers are crossed! 🙂
Just left a Periodontist in Houston TX. I too have very thin gums and she recommended the pinhole procedure to me with a price tag of $30,000 for upper and lower. My dental insurance will cover $400-$500; and medical insurance covers nothing. My mouth dropped wide open when she showed me that price; and she acted like it was no big deal! $30k cash out of pocket and wanted to schedule my 1st appointment in 3 days from today! I couldn’t run faster enough from her office.
Have another appt with another Periodontist next week but after reading comments, I’m scared to death now that this problem I have can’t be fixed!
Scared shitless in Houston!
Wow, my periodontist charges $2500 a quadrant, so a full mouth would be $10,000. I did the upper arch for $5000. My dental insurance will cover it up to my yearly max, which is $2500.
Whoa! I am in San Francisco and I got 3 quadrants done for $8500. And in case you don’t know, things usually cost way more here than in Texas! I would call around and try somewhere else. That seems bananas to me!
I think the pinhole thechnique is very successful……. at separating people from their money, and not much else.
Has anyone brushed the teeth that were not treated with pinhole. I had my full upper arch done, so I don’t see why I can’t brush my bottom teeth. I also don’t see why I can wipe my upper teeth very carefully with a dental wipe. Thoughts?
Yes, I was able to brush my bottom teeth normally after 2 weeks. I too had the full upper arch done. I am at 7 weeks post op and my left side has healed quicker than my right side. I am still feeling “weird” under my front lip as if there’s still cotton swabs in there? Can anyone tell me when that feeling goes away and I still feel like I don’t have my old smile back. When I smile my top lip doesn’t raise where it normally would raise up to and I still feel like my top lip sticks out alittle which makes me think theres cotton swabs underneath. I know it varies for each individual. I just want to feel normal and be able to have my old smile back soon.
I’m having the same issue with swelling in my cheek. I’m worried its a complication that may not be resolved. Did anyone warn you about this side effect? When I showed my dentist my swollen face 3 months post procedure he looked concerned and spit out a bunch of medical terms that made no sense to me.
It is now 2 months since my pin hole procedure and I still have constant dull pain on the left side of my mouth. The worst part is that the left side of my mouth is also puffy and droopy and makes me look like a chipmunk. has anyone else experienced swelling that wont go away? I went back into the dentist twice, he seemed a bit concerned but didn’t give me any real answers as to why my face still looks distorted. It’s a bit disconcerting because it has change the appearance of my entire face. The interior gums looks ok, but 2 of the teeth are already receding back to their previous appearance so it looks the procedure did not work as as expected.
Hi! I’m only a week post OP and have the same puffy droopy smile. i know its only a week bu tim terrified its permanent. did yours ever return back to normal??
I got mixed reviews on any type of gum sugery, so knowing I don’t do well with any dental anything I thought this would be the best options because they said it was minimally evasive.
I needed my whole mouth done, they did it at one time.
I was ok until all the meds from the sugery were off and expecting to go in to work 4 days later was flat on my back in pain. A week later I’m still working on soft foods and praying that I haven’t done any damage to the work.
I saw all the reasons this doesn’t work and none of them apply to me and I think that as little as I want to do this again if there was any other way to reverse this I’d do it.
I believe the collagen used in this procedure is Bio Gide or Bio-OSS by Geistlich. This is sourced from pigs. This may be causing allergic and inflammatory tissue reactions presenting as itchiness etc.
Eye-opening information. Thanks.
I have some gum recession on only two teeth. They are 2 of my lower front 4 teeth. I need to get this corrected before I get Invisalign. I had braces as a kid but i neglected my retainer in my youth and now my teeth have shifted and i am very self conscious about my smile. My perio has me slated for the pinhole procedure as well as a frenectomy. They are going to remove the ligament that connect from my lower lip to my gums. He says this will get rid of the downward tugging that that ligament does. However, I am now terrified after reading your comment section that this wont work. I’m fine with pain and spending the money on the procedure if it works. Not I am worried that it wont. The Perio I am going to is the one my mom went to. She and every other dentist and orthodontist I’ve talked to say he is amazing. Am I being nervous for no reason?
Really, it depends on the individual, the procedure being done. Make sure you ask lots of questions prior to the procedure, it sounds like you’ve done your research. I came into it with a positive attitude but did get scared after I saw how swollen my face got,it took a good two weeks for the swollen to go down. Again, it varies for each individual. I should of taken the 800mg motrin prescribed every 8 hours for inflammation, but I didn’t. Make sure you take it for inflammation. I have to say I was scared where this healing process was going because so many things were changing in my mouth and my face didn’t look the same. This is due to the gum tissue still taking its time to slim down. I am at 8 weeks post pinhole and just had a visit yesterday with doctor, all is healing wonderfully, It takes patience. I couldn’t smile well but slowly my smile is coming back, once the gums slim down more it will be easier for me to smile. I am just remaining positive about the healing process because each day its starting to feel better and soon I will be fully healed. Make sure you are brushing teeth with a soft tooth brush and brush downwards. I think everyone commenting on this site is searching for answers regarding this procedure as I was too but the bottom line is we all heal differently and may have different situations as to why we need pinhole. Some of these comments terrified me too! But we can’t read into it too much…..I pray all will go well for you. Best of luck!
These posts are very informative. I will certainly avoid this procedure after reading the vast majority have had negative experiences and outcomes. Thanks for being so open, honest and willing to share.
I agree. I am so glad I initially wrote this because all of the feedback and comments have been very informative. I see that I was super lucky that mine went so well.
Thank you so much for starting this thread.
Yes. Thanks you. This thread is so unique and valuable.
I had this procedure five days ago. My Periodontist was honest with me and told me it would be painful/uncomfortable. There would be swelling and bruising. I had five teeth done on my lower left quadrant. The first day after the meds wore off was bad. The second day wasn’t as painful, but had a drive for five hours the next day and that wasn’t so great! Still uncomfortable and I can’t imagine I could return to work tomorrow if I had to. Thank heavens I’m retired. Best thing I can say is don’t try to tough it out, take the pain meds and keep ahead of the pain. I did not do this and I paid the price. My doctor told me two weeks of soft foods, I could brush the areas that were not worked on, but stay away from the quadrant that was worked on and any teeth adjoining it. A couple of the collagen strips came out, and there is blood around one tooth. They told me not to look but as usual you can’t help it! I was just careful with pulling the gum not putting any pressure on it. Looks like most of them are doing well however one gum seems like it has receded. Still a bunch of white stuff, which I’m assuming is the collagen, around the tooth next to it. Anyone know if this may possibly change? Can’t say if I’ll go back for the upper quadrant I still need to do. Guess time will tell.
Oh forgot to say she told me to sleep on my back and not to put my hand on my cheek (like you do when your jaw hurts!) She also gave me a thick gel with a long nozzle to put along my gum line. Said to stay away from mouthwash, swishing and spitting and straws.
Hello Everyone,
My periodontist suggested me to undergo this procedure. I seems that it would be a success to cover the roots of my teeth but it shows it is not a guarantee that it would last longer.
I had this surgery 63 hours ago and I wanted to share my experience so far. I had 3 quadrants done at once, the 4th quadrant didn’t need it. I’m not sure how many teeth he did because I was charged by quadrant. I trust the guy since I had LANAP from him a few years ago and it seemed to help. I was able to keep my periodontal disease mostly stable after that.
For the surgery I didn’t get any additional painkillers or valium or anything. i just had the shots in the mouth of local anesthetic. Though, if I were to do it again, I’d just ask for valium or something to keep me feeling a bit more relaxed. It’s not the most pleasant thing and I had to sit there for 3 and a half hours. The procedure it self was okay. It felt like an aggressive cleaning. It didn’t hurt because I was numb but I could tell he had to put some muscle into it.
Afterwards, I was numb for quite awhile. In fact, the next morning I woke up and was still numb on part of my face/lips. I was a little freaked out because I read that you can get nerve damage with local anesthetic sometimes but a couple of hours later I could feel that it was starting to subside.
I had my visit the day after and he said that everything still looked good and all of the collagen strips were still in place and he took some photos but I didn’t ask to see them since I don’t want to end up obsessing over it too much.
I feel like I’m getting more swollen by the day but I stopped taking the ibuprofen and tylenol last night and it hurts a bit. It’s pretty uncomfortable and I don’t see how they can recommend that anyone goes to work the next day. I can’t even imagine going to the grocery store looking like this! I read somewhere that swelling can peak 48-72 hours after surgery so hopefully things will subside. I also feel pretty gross and a bit grumpy because I feel uncomfortable and have dirty feeling teeth. I haven’t eaten anything but soup and smoothies because I don’t want to risk messing anything up.
I bought a waterpik since in my instructions it says I can use it on the lowest setting from the inside but I used it once and I’m also a bit afraid this will mess it up so I think I’ll wait until after my one week checkup to ask my dentist about it and make sure everything still looks good. My teeth feel so gross and apparently I’m not supposed to brush them for 6 weeks. I can brush the quadrant that didn’t get any work done but what’s the point. I feel like I might damage it trying to get a toothbrush in there with everything being so swollen. He said every time I come for a checkup (except for the one that was the day after), they will clean my teeth for me. I am prescribed Therasol mouth rinse but it doesn’t help that feeling of having sticky teeth with a layer of grime.
