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Author Topic: Gum graft(?) and what to expect  (Read 5473 times)
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peter_trb3

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« on: Mar 18, 2008, 06:39AM »

 :cry:

Have a consultation with a periodontist coming up to look after some recession in my gums. My dentist spoke of the possibility of a graft of gum tissue from the roof of my mouth to the affected areas on my gums. What can I expect regarding recovery times and effect on playing?

I am a professional orchestral bass trombonist and as it stands now this regular season looks to be ending in June. However I am planning on playing the Honolulu Symphony audition and the Buffalo Phil audition which are late May and early June respectively. I thought that I would schedule any dental work for after those events so as not to lose any prep time.

Additional info: I'm 39 y/o and in very good health. I am embarking on a bit more of an exercise regimen leading up to these auditions to maintain that good health and to offset all the sitting and practicing.

Thoughts are appreciated.

 Good!
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Peter Collins
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Hamilton Philharmonic Orchestra
www.wesmoredigital.ca
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« Reply #1 on: Mar 18, 2008, 11:38AM »

Dental problems are not my area of expertise, but I think you are wise to put off any definitive intervention until after the auditions. This is something that I would definitely discuss with the Periodontist. The treatment would most likely depend upon how much gum tissue has been lost. I would explain your career situation with the periodontist and have him explain the various treatments and the benefits and risks of each. Also get an estimate of recovery time for any surgical procedure contimplated. He/she should be able to advise you far better than anyone on the forum could. You are wise to get this taken care of, ignoring it could mean the loss of one or several teeth and could be career altering. Best of luck, and let us know what the periodontist says.
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Galen McQuarrie

  "Some days you get up and put the horn to your chops and it sounds pretty good and you win.  Some days you try and nothing works and the horn wins. This goes on and on and then you die and the horn wins."  Dizzy Gillespie
peter_trb3

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« Reply #2 on: Mar 21, 2008, 05:38AM »

I agree that the periodontist would certainly be able to offer better insight regarding the procedure than some people here on the forum. However, real world experience from the perspective of the trombone player would be far more helpful to me in this case. I have found that generally the medical profession is insensitive to minor details such as a career that depends heavily on oral usage. "This won't hurt a bit..."

Where a pat answer for the general population might be that one can expect to be feeling 100% in a few days that may mean two weeks without playing for someone in our choice of careers. I think that is a significant difference that a non-trombone playing periodontist may not be aware of.

I do certainly feel fortunate that my wife has terrific benefits through her employer and that I AM able to have this looked after. It is high time as I have seen my gums receding for the past several years and with regular dental visits am somewhat happy that my dentist has referred me to the periodontist for this procedure. I would still love to have some input from other trombonists who have had this procedure performed on them.
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Peter Collins
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« Reply #3 on: Mar 21, 2008, 05:56AM »

I've never even *heard* of this procedure. Very best of luck, Peter.
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Christine (red hot - that's what!)
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« Reply #4 on: Mar 21, 2008, 12:30PM »

I agree that the periodontist would certainly be able to offer better insight regarding the procedure than some people here on the forum. However, real world experience from the perspective of the trombone player would be far more helpful to me in this case. I have found that generally the medical profession is insensitive to minor details such as a career that depends heavily on oral usage. "This won't hurt a bit..."

I understand where you are comming from, Peter, but I would hope, perhaps in vain, the periodontist would be a bit more forthcomming. As a medical professional, I try to be aware of aspects of care that will seriously impact my patients' occupation. I would seriously consider obtaining another opinion if they did not. Perhaps someone is on the forum who has had this procedure, and can chime in. (Anyone out there!!) But you need to realize, that even if they did, the experience may vary a lot depending on the situation. Depending on what I know about oral surgery, I would **guess** that you might be off your horn for about a month. That probably is marginal information, at best. In the past we have had dental professionals frequent the forum, and hopefully one of them can pick up on this and shed some light on your problem. At anyrate best of luck with the procedure, and really quiz the periodontist. Let him know that this can severely impact your career. By the way, keep us informed as to what your proceedure and recovery information is. You may well be the pioneer here.
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Galen McQuarrie