I hope things turn out well for me. I still think it’s probably better than the alternative but I agree with the others that say this is no walk in the park! I think if you’re going to do this surgery you probably need at least a week off of work. Luckily I decided to do this while I’m in between jobs so I don’t have to worry about it.
Just went in for my first week post-op check-up and so far so good. I also got clearance to brush the inside of my teeth (tongue side) which is a relief.
I’m having less swelling but still have some pain in my jaw that comes and goes. It makes my whole head hurt. Hopefully this will subside soon but as of now, I’m still taking 2 Ibuprofens from time to time.
Hi Monique,
Just have the pinhole surgery on November 14, and I can say your description is very similar to what I experience. I went to see the periodontist 5 days after surgery, and he was happy I was taking good care of my healing process, only liquids or smoothies, and have to keep that probably for longer. Now, after 10 days of the procedure, the swollen have subside a lot, but still I feel like something bulky under my right cheek. When, someone says something funny, I try not to laugh but still bothers and I am afraid that the movement of my cheek can interfere with the healing or the treatment. I have no pain, but sometimes I feel a very very mild pain inside.
I will return to work this Monday (I am a college professor), so I hope it will be ok, and my second visit to the periodontist will be this coming week.
I know everyone heals differently, but how are you feeling now after two weeks of your procedure? I hope much more better.
It’s been almost 3 weeks for me. I have my check-up tomorrow morning and will probably post an update again then. I still feel like there are lumpy things under my gums. Sometimes food gets stuck on top of them and it’s really uncomfortable. I’m pretty sure it’s the collagen strips. I think the speed at which they are absorbed varies from person to person. I’ll ask my dentist about it again tomorrow if I remember. I believe last time he told me it usually takes 3-4 weeks. I don’t really have any pain but I do have a lot of sensitivity.
Good luck, Mary! I hope you heal well.
Good luck in you check up. I went yesterday for the removal of the stitches, Doctor says everything look that is going well, but still need to eat only fluids (soups, smoothies, etc). The bad thing is that because I cannot brush the upper part I feel my mouth is not clean enough, but he insists for now I can only rinse it with salt and water and a special moth wash. I two weeks I ella see him, so hope the treatment is still working. I don’t have pain, but it is a bit sensitive, and I feel something there probably the collagen.
I will cross fingers for our treatment to have good results. Good luck today 🙂
Thanks, Mary!
I went for my 3 week check-up yesterday. He showed me the before and photos from yesterday. It definitely doesn’t look as good as it did on my first week check-up but I looks greatly improved over the before photo.
I’ve looked at a lot of these before and after photos online for the Pinhole and I think when they post a day after or week after photo, it’s a bit misleading. From what I understand they pull the gums down further than they will likely end up so a post-op one week isn’t going to be what it ends up looking like. I think what they’re aiming for is root coverage. If you look at the study, root coverage is how they measure success with the procedure. Another thing you can’t tell from these before and after photos is when they’ve been taken. Most of the time, the timeline isn’t marked on the photo.
Back to how things look so far. If they stayed as they are now, I would be pretty happy. Most of my roots are covered other than about 3 teeth but he did a lot and these 3 teeth are mostly covered. You can just barely see the root.
He said that there is sometimes a phenomenon called ‘creep’ where during the few months after the procedure the gums will move up slightly. So there’s a chance those roots will be covered during next 6 months as I’m able to brush again and improve my hygiene. I looked it up and it is such a thing called ‘creeping attachment.’ But I can only find literature on this happening with traditional gum grafts. Though, in general, it’s really hard to find information about the Pinhole other than the same marketing materials and variations on the 6 week post-op protocol.
When he was cleaning my teeth, they were super sensitive. I even took 3 ibuprofen before I went this time. Lately, they haven’t felt too sensitive only during and after I get them cleaned. He said that it’s normal for the teeth to be sensitive and once I start brushing and can use a de-sensitizing tooth paste that should help.
Oh also, he mentioned that it was normal for me to still feel like there was something under my cheeks but didn’t mention how long I would feel it. I didn’t think to ask how long because this was before he looked at my mouth and I was nervous to hear how things were going. 🙂
Thanks a lot everyone for your feedback / review. Almost all look genuine. I am so disheartened because I was looking very much forward to PST. Now I will definitely avoid this.
If anyone comes across a real genuine treatment pls share.
Mary, I’m curious how you’re doing. I’m at 4 weeks and starting to feel a bit more normal.
I think I’m back at the point where I can’t tell if it’s better than it was. I was convinced after I saw the photos that it was much better but I have since forgotten what the photos looked like and now I’m not sure. Hopefully he’ll give me copies of them.
I’m looking forward to being able to brush my teeth again. Finding something to eat that doesn’t get stuck is getting frustrating.
I know they consider you healed once the pinhole heals (after 24 hrs), but I don’t really consider things healed until I can go about my normal life. So anyone considering this surgery keep in mind that there are 6 weeks where you have to follow a long list of restrictions.
Hi Monique
I went for my third visit to the doctor exactly four weeks after surgery. He check how it is healing and said it was going well. I have some sensitivity, so he gave me a extra soft toothbrush to brush only the teeth but not the gums. Also I got my teeth cleaned and polish, I was worried with the cleaning but I guess they know what they are doing.
I need to continue on the liquid diet after I see him again the first week of January (almost 8 weeks after surgery).
In terms of how I feel, I feel almost back to normal, except for the food and the brushing, I have no pain, just sensitivity, and dry mouth (for what I got a homeopathic mouthwash). He did not take pictures in the last visit, and even when he said everything looks that is healing well, I can see that the roots are covered but not 100%, as you were also explaining about your case. I would like to see pictures to know how much it is covered. I am following all the instructions word by word, so I hope my gum can heal and the roots of my teeth get the most part of it covered.
I guess for the periodontist when saying everything look well they are considering that effect.
Let’s see,
How much in percentage do your roots after surgery
Sorry my question was incomplete. How much percentage of your teeth roots were covered by the process.
Just hope the coverage of my roots stay within the “optimal” range published in a research.
I had this procedure done four days ago and the pain was at it’s worse 48 hours post surgery, and never higher than a level 5. I don’t do well with pain or dentist so this was the best procedure for me since I wanted to be awake and able to drive myself to and from the procedure home. So, far feeling good about it and just hoping that it will work. I think the worst part has been the swelling but is looking better and better each day. Speech has been affected, but I think is due to the swelling. I do agree that there is no way this is an over lunch procedure. There is a recovery period and you should plan in being off from work for at least four days. If you job requires a lot of speaking then maybe more. Tomorrow is Monday, five days after surgery, and I will be staying home. I will update if anyone is interested in how my recovery and success rate goes.
Nestor, your comments are similar to my experience, too which is why I wrote the blog piece in the first place. It is very true that the procedure is not as simple as some tout it be online. But for me, my recovery went well as long as I stayed down for a few days. Now almost two years later, I can tell you that the procedure worked with no ill side effects years later. I also must stress to those reading this comment, it is crucial to find a periodontist who is reputable and has performed this new procedure extensively. So glad yours is going well so far and I hope your road to recovery goes as smoothly as mine has…but it does take time. Wishing you well. Thanks for reading my blog and for leaving a comment.
How are you doing now?
Thank you very much for all very informative comments. I have considered to have PST, but I may not do it due to the cost and especially the outcome.
I just found out there is a new technique called ” RejuvaGum Lift™, also known as French Gum Rejuvenation™. Utilizing Advanced-Platelet Rich Fibrin (PRF), this gum grafting procedure is performed by processing a small sample of the patient’s own blood to promote faster healing and regeneration of areas affected by the recession of the gums. No tissue graft is taken from the roof of the mouth, eliminating an often painful process and reducing recovery time” by the doctor in Los Angeles area. Has anyone known about this one?
Thank you,
I am so grateful for this post and all of the comments. I had a lower frenectomy earlier this week to prepare for the PST on 1 of my lower front teeth. After reading all of the comments, I’m not sure that I want to proceed with this procedure. I went to, who I thought was, the only provider (a dentist) in my area but I have since found a periodontist who also does this procedure. I think that I will go see her for a second opinion.
I’m very nervous to have the PST done especially after the dentist told me that the laser frenectomy would be no big deal and there wouldn’t be any pain. Well, that’s not true and at 3 days post -ectomy, I have to be very careful how I move my mouth and have to chew with my mouth open or it’s pretty painful. The area is also swollen and feels bruised to the touch. I guess I feel like if he thought this was no big deal, what in the world is the actual PST going to be like???
I’m hoping that the frenectomy was a big contributor to the recession and now that it’s done, along with wearing my night guard, the recession will stop or at least slow to the point that it can be monitored and I can put any gum procedure on hold. I was interested in the PST because I’m a baby when it comes to dental stuff but now, hopefully, I can hold off until something better and not so painful comes along.
I too had the procedure done in Pennsylvania on 1/18/19. My regular dentist said there was nothing that could be done for my recession so I believed him. A couple years later I decided to see another dentist who recommended me to a local periodontist. He told me about the two options and I chose the Pinhole procedure. There was some tugging I felt, but other that that the procedure was not too bad. I was asked if I wanted a few narcotics for pain and I opted for none. I had read to alternate Ibuprofen and acetaminophen which I did and It worked just fine. The was some jaw pain, but very little swelling. I did not care for the dry mouth and lips I had, but it is getting better. Sleeping on the side is not allowed as well as chewing. I only did soft foods for a few days, but avoid real crusty things and no sticky stuff. Not brushing in that area for two weeks was not fun, but I was giving a gel to apply.
I was not told about all the return visits that were required, but I was relieved to be told each time things were looking good. Speaking of looking, you are not to look or run your tongue on the area which was a bit trying. All in all I am happy I pursued options and now my roots are not showing!!!
That’s cool to hear. How are things now?
Just had the PST done on my upper gums across the front 7-8 of my teeth. Found this article several months ago and got 2 different opinions about gum recession grafting. The first was from one of the top periodontists in my state who is actually a teacher of this method. He did my daughters implants so we already knew him. He actually suggested this technique to me – I did not mention it. He said he only does it after a complete exam and knows that the patient is a great candidate. Second opinion periodontist recommended traditional grafting with allografting (donor tissue). I did not bring up PST. Turns out, he knew about it but was really young and I don’t think he was trained and comfortable in the procedure. By the way, both options were within $300 of each other.
Anyway, I really prepared for the procedure, exercised a bunch, ate really healthy, quit drinking 30 days out (for my own goals) and had it done last Wednesday. Had sedation – the bomb!!! Didn’t remember any of it. Went home, rested and started into my recovery. The worst swelling was day 4-5 for me. I used the 800mg prescription advil and extra strength tyenol and it helped a lot. I iced religiously and after my followup, they recommended warm compresses to help with the achies that happen esp at night. My gums feel weird tbh – very smooth. I am brushing as allowed with a very soft brush in the area. Just started eating more real food and yes…..craving a steak right about now! I took 3 days off of work and the weekend and I needed all of it. Just not 100%. Looking forward to the nerves to settle down – not really pain just tingly….guess its the healing. I think if you need to have a large area done this is a good option since having to cut up the roof of your mouth is not great. Or you can use Allografts. Hopefully it gets better and better…..I was told he wouldn’t do this on the bottom teeth – gravity etc leads to less good outcomes. Good luck. Pick a very well trained periodontist, not a weekend trained dentist – my 2 cents.
I have been told that I need to have the pinhole procedure done on many of my top teeth and a graft done on my bottom front teeth. The total is going to be over $8,000. I do not make a ton of money and I am concerned if I do this that it will not last or will need to be done again. Have your dentists charged when it needed to be fixed or didn’t seem to work? I have had the grafts done several times and have no issue with that process. Do you feel that it the better way to go. I would appreciate any and all opinions. I am really struggling with what to do because of the cost.
The answer is more straight forward than you may think…. if you have a clear and accurate diagnosis. What is it that you are trying to fix and why did it get that way?
“Gum Recession” is NOT a diagnosis. It is the visual appearance of an underlying set of problems. Have the doctor explain in simple terms what are the underlying problems that have led to the roots becoming exposed. If those are not identified and managed along with any surgery, you will end up exactly where you started.
Revisions are occasionally required with any clinical procedure. The healing process is not entirely predictable. Depending on the circumstances and timing, most of us do not charge for revisions. It is simply part of the process.
Finally, nobody NEEDS to have a pinhole procedure, it is simply one of the many possible treatment modalities available. The one procedure that is universally applicable in every case does not exist. Find out the specifics of your problem, the different treatment options and then a clear explanation for what/why is being recommended. Don’t do anything until you are clear on all of these.
If you don’t get a comprehensive diagnosis and path forward, perhaps you may want to consult with someone else.
Thank you for all the info you post, really appreciate it. I am looking at Laser surgery to fix bone and pockets in teeth, was hoping that was the only procedure needed but it seems tissue grafts are the next step in the process, not really sold on that idea so I will do more research.
I had my surgery done in November and now we’re in March and my gums have mostly receded back into the position they were in before. It’s still a little better than it was so hopefully it doesn’t recede even more. I still have a lot of sensitivity. Hopefully that gets better with time.
Had my upper left quadrant done yesterday. My face is swollen on the left side. Prescribed and taking Motrin every 6 hours, Steroid for a week, Antibiotic for a week, no brushing the site, and prescribed mouthwash 2x a day.
When can I resume biking? I spin vigorously. Can I resume in a couple of weeks? Why is no exercise part of the recovery and can someone please help me understand what exercise is safe to do when?
Thank you!
Any Dentists or Peridontists in Perth Australia perform this surgery?
I had three quadrants done four days ago and the swelling and pain is excruciating. I have had jaw surgery and five implants and the pain and swelling from the pinhole surgery is far worse. I am very unhappy because I was not warned the pain could be intense. To make matters worse, my mom died two months ago and I broke my ribs a month ago. I was in no shape to do this procedure. Now that I read it might not even work, I wish I never would,have done it,
Hi Kathy,
I am really sorry that you are going through so much at one time. I had the Pin Hole procedure done 8 days ago. I felt the same way for the first 5-6 days post procedure. I was very swollen on the procedure side and bruised. I was not prepared for the post op mooshy/liquid food, no exercise, swelling, and overall discomfort and fatigue. I took steroids, Motrin 800mgs 2x a day, and antibiotics for a week. The Motrin helped with pain and swelling. Once the swelling went down (about 6-7 days post procedure) and I’ve been able to eat more foods and I am feeling better, my mood improved too. I basically cut up all my soft foods and put the fork to the side of my mouth that wasn’t worked on and chew carefully. I drink a lot of Glucerna and Boost to stay full. I hope your pain decreases very soon and you feel better.
Nancy, are you still on the soft food diet? I had my procedure March 27th, so a little before you, and just had my 3 month follow-up today. They still say I can only eat soft food, nothing crunchy or chewy. It just seems crazy to me, and it’s extra hard during summer you’re much more likely to have social gathers that include all kinds of chips and appetizers that I’m not allowed to touch…
I just had my 6 week post op cleaning with Dr. Kathrina Agatep in San Diego. I like my results so far, and I’m healing well. Swelling the first week, but I was back to golfing by week 2. I’ve been eating mostly soft foods, although I broke the rules a bit over the weekend by eating a bit of pizza. Probably not the best idea, but I just couldn’t resist. She charges $2,500 per area (I did 2) and she was nice enough to give me a discount since it wasn’t covered by my insurance plan.
3 months post-op. I have super mixed feelings on this procedure. Despite clear evidence of bad recession and multiple appeals, insurance still isn’t covering a dime of the $8000 cost to do most of my upper mouth. The recession has bounced back on a few teeth – not fully, but a little bit. Everything is better than it was, but I was hoping it would be a more drastic improvement.
The worst part is the dietary restrictions though. I was convinced that at 6 weeks I would be free of the dietary restrictions and could eat whatever. But then they told me nope, still no crunchy or chewy foods until 3 months. I just had my 3 month check-in and they’re telling me STILL no crunchy or chewy foods until the 6 month point. It’s miserable – I’m constantly having to stress about what is considered crunchy or chewy, not eat some meals, not go out to eat, no go to friends’ houses, not snack, etc. We went on vacation and I couldn’t eat anything they had on the plane due to these restrictions. I was so so hopeful this morning before the appointment and now I’m just devastated that I have another 3 months of this trash.
I would have rather had a more painful more expensive surgery than deal with this miserable, stressful recovery. Sure, the initial procedure was easy and the pain wasn’t bad, but the stress it has caused has been super difficult, and I’m absolutely sick of living this cautious lifestyle. I still can’t brush or floss those top gums either, meaning I’m still just using their mouth rinse which stains my teeth black.
Anyone else go SIX MONTHS with no crunchy or chewy food???
I am one week post op. I had about 9 teeth done at once, only upper teeth. Swelling has final subsided overall but not on both sides of my nose. It is very sore there as that seems to be the places that the gums were really filled with the collagen. The worst part now has been that I can’t smile. At ALL. My upper lip is tight still and gets twitchy when I do try to smile. Is that the nerves? Did that happen to anyone else? When did your smile come back to normal. The other downfall is the fatigue. Not interested in doing anything. No, I am not a depressed person, I have just felt blah and very tired. I am guessing that is just my body healing and rest is probably best since it has only been 9 days. Hope everyone that has had this procedure is healing quickly. Although, it definitely has not been the “breeze” that I thought it would be.
Hi VJ, I recently had this procedure done and have had a similar experience to you post op. I’m just wondering a few years later how you are doing and if you were happy that you had the surgery.
I’m getting a gum graft on my bottom front teeth on october 14th. I’ve had recession on my bottom teeth since 13 years old, and now it’s so bad on one tooth in particular that my new peridontist says grafting is my only option. He said he doesn’t mess with the pin hole procedure with severe recession, especially on the bottom teeth, because the chance of relapse is high.