  "Some days you get up and put the horn to your chops and it sounds pretty good and you win.  Some days you try and nothing works and the horn wins. This goes on and on and then you die and the horn wins."  Dizzy Gillespie
sanfranboner

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« Reply #5 on: Mar 21, 2008, 01:37PM »

My dentist has been bugging me to do this procedure for a good while now, and frankly the idea scares the bejeebus out of me.   On the other hand, having my front teeth fall out won't do much to help my career either...

But I do have a friend who had this procedure done, and he was back on his horn in a couple weeks with no problems.
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BarryLee

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« Reply #6 on: Mar 21, 2008, 03:15PM »

I've had periodontal issues for a few years now, myself. (I'm about ten years older than you).

My understanding, based on more than a couple consultations, is that periodontal disease is extremely difficult to arrest. Sometimes it's a result of poor hygeine, but I'm told there's frequently a genetic element too. And receding gumbs, unfortunately, are just really common as we grow older (welcome to middle age!), and some of us are more apt than others to suffer from it. Bone loss is also a consideration, I'm told.

Grafting and injections and such are NOT guaranteed to "cure" this -- that's something I was told by virtually everyone I've spoken to. It's also quite expensive, and here in the States anyway, virtually none of our so-called "Health Care" plans covers this.

I wouldn't be in any rush to submit to it, personally.

I first opted for some of the standard root-planing, and it's decidedly unpleasant. I was off the horn (and solid food) for a couple of weeks. More distressing was the fact that the procedure didn't really solve the problem of my receding gumbs, and I ended up losing a couple of teeth.

Yes, the front ones.

Initially, I got a partial, and the goofy thing was that I was able to get most all of my chops back almost immediately! The following week I played a Salsa/Brasilian gig with no complaints.

Some time later, I got a pair of implants, and my bionic chompers seem even better than my original teeth! It's amazing what can be done by screwing some titanium rods into your jaw...

I'm looking at more implants soon (I think I posted about this some months ago). Prices and quality of this kind of work vary widely, so you should certainly shop around. Consider Latin America.

I think the psychological aspect of this business is the most difficult.  I'd just like to assure you that these problems are NOT the end of the world.  There are several options. And I know more than a few really fine players who play with bionic teeth -- if it comes to that.

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Did you do your long tones today?
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« Reply #7 on: Mar 21, 2008, 06:36PM »

I have had this procedure done three times. The first was about 30 years ago and the last was about 5 years ago.  It is uncomfortable for a few weeks.  I was practicing, carefully,  again after one week.   I would certainly talk to your periodontist for his/her recommendation. My gums were in bad shape due to neglect on my part.  The surgery saved my teeth.  The work that I had done 5 years ago was to make sure that I kept my teeth into my old age.  Proper periodontal care is very important.  I floss every day and have my teeth cleaned 4 times a year.  I have had no further gum deteriation  in the 30 years that I have been receiving periodontal care. 
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peter_trb3

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« Reply #8 on: Mar 27, 2008, 06:10AM »

Wow! I hadn't checked on this thread in a bit and I'm very grateful for all your responses. It seems to be a real mixed bag of experiences out there with regards to both the treatment end and the success thereof.

I have my initial consultation this morning so I have my questions lined up in my head to ask. I'm mostly concerned about recovery time and the general impact on my playing and my oral set up (for lack of a better word). I'm not too concerned about the timing as it is post season and post auditions as well and add to that that I can always find an excuse NOT to get dental work done. There really is never a good time.

Money is not an issue in this case as my wife's benefits at work cover all procedures 100%. She thought last night that they may not cover it which really stung. I'm not particularly a fan of spending tons of money let alone when that spending leads to an immense amount