I had the procedure done on my lower front teeth on Aug. 5. Like everyone else I was told it would be virtually painless and that I would have little swelling. Not the case! I was very nervous about the procedure and had a hard time until they finally gave me the gas to calm me down-I would recommend starting with the nitrous from the beginning-it will make the tugging and scraping not so terrible. I had a crazy amount of swelling (dentist thought it was edema from the trauma) so much so that it was difficult to talk and my husband and daughter had to feed me and pour water down my throat. The second day was awful, felt like I was hit by a truck, just super tired. I was prescribed a antibiotic and steroid for the swelling. He also prescribed a pain med which I just used for 4 nights to help me sleep. I have a job where I have to talk a lot so this was very difficult, but I slowly improved each day. On day 9, I broke out in an itchy, red rash and had to go on steroids again. I think this was an allergic reaction to the collagen, but my dentist did not agree. Week 2-5 saw very little improvement. I was in constant pain (I’d say a level 2) and didn’t want to take pain relief for that long so I just dealt with it. At week 5 I finally started to feel better. Still uncomfortable (like something was stuck down there), but better. I just went yesterday for my 6 week follow up and after scraping the incredible amount on plaque off my teeth from not brushing, I felt a lot better. My gums are very irritated and red still from the not brushing so I have to use the mouthwash to get rid of the bacteria. I go back in two weeks. I am now off of the restrictions (thank goodness)! If you are a person like me who loves to work out (it’s like therapy), this procedure will be harder than you think. The restrictions are just too much, I’d rather deal with the pain of grafting then 6 weeks of this. This blog was so helpful-I read every single comment. It was good to know that I am not alone in my struggles since my hygienist/surgical assistant said they had never had a case like this and that I was the 1% that this happens to. For all those struggling with this right now, know that there is hope and it will get better! At this point I’m now praying the procedure actually worked since I had very severe recession.
Hi – I am currently looking into the Dr. Chao Pinhole Gum Rejuvenation to restore receding gums.
Just curious if everyone who had good or bad experiences did a search on Dr. Chao’s site to make sure the dentist you chose was actually trained by Dr. Chao and certified by him.
I have realized doing my research, there are dentists performing this technique that is not actually trained or certified by Dr. Chao – that may be part of the problem if things didn’t go very well.
Any feed back on this would be greatly appreciated.
Pinhole surgery is a great way for unethical general dentists to rip-off naive patients.
Thanks for your opinion. Do I read well that you are a professional yourself ? Sorry, I’m Italian and I’m not sure I correctly understand everything.
I’ve been proposed to do this operation in Italy but I feel extremely uncomfortable about it. What can be done instead to keep under control the gum retraction?
Thank you for your time
Hi Paul, I had minimal recession on a couple teeth and went to a perio who regrettably talked into getting lanap treatment on my whole mouth. I now have pronounced (in my view) and ugly recession on several teeth including top front. The lanap was pretty rough. Does or can lanap cause recession? Boy do I regret that bad mistake. Ruined my smile. The recession is not severe enough for grafting and this pinhole technique sounds worthless. Thanks for your input.
I underwent this procedure last week in Michigan. I had a Periodontist who is certified with Dr. Chao. I had a pretty bad experience, although the final outcome is yet to be determined. I had both arches done at once. I will say this:
1) Double the recovery time you think you will need – I have had to cancel business appointments right and left and I feel horrible letting down my team. I was told a week. It will be at LEAST 2 if not more before I can get in front of people.
2) For me I asked to be sedated, it was a long procedure and I don’t think I would have felt good with all that going on. I had IV sedation.
2) There is pain. Use ice…you will need lots of ice…. plan ahead and purchase a big bag. Use the meds. Sleeping in an elevated position helps a lot.
3) Think ahead on food. I have been unable to eat anything except pure liquid, and I am getting nauseated now when I try to choke down protein drinks. I did find that instant oatmeal with added milk will go down. Also yogurt blended with juice and ice. This is a weight loss opportunity or challenge depending on how you look at it. I think I dropped 5 or 6 lbs so far and I am not overweight.
4) I have been able to get out and walk, which help at least lift my spirits.
That’s it. I hope my outcome is good, I still have 8 days on liquids before the stitches come out. I am planning to talk to the dental office when all this is over and suggest that they share more reality. The literature actually says “The day after surgery you may feel fine, but please follow the post-op guidelines anyway.” — OK , MAYBE if you had just one tooth done….
Good luck in your journey, I will try to provide an update.
Oh, I forgot to add that I was not told not to exercise – obviously I am not running right now but walking and light weight lifting seems to not bother me. Can’t imagine why an active person could not continue an activity that did not cause pain?
Here’s my update, 4 weeks post surgery. As a reminder, I had full-mouth surgery, and I have to say it was pretty awful. The first 10 days were terrible, I mean, really miserable. I regretted my decision; I was sore; could barely talk; had to stay off work; and I was starving. Not to mention feeling very isolated because I looked so bad and was not supposed to do much talking.
At the 15 day mark, the stitches came out; I could eat all normal foods again but with care (was not easy starting out) and I could also gently brush my whole mouth. I felt like a new person. I could smile a little, though still not much, and was still puffy. However, I started to see the light at the end of the tunnel. Also back to exercising, but no “inversions.”
Now at 3.5 weeks I am eating well, smiling about 75% of my “old” smile, but I still have a lot of healing to do, my gums are still puffy, and I had apparently a lot of collagen shot into my mouth below each gum line, resulting in the sensation of having a hockey puck in my mouth – like my gums are made of plastic – and my chin is still numb. So is most of the inside of my mouth. I was told this was normal.
At 4.5 weeks I will back for another evaluation, and they will determine if I need a laser procedure to “release” my gums to allow me to get my full smile back. Overall, however, I now see what the result should look like and I think I am going to be happy in the end, when this ordeal is behind me. Can’t wait to have the full cleaning in a few weeks as well.
I should also mention that I did get an infection – at 3 weeks I woke up with a new chipmunk look and pain on one side. I was given antibiotics and my friend who is a hygienist also gave me some ideas such as rinsing with peroxide, cleaning my toothbrushes etc. She also suggested that I massage my face gently daily to aid in the healing.
I will post again when I have made more progress. In the meantime, here is what I would have like to have known i advance:
1) Take at LEAST 10 days off work
2) you will look and feel like hell for 7-10+ days
3) you may not be able to smile for several weeks, and talking will be difficult and may be limited
4) Only taking 2 weeks off brushing was not as bad as I thought it would be
5) Sleeping in an elevated position helps greatly
6) you may want to ice to help with the pain for up to a week
7) if you are prone to being lonely, make plans to have close friends spend time with you since you can’t really go out without scaring people
8) if your job puts you in front of people (yes, I am in sales and do faciliation…..know that you will take some time to get back to it
9) asl your doctor for a timeline – everyone is different but when does he/she think the stitches will come out, how long will he /she ask you not to brush, exercise, etc. Also ask more specifics about where you will be having the collagen injected
Good luck and hang in there!
Thank you so much for sharing your thorough and harrowing account of your experience. Bless you! My procedure was only a small part of my mouth. I can’t imagine full mouth surgery! Wow! Your tips are so helpful and I’m wishing you a good full recovery. Keep hanging in there!
OK it’s me again….I am one year post surgery. I was told that it would take a year to fully heal from everything. I would never go through that again, and even now, I am not sure it was worth the cost and agony.
But here’s where we are now:
1) My gums are much better, much less recession and exposed nerve
2) My chin is still numb, I am thinking this will not go away
3) What bothers me most is that my smile is not my smile any more. With all that collagen in there I have a gummier smile and although it’s probably subtle, I don’t like it. I also talk for a living – and when I talk a lot I can tell that things are not normal in there, I start to sound like Syd the Sloth from Ice Age.
4) I find it VERY hard to keep my mouth clean, given all the brushing restrictions.
5) If I were to go back I would 100% ONLY address the individual teeth with issues, not the entire mouth. That was crazy, and I feel a little unscrupulous by the doctor.
That’s it! Good luck everyone!!
Hello. I need your help! I’m writing from Italy where my dentist suggested me to do the pinhole operation. I couldn’t find anything about it in Italian forums and I ended on this blog… I’ m very much concerned about it. Any latest news about performance in time?
Thank you very much for your help!
Yikes I wish I had found this site earlier. I had this procedure PST done 3 days ago. The dentist did full mouth and recession was horrible on bottom teeth. It took 5 hours and it was painful. Then when the numbing wore off very painful. I should have taken pain reliever sooner. Procedure was complete at 1 pm & pain was well controlled by 5 pm. The dentist had an excellent anesthesiologist giving the novocaine shots (virtually pain free). Also put a TENS unit on my temples & back of neck to try & alleviate any jaw pain (that worked great). They took blood to make platelet rich fibrin to aid in healing. He made very fine collagen strips so it wouldn’t feel bulky. He saw me in the office the following day & will see him a week from now. I am on liquid diet, limit exercise, no talking and he did the frenectomy. I feel pretty good already but still fairly swollen. Since the lower teeth were so bad & what I read here – I am concerned that may fail but will do all I can to ensure success.
Hello,
I had mine done on the 12th on three teeth but also with the platlet fibrin, because of what is going on in the world now my follow ups keep getting pushed back! But while flossing I got an accidental peak of one site and there is like white gunk that I could see, did you have anything like that happen around the theee week mark!
Well, thanks for your experience. Keep us informed about it and finger crossed.
It surprised me to know that the operation lasted 5 hours. I’ be been told it’s about 1 hour or 2 for a full arcade. As far as I ‘m concerned, I haven’t decided yet if to do it or not.
I just had this done 4 days ago on 4 of my lower front teeth. It took about two hours and I did have IV sedation. Now I’m worried about the success rate after reading all the negative experiences. I did go to the top periodontist in Michigan who has performed so many of these so that does make me feel a little better but still worried. The recovery is a lot tougher than I thought. There’s hardly any pain just discomfort. He wanted me to wear the dressing around my head to support the area more, minimize talking which is hard! But the hardest part is the diet. Only soft mushy foods for about 2 weeks. Hoping it’s not longer. It’s defintley not as easy as they make it out to be but I’m assuming easier than the conventional way which sounded painful. Will update when the stitches come out
Thanks! Let us know how it proceeds
I am scheduled for pinhole on 4 top front teeth in 3 weeks. The teeth have some but not much recession, but the recessed areas catch food all the time so that is why I am doing it. Now may not do it after reading this. Anyone have experience with minimal recession?
I am about a week post-surgery and have been absolutely miserable! First off, the procedure was not as easy as the Internet made it out to be. What makes this ten times worse is that I am dealing with the aftermath of this surgery during a global pandemic COVID-19, which makes going to the doctor, getting meds from the pharmacy, and finding soft foods almost impossible. The first day of the surgery was not too bad. I didn’t feel pain during the actual surgery, except for the shots. I’ve had a tooth pulled before so that didn’t really bother me. The worst aspect was the idea of it. I had researched what the doctor does to the gums and that freaked me out a bit, especially seeing and hearing the entire process. The numbing started to wear off towards the end of the procedure and I began to feel the tugging and the pressure on the teeth. This also made me squeamish. I only had two teeth done, but definitely had some swelling and bleeding. The pain really kicked in the second day. My doctor pushed hard on the teeth to secure the collagen, so the teeth were sore as well. My jaw was also killing me. This pain lasted a few days. The swelling was just beginning to go down, when I noticed a different kind of pain and discomfort yesterday. The surgical area began to sting and I noticed this horrible taste and smell coming from the mouth. I hadn’t really looked at the area before this, as instructed, but when I did, I noticed a small painful sore (looked a bit like a canker sore) and yellow pus coming from the gums and the teeth. This really frightened me. I looked it up and saw that it could be an infection. I couldn’t get a hold of my doctor until this morning and he prescribed some antibiotics after hearing my description. I would recommend that whoever is considering this procedure ask their doctors to prescribe antibiotics as a preventive measure. You could imagine how difficult it was to get antibiotics during a city lockdown. So now, I am taking antibiotics and continuing my routine of soft foods and saltwater swishing. I can’t yet say if the surgery was worth it. So far, the gums appear to be covering the roots of the teeth (which were exposed before), but I don’t know what it will look like in a few weeks, let alone months. I am in my mid-20s and felt that this gum recession needed to be taken care of. The causes for my recession seem to be teeth grinding, having braces for years, over brushing, and genetics. I am wondering if anyone else has had an infection following the procedure and can speak to how things turned out. I am incredibly uncomfortable with this disgusting taste/pus and am becoming so frustrated with the constant pain. The Tylenol does nothing. Any advice or insight?
Parker I agree it is much worse than we were led to believe! My dr prescribed steroids and antibiotics in case I got an infection. I hope everything turned out ok for you!
Elaine says I had the procedure on Feb. 1st. I consider it quite an agonizing thing to go thru but if you have to do your whole mouth, unless you want to lose a lot of weight, it might be the way to go. My gums were incredibly thin. Everything looks good and feels good now but the dentist is not happy with 3 lower teeth. The gum that is there now is much thicker but there is still a lot of recession. He would like to redo those 3 teeth for no cost. I am not sure if I should do that or go for either the free gingival graft or alloderm. I talked to a man who had the gingival graft & he said it was only a two week recovery but he has very jagged edges. I know nothing about this and would appreciate comments from others. Also does a periodontist perform the LANAP? Because I also have bone loss. Thx
Be careful with lanap. I had it done and it caused more pronounced recession and increased black triangles between teeth. It was a huge mistake for me, but may have been the perio who did it. I’m not sure lanap is proven to increase bone growth, I read someone said it is a lot of hype. I’m not an expert.
I had the traditional grafts over 5 years ago. I still have great coverage and it was so much easier than this procedure. If I have to redo this I’m going to do a the traditional kind. I feel I was duped 🙁
Hey everyone, I just got pinhole surgery on my lower canine tooth 7 days ago, and I’m kind of worried because I can’t smile at all. My left side of my mouth feels extremely tight and I don’t know if this is normal after surgery or if it will go back to normal? I feel like I have a giant cotton ball in the lower left side which I know is the collagen that will eventually dissolve, but once that’s gone will my smile be back to normal? Any advice you could offer based off of your experience is so appreciated!!
Hi Christina, sorry you had such a rough time. I am thinking of having the same tooth worked on. Sounds like your experience is common. How are you doing now?
I read comments before I had procedure two weeks ago. I am happy to report I had a “good” experience. Uncomfortable but successful. Lost 5 pounds so far. Will go back to doctor in 2 months; had six teeth done. Dr very pleased except for one place on front. Recommend mouth freshener sheets because the mouthwash did not help with yucky mouth. Good luck everyone.
Emily
Hi there, I will need to have this procedure in the future as i am only 38 but my dentist says I have the gums of a 50 year old 🙁 This is not good news given I have had braces on my teeth 3 times and have meticulously looked after my smile (or so I thought). Turns out that not only have I been over-brushing (something that is both taught and required with having braces) but I also have a genetic disposition to receding gums…. luckily I have healthy teeth (so far) with no gum disease or sensitivity etc.
My questions are- How much would I be looking at to get this kind of procedure done? I do not have private health cover and I’m a single mum of young kids on a centrelink pension. I also have no family around. I’m concerned that this will cost thousands yet I know I’ll need this doing in the next few years. Also, is this permanent? I read an online article that suggests it’s not.
Thank you
I’m having the procedure done tomorrow on my bottom gum. I don’t know how many teeth are being covered, but it’s almost all. I’m 49 years old and live in Colorado. My cost will be about $2,100 this time. My dental insurance allows $1500/year and that’s why. To do my top gum after January 1, 2021 it will cost me $1,800. I’m going to a well qualified and top notch periodontist with numerous certifications and awards. I’m not having the collagen because it hasn’t been around enough to know how it will hold up. I’m going with donated tissue since we know that’s been working for 50 years for a variety of procedures.
Like everyone else, going in for gum grafting several times over the years and the pain I heard about caused me to give up and see what happened. Once I found out about the pinhole technique I was immediately interested! I’m fortunate enough that my doctor is 10 minutes from my home. My teeth and gums are healthy and I don’t want dentures later on. With this costing me basically 4K, I’m saving money in the long run than dentures.
Luckily I’m working from home and plan on taking 2 days off work and the weekend that follows. I bought all of my soft foods for a week and am looking forward to losing some weight! Not happy about no chocolate for 2 weeks though. ☹️
How did it go?
Howdy from Golden, CO. I’m in need of this procedure. Are you happy with your results and would you recommend your Dr, if so who. Many thanks in advance. Matt
I left a message about a year and half ago. I see some people having concerns about the success rate, and although I can’t speak for everyone my has been successful so far. About six months post surgery I noticed some recession and thought it was not going to work. I was obsessed and checking my gum almost everyday until I decided to just go on with life. Then, 8-9 months later I noticed that my gum line was back to normal and it has been since then. During my last visits to my teeth he has noticed much improvement on the measurements. I am very happy that I made the decision to have the pinhole surgery vs gum graft.
So glad to hear that!
Hi everyone! I just underwent the Pinhole Technique Surgery with a respected periodontist in my area. I have had two traditional grafts in the past and I can tell all of you that so far this is far worse than my other grafts, in terms of swelling and bruising. I had no swelling with the traditional grafts….probably bc they take the tissue from the roof of your mouth and stitch it over the gum line. Today is day 3 and my face is so swollen that I can’t even smile. It hurts to chew. I’m on antibiotics, steroids, and ibuprofen, as they refused to give me any type of narcotics….and I am struggling. This is, to date, the most painful dental surgery I’ve ever had. I hope things get better and I hope it’s worth it. I can’t see doing this again.
Hi Lora, I too have had both the traditional gum grafts, and pinhole…2 surgeries done in 2019 and a third final one on Feb 18 2020. The one thing to be cautious about is the combination of antibiotics and steroids. I was on 2 antibiotics along with the steroid after my gum pinhole surgery, so you may not encounter the same problem, but I got a very bad case of Candida from this combo. If you aren’t already taking pre and probiotics, I would get onto those. I also took caprilyic acid and undecylenic acid to get rid of it. On the diet side, I came across Garden of Life protein drinks (they have a few kinds…all very good, and healthier than Boost and Ensure). If you struggle at all with the liquid diet, Garden of Life is worth trying. Good Luck with your recovery. One year after my surgeries, life is so good. No more receding gums. The Gum Pinhole Surgery results are great…likely much more aesthetically pleasing than traditional grafting I think.
Hello! I just had pinhole surgery on my upper teeth two days ago. I saw this site earlier, but still decided the pinhole process looked a lot less traumatic than the old-school graft, and so far I’m glad I did it–I will add, though, that I went to an endodontist that specializes in this procedure. The crew was very professional and did the work in less than an hour, and I always felt that they knew what they were doing, and had a good bedside manner.
I had IV conscious (moderate) sedation, so the most traumatic part of the entire even was getting the IV needle inserted. I had no pain or negative emotions during the operation (I remember a little despite the sedation, and my favorite part was when I heard them say “OK, now let’s start on this side” and started working there, and I remember feeling “Wow! Half done already, this isn’t so bad at all.”
When I got home I was able to eat some applesauce and yogurt while waiting for the numbing to wear off–and it was no harder than after a filling: No pain, and no nausea. Later that night I had some clam chowder–I knew I was going to have to fast in the morning for the sedation and might not want to eat much later, so I ate like a king the day before with all the foods I wouldn’t be able to eat in recovery, including a late 9pm dinner to tide me over the day of surgery.
The morning after surgery my face was swollen and it looked like I had two sort-of black eyes (more green/yellow/brown). I was able to eat a banana but it hurt a little. A little later I had some scrambled eggs, and then some hommus, and things got better. I was thinking before that I might work from home that day, but I needed to recover and let the last vestiges of the sedation wear off, so I had a nap-filled day of rest. It really wasn’t bad at all.
Today is the second day and I’m back at work. I don’t feel at 100% yet, but the swelling and black eyes are mostly gone, and I have no difficulty eating soft foods. After today I’m allowed “anything you can cut with a fork” to round out the first two weeks, and then I’ll go in for a follow-up checkup. Only walking for exercise the first week, but then I can take it up a notch to jogging–just no heavy lifting or anything that makes you clench your teeth. (And no swimming for the first two weeks–as a lap swimmer that’s almost the hardest part.)
My doctor modifies the procedure a bit to add stitches as a “safety belt” to hold the gums in their new location for the first two weeks, to reduce the chances that you accidentally pull the gums back accidentally. I can’t even tell they’re in my mouth, so I’m glad he did it. I wouldn’t want to do this again if I accidentally yawn in a way that undoes all the work!
Anyway, so far, so good. I’ll post back later when I get a better idea how the recovery is going. I’m looking forward to getting off the meds and eating more normal food!
Thanks for leaving your experience in the comments section, Jeremy. Like you, my experience was mostly positive and I was glad that I went with a reputable endodontist that specializes in this procedure. I think that makes a difference. I’m wishing you continued good healing and positive energy as you return to post-procedure life!
3 week followup!
I had my 3-week followup appointment yesterday and got my stitches out. I decided to give myself the best chance of success so I stayed away from caffeine and alcohol and made sure to get full nights’ sleep every day. I only walked for exercise the first week, pushed it to an easy jog the second week, and added swimming and a harder run the third week. (I’m still holding off on heavy lifting until after week 4.)
The first week I was swollen, but nothing really hurt except when (accidentally) touched. Honestly the hardest part was the antibiotic and steroid (to reduce inflammation) I was on that first week–they gave me some side effects, and with the dentist’s permission I dropped the antibiotic after 5 days. I usually sleep on my side, but had to sleep on my back that first week, so that was a little uncomfortable for me–and I generally had to be awake for an hour in the middle of the sleep cycle to be able to get back to sleep on my back (but that’s just me and my body–it’s always hard for me to sleep on my back).
I took the surgery day and next day off work to rest, and came back to work on Day 2 (but was not too productive). But then by Day 3 I was mentally back, and Day 5 I was full of energy again. Day 11 my right side felt “basically normal” and Day 14 my left side did too. Week 1 I stuck to liquid and slurry foods (soups, hummus, yogurt, applesauce) but Week 2 I started eating stir-frys and pastas and salads (minus the crunchy parts) Week 3 was most normal foods except nuts and seeds and tough meats.
My mouth was a little sore the night after the stitches come out, but nothing a little Ibuprofen couldn’t fix. So far it looks good, but the stitches were the “seatbelt” so far, so there’s a small part of me that worries it might all retract in the next week, but time will hopefully prove that wrong! Because I healed so well so quickly they said I can now brush the area (lightly), eat any foods, and do any activities, and I won’t have to do the 6-week checkup, but just come back in 3 months.
So far, I’m glad I did it. It was never really painful, the procedure was quick, and really the main issue was the inconvenience of the first 1 week of recovery. It still seems MUCH better than a traditional graft, which certainly scared me. I’ll give y’all another update in a few weeks so you can see if it “sticks” in place.
My biggest recommendation is to get a GOOD periodontist that specializes in this type of work, and also knows when to recommend an alternate path. I specifically asked “Is this good for me, or is a traditional graft better? I’m willing to put up with a traditional graft IF it’s more likely to succeed, but if everything else is equal I want the less invasive approach.” I went with “Michigan Implants and Periodontics” in Ann Arbor, and so far recommend them highly.
Thank you so much for sharing your experience, Jeremy. I am going to Michigan Implants and Periodontics with Dr. Bunek in Jackson next week. I really appreciate you naming where you went. Both the upper and lower teeth need the procedure and he said I was a perfect candidate. Started to get freaked out last night reading all the horror stories. Your comments support the recommendations here to go with someone who is highly experienced. Dr. Bunek shared with me at the consultation appointment that he modifies the technique a bit and uses sutures to improve results. I will post here again after the procedure to share my experience. Thank you to everyone for sharing your experiences!
Hi Jeremy – can you give us an update on your results? I am still debating which method to go with! Thanks!
Thank you! I have read all your comments and truly appreciate your sharing your experiences and insights. I now am absolutely convinced that I will not have the pinhole technique and most certainly not from my regular dentist, regardless of how encouraging he is. He attended a two-day workshop a few months before Covid hit, and considers himself an expert. I’m sure doesn’t have extensive experience with the procedure. I’m not willing to be a Guinea pig! I do, though, now have a very long list of questions for the dentists I need to see for recession. To each of you — DDS and lay persons — thank you.
I am a young healthy male in my early 40’s who had gum recession, and no other health conditions to speak of. I’m currently 6 weeks post-op on my Pinhole Surgery. Unfortunately, at this moment in time I can’t express that I’ve been happy with the decision.
The procedure was definitely more painful than I was led to believe based on my Dentist’s description or other dentist websites. The dentist mentioned some pain and swelling right before the surgery as well as not being able to wear my regular retainer/nightguard for 6 weeks after the procedure.
The actual procedure went as most here describe, but my face definitely swelled up after the surgery and my body was quite achy like I’d been cut into. It kind of took a week until I felt back to normal.
However, the dentist had also given me the list of Do’s and Don’ts prior to the surgery but never really went over it with me in depth. For example, she advised not to look at the surgical sites because it had freaked out one lady who had. I’m not squeamish however, and took a peek when it felt with my tongue that one gum line was higher than another. I mentioned this to the Dentist on follow-up and she was mad I had looked because only then did she inform me that not looking was to not tug at the tissue, that looking might undo it! I had no idea. They said “Don’t look,” but never gave the reasoning why.
I was very paranoid that the procedure wouldn’t work after this and it caused a fair amount of anxiety. I tried to be super careful even adjusting my sleep to not sleep on my side (it’s quite difficult for me to sleep on my back) so I wouldn’t mess it up. I was heartened three weeks in during a check-up where the dentist suggested things looked good. I was finally looking forward to getting my teeth cleaned after 6 weeks and during the follow-up my dentist looked and said “the gum line is higher than I’d like on both sides.” She proceeded to clean my teeth and take pictures (which I did not get to see).
I asked if I should return to wearing my nightguard and she said no, that I should get a new one made. This time for the bottom teeth. However, this would leave me without any kind of retainer on the upper teeth to keep the shape. I don’t think I can get impressions quite yet.
I’m sure folks on this forum know that retainers and nightguards are usually $300-500. So, I’ll have another expense I was not prepared for, which it seems like I should have been made aware of from the get-go.
I returned home and finally took a look for myself. You can barely tell that I had a surgery done. The molars in the back have pretty much receded to where they were pre-op! Roots exposed.
I’m sad and frustrated and certainly poorer for the experience. I could have gone on a vacation (once Covid has ended) for the amount of money I spent on this, not to mention the pain and the general Suckitude of not being able to brush for 6 weeks.
Now another 6 Months of brushing with a special tooth brush to not damage my gums further? You mean make it WORSE than it was prior to surgery?
So far my only recourse is to vent about the process on an internet forum, though I do plan to follow up with my dentist at the next appointment to ask if the surgery was not successful, if there is any kind of discount I might be given on the cost of retainers or something.
The pinhole technique seems a viable option for many people, however, it doesn’t seem to have worked for me. I know I’m in the minority. Statistically, it supposedly has a 95% success rate and an 86% coverage rate of roots. However, I felt like it was a waste of my time, energy, emotion, and money. I wish the dentist might have gone over with me all the in’s and outs more thoroughly prior to the procedure if not recognized that maybe I wasn’t a good candidate due to thin gum tissue or any underlying bone loss which would make the gums not stick. Perhaps the painful grafting would have been more successful for me due to the procedure ADDING tissue.
I’m certainly not wanting to every have an oral surgery again though.
I am 5 days out and the swelling is so bad that half of my teeth are covered……even teeth she didn’t treat. Periodontist has me coming in every week for 6 weeks. Wondering if I am having an allergic reaction…..anyone have a similiar reaction?
The swelling is pretty normal and some people have it worse than others, just depends. It’s your body having a reaction to being injured really and trying to heal itself. Ice if you can and take it easy.
I just want to say hi and say if you’re reading this before getting it done or have had it done and obsessing over the results, I may have some good news for you.
Firstly, in my experience, if you have minor recession with no or low bone loss, it should be good for you. If you have overbrushed for example, even better (again, in my experience).
I had braces, still have a bit of a weird bite and had my entire mouth done to cover a few roots and ensure that my teeth were all even. I had overbrushed and neglected my gums although I thought I was keeping them clean.
I was super nervous before getting it done and had built it up in my head. The last thing I should have done as I needed rest after the surgery. I did obsess a lot before, during and now not very much after. My advice – let your body deal with what’s just happened i.e. foreign tissue now in your body.
Don’t look, don’t touch, don’t worry about the white strips coming out (very normal), try not to touch your face externally from bruising and DO NOT go back to work the next day. I’d suggest a week off.
I’m now five months out, all my gums are happy, healthy and actually one that I thought was receding again has come back up.
All I can say is trust the process if you think that you have ample bone below to support the new tissue.
Please do not get this procedure done! I am four weeks out of my pinhole gum procedure for recession on my bottom four front teeth. The recovery was incredibly painful for the first week and I am just now able to speak normally without contorting my front lip or speaking with a strong lisp. My front teeth feel loose and I still cannot chew with them. I’ve looked now and already my gums have receded to the level they were before surgery. If you have gum recession, I would not recommend this procedure.
I had PST surgery at the end of September in hopes to relieve the pain I was having after concentrating my toothbrush on a dark area of a recessed gum (recessed gum was caused by aggressive brushing many years back in that specific area). It is now December, and I still have the pain which is miserable. Initially, before the pinhole surgery, they had done a basic fluoride treatment which took the edge off. I went in yesterday, and they gave me the fluoride treatment which can turn your teeth a dark color, but it did absolutely nothing. Not sure it’s making it to the area now covered where my gum was pulled down. Has anyone else had this pain after the pinhole surgery? One of the dentists in the practice assured me that it will eventually ease up as the gum reattaches. I had the surgery 2 months ago but have had he pain about 3 months. I’ve tried saltwater rinsing and sensitivity toothpaste. Yesterday, they gave me a prescription toothpaste to massage in, but nothing is helping yet. I thought they were going to fill in the area yesterday (not sure how that works exactly with gum covering the area but someone mentioned it), but the doc didn’t want to mess up the surgery work they did. Any suggestions because I feel like things only get worse each time I go into the dentist’s office? Now I have darker teeth in between them, out 3K for one tooth, and still have the initial pain. Beyond frustrated by this whole process. My pain is constant too – only relief I get is at night when I sleep. Thanks!
I came across this website and appreciated all of the comments related to PST, so I thought it might be helpful to share my experience. I had PST in 2019 for generalized gum recession, had one session for the top arch and a second session a few months later for the bottom arch. Total cost was just under $8,000.
I was pretty disappointed with the results. Similar to what a few others mentioned, it looked spectacular at first, but within 6 – 8 weeks I noticed recession nearly everywhere. It was better than where I started, for sure, but really just a marginal improvement.
My general dentist took a look and he agreed, marginal improvement, but not wonderful. He has also told me he has had other patients with a similar experience and he no longer refers patients to the periodontist who performed my surgery.
In the summer of 2020, once the COVID lockdowns began to lift, I went to a different periodontist who does not offer Pinhole. He said he looked into it a few years back, but decided it just isn’t as good as the traditional grafting techniques. Specifically in my case, with a thin gum bio type, pinhole was not the best procedure for a great outcome. He re-did one upper quadrant using the free gingival graft technique. This was much better – roots completely covered, sensitivity is gone, tissue much thicker. This is the procedure I should have had in the first place.
Comparing the two procedures: Better outcome for me with FGG, I kind of wish I never heard of Pinhole.
I think a lot of the stuff with Pinhole is really just a marketing scam. I didn’t think it was really less painful than FGG, only slightly less. Both had some swelling and soreness that peaked on Day 3, and then fully resolved around 10 days. And I say slightly less because FGG comes with the second surgery site on the roof of your mouth, but that is easily managed with a plastic stent. Ice packs helped with the swelling in both cases, OTC ibuprofen helped with the pain in both cases.
There’s no suturing with Pinhole. But in reality, you’re numbed up and can’t feel it anyway, so this is marketing nonsense.
Length of time is really the only area Pinhole has the advantage that I can tell. I had the complete top arch done in one procedure and complete bottom arch done just a few months later. FGG using your own tissue would be limited to about one quadrant every six months, so two years in total for the entire mouth. Using donated tissue would speed that up obviously, but my periodontist said he prefers the own tissue method whenever feasible.
Hi everyone. Really glad I found this thread as I too was thinking of having this, but I’ve decided to look into other options now. The way I see it, if they are stretching your gums, they are going to want to go back, unless you have super thick gums. I’ve decided I might have a gum graft because adding flesh to that area sounds much more normal and workable. I know that people who have had success with this procedure are less likely to post, but I’ve also seen some YT videos where it hasn’t worked either. I think the Dr who invented it is a crook!
Also, you can get dental bonding to cover up the darker tooth colour that the gum is exposing, although it’s not ideal, it might be worth looking at.
I wish I could subscribe to this thread.
I am a dentist who has observed the pin hole procedure. Based on my observations, it is my opinion that the pin hole procedure may not offer long term results. The reason is that you are not increasing the amount of attached gingiva (gums). You are just dragging down mucosa which is not keratinized. Keratinized tissue is able to withstand trauma from brushing and eating. Conventional gum grafting actually adds keratinized tissue donated either from the patient himself or donated cadaver tissue. Thus the results will probably last longer and provide better overall results.
To the woman who posted this. We can’t see how recessed your gums are before your procedure. It looks like you do not have a recessed gum line. Can you post how recessed your gums were before the procedure?
Also can you post how ‘not-recessed’ your gums are now years later? 80% of the people commenting on here who had the procedure say their gums recess back again.
This leads me to believe that all ‘before and after’ pictures I see on periodontist website are snake-oil scams. So what if their gum line came down ‘after’, if the gums are just going to recede almost completely back again in X months.
Please help by posting your pre-op picture, followed by a post-op picture, followed by a 6 months picture followed by a 1+ year post-op picture.
thank you
Hi Ian. I am the writer of this article. Thanks so much for reading the article and leaving a comment. Both my long-trusted dentist and then oral surgeon told me that I needed the surgery for gum recession. I had not noticed it myself until they pointed it out to me. I didn’t think to take a before picture so I don’t have one to post. I also didn’t take a 6 month post-op photo so I can’t produce that. I can tell you that I actually just saw my same oral surgeon yesterday for a tooth implant follow-up…boy is a tooth implant a long process, but that’s another story…and I actually asked him yesterday if he thinks that I will need any more gum recession procedures…so your comment is well-timed. I was pleased that he told me that I don’t need any future procedures and that the pinhole procedure worked for me. I will go into my blog article now and post an update with a current photo so look for that later today. My apologies for not having photos of my gum through the different stages. It wasn’t my intent when I wrote this article to show a before and after…it was more to let readers know how the surgery felt and how the recovery went. I also didn’t receive any compensation for writing about this and my oral surgeon didn’t know that I decided to share my experience. I decided to share it at the time because the pinhole procedure was so new. Never did I imagine I would get this many comments. Dental work is never fun and is trauma to the mouth and body…but it is crucial to take care of our mouth and gums. I do believe that seeking dental care can add years to one’s life. I guess I am lucky that this procedure worked so well for me. My oral surgeon, here in Phoenix, also came highly recommended, has excellent reviews and I trust him and his team, which is why I chose him. He told me (as did some of my family members) that traditional grafting is more invasive so that is why I opted for the pinhole. So far, so good. Thanks again for your input and questions. I’m wishing you…and all of us…wellness ahead.
Hi, thank you for your wonderful article explaining a great deal to those of us previously uninformed on this procedure. You have convinced me to go ahead and get the “pinhole procedure,” as it suits my needs. (and budget)
I’m grateful that there are still good people like you who share their knowledge and experiences, and selflessly help others.
I’m saving this article and bookmarking your website to share with others.
Again, thank you, and please allow me to remark on what an intelligent, kind and (pardon my saying so) naturally beautiful woman you are.
Best regards,
Pete in Ohio
Thank you for the nice compliments, Pete. Good luck with your procedure. Not everyone has a good experience as you can see from the many comments. Make sure you are using a reputable board certified periodontist with good ratings. Whether you go with the pinhole procedure or traditional grafting, they are both oral surgery and the body needs lots of time and TLC to recover. Good luck! Wishing you a successful procedure and good strong recovery!
Hi Everyone!
I’m Dr. John Chao, the inventor of the Pinhole(R) Surgical Technique. (PST). I want to thank everyone who has taken the time to shared their experiences undergoing PST on this website. The best way to answer everyone’s questions and concerns is to post a Q & A. Hopefully, a series of simple questions with simple answers will be helpful in understanding this new technique. So it does not become long drawn, I’ll post a few questions and answers at a time.
(1) What is the Pinhole(R) Surgical Technique (PST)?
It is a scalpel-free, suture-free technique for correcting gingival (gum) recession. Through tiny Pinholes, gums are detached from the underlying bone and “draped” down like a curtain to cover the defect. Stripes of collagen is inserted under the gums to stabilize the gum in the new position.
(2) Is there any peer-reviewed study to support the use of this technique?
Yes. A 33-month study of 43 patients was published in the International Journal of Periodontics and Restorative Dentistry (IJPRD), 2012. This peer-reviewed journal is one of the most respected journals in the field of periodontics. A number of articles have been published in other journals, including the Journal of the California Dental Association and Dentista Morderno of the Italian dental association.
(3) What does this study say about the effectiveness of the Pinhole Surgical Technique (PST)?
Where there no bone loss and no loss of gum tissue between the teeth (Class I or II Miller), PST on the average can cover 100% of the exposed root 81.4 % of the time. In other words, it’s 100% successful about 80% of the time. The study further states that even when the coverage is less than 100%, 90% of the exposed root is covered 90 % of the time. In other words, most of the exposed root is coverage 90% of the time.
More Q & A in the upcoming posts.
Dr. Chao
Dr. John Chao
Why should I even consider this method when there are other more traditional methods?
The most common traditional method is the Connective Tissue Graft. This calls for taking tissue from the roof of the mouth and suturing it to the tooth with the gum defect. The “morbidity” or severity of symptoms on the roof of the mouth will often require narcotic pain medication.
Another consideration is that Connective Tissue Graft is limited to 2-3 teeth at a time because there is just so much tissue on the roof of the mouth available.
Pinhole Surgical Technique is especially suitable for patients with multiple sites of recession.
(4) Why does Pinhole Surgical Technique hurt so much with some patients?
I have personally trained over 3700 dentists, including over 900 periodontists. The collective experience of these properly certified dentists is that on the average patient needs 2-3 over-the-counter pain pills, such as Advil or Tyenol. Pain is typically gone by the third day. Only in rare circumstances does a patient need a narcotic prescription.
Regrettably, as with any surgical procedure, there would always be a a number of patients whose experience is quite the opposite. We are deeply concerned by reports of severe symptoms experienced by these patients on this website. Our highest priorities at the Pinhole Academy continue to be finding methods or strategies that can further reduce symptoms. The latest is that of using PRP (Platelet enriched plasma), which is derived from your own blood. PRP tends to ameliorate symptoms and enhance healing.
Dr. Chao,
Thanks for starting to post some Q&A. My new dentist has suggested PST and I am probably a good candidate.
But upon reading the Principal Risks and Complications section of the CONSENT FOR THE CHAO PINHOLE SURGICAL TECHNIQUE (PST) form, the list of complications concerned me. I came to the internet looking for answers to questions like “Why might some people experience permanent tooth sensitivity as a result of PST and how often does this occur?” or “Why might some people experience permanent numbness of the lips, chin and gums?”.
Under the No Warranty or Guarantee section, a sentence reads in part “Rarely, there is a risk of…..even worsening of my present condition….” What might cause worsening of someone’s condition as a result of PST?
When asked about these risks, a dental assistant tried to brush off my questions by saying something to the effect of “All consent forms use wording like that.”
I would appreciate it if you could address these questions.
was this question ever answered?
Hi all,
So my back story is, I had PST done initially abroad 5 years ago, Wasn’t seen 1 day, week, 3 weeks and 6 weeks later. Was told I could brush gently after 1 week (big NO NO) etc so my results weren’t succesful, improved yes but not successful. I then enquired about retreatment here in Ireland with a dentist I’m sure Dr Chao remembers as during his training he referenced him as his first Irish Dentist to take his course. He is a phenomenal Dentist, he recommended orthodontics first as my bad and poorly positioned teeth were the primary cause of my recession. Four years with braces on I could start my PST treatment. I’m now 4 days out, swollen but no pain. In comparison to my last treatment, 3 days after my first PST abroad, my gums began to recede slightly, 4 days out from my re-treatment my results have maintained, so I am hopeful it may actually stay stable this time.
I had my entire upper arch treated, my routine was/is no brushing anywhere for 2 days, then on 3rd day use a syringe with a hydrogen peroxide solution to spray gently at gumline treated, brush remaining tooth surfaces except the buccal surface of teeth treated. I will have my entire bottom arch treated when I am healed from my upper arch. I wish I could post pictures on this from my before and afters of initial PST abroad and now showing the difference.
The fact my gumline 4 days out has remained the same as the day of surgery is promising as last time after 3 days it had recessed and that amount of recession was my final result so fingers crossed what I see now is my final result. During my orthodontic treatment my gums did recede but this was to be expected.
I would just like to end with finding the right Dentist is important from my experience. I was not warned about never using an electric toothbrush again and advised to brush the surgical site after only 10 days. I don’t recommend dental treatment abroad but if I did my Dentist in Ireland would be the way to go, a master of his craft and my entire upper arch only cost 1800 euro.
Hello everyone!
It’s day 5 or almost 6 after my pinhole surgery.
First of all: Did you also had a white coating on the gums after a couple of days and experienced weird tingling?
I had pinhole surgery on tooth 25 and 24 (front buttom teeth, I heard buttom teeth are worse to work on when it comes to gum recession). The doctor said he never had to work on such thin gum and he seemed to really struggle during this procedure so I was really worried that it could tear. I had the first check up today and the doctor was happy with it and seemed kind of relieved. It was planed that I get an inlay on tooth 19 but the inlay was not delivered on time (this was the second attempt after the first inlay was not placed properly). The doctor said we should do this next week. I would not have been able to open my mouth due to swelling today, but also hope that one week after pinhole surgery will be enough. I’m worried that the gum could move. Also tooth 25 needs to be done again in about a year, because the doctor said he wasn’t able to place the gum as high as tooth 24. I get it, the gum there was teared due to an accident about 15 years ago, so I’m glad he was able to lift it at all. Hope the gum stays in place, I’m trying my best to follow the instructions, even though it is not easy, since everything feels different and weird everday and there is also this fear that my gums or will be worse and will vanish totally and I will get an awful infection. 😉
Also as a saw the white coating on my gums today I saw a little teared gum at the edge at tooth 27 that I didn’t have before. Hope this will not be a new beginning for another recession.
Still, I hope for the best and thought I will share my experience as well.
Hi seven7,
Yes, white coating and tingling is perfectly normal. In my experience having had it done before, before my second treatment, what I saw after 1 week was my end result as in root coverage. Over the following weeks it just attaches entirely at that level. I know they stress the importance of not looking as it pulls on your cheek, I find if done so, very cautiously it wont entirely ruin your results. For instance, you are allowed to smile which I find pulls more than cautiously lifting your lip. I’ve been looking cautiously since I had it done 6 days ago now and it has maintained at same level it was as day of treatment. I have my one week follow up appointment with my dentist tomorrow so will find out how I am doing and can I expect this to be my final result. I find no brushing or flossing of the surgical is the crucial part to having a good outcome. Hope this helps.
Update: I had to postpone this weeks appointment (3rd follow up) because of being sick (covid). 4,5 weeks after the surgery, the gum on the bottom two front teeth unfortunately dropped. The itchiness got worse, I guess because of the covid infection and my weakened immune system so I had too peek and saw that the gum was not as high as it was 1 weeks after the surgery. The result 1 Week post op my dentist showed me was great. Now, the recession is back to the previous state (or maybe even worse – because it seems I can see the sides of the teeth now too, and the gum of one canine tooth was ripped a bit, but was totally fine before, is worse too). Still discomfort and weird tingling. It is better in the mornings but still there every day. I followed the instructions precisely. Ate nothing crunchy or hard, still soft food, chewed only on the sides, always very carefully.
Hope you had more luck, Stephen!
Hi Seven7.
Did you find a way to get rid of the tingly feeling?
For me it’s the same. In the mornings everything seems fine but during the day the tingly feeling gets stronger and stronger. Any idea what the reason for that is?
One important thing I forgot to say: I don’t know yet how it will turn out in my case, but I was so unsatisfied with the recession that I wanted a quick fix and did not go to other specialists to get other opinions. The dentist who did the pinhole surgery didn’t educate me about the risks at all, and that should have been a red flag. What he said seemed like this procedure wouldn’t be a big deal at all. It still is a surgery and yes, it is a big deal and recovery time and all the worries that come with it are justified and I should have asked more questions and be more suspicious, when the dentist provided me with so little to none information. It was basically not more than: Yes, I can fix it whit pinhole surgery (I think he doesn’t do other gum grafts), but that I will need a redo in one year. And here I am, hoping, that everything will turn out okay. Wish you all good luck with making those decisions and finding a good specialist that find’s the perfect treatment or mixture of different treatments for your needs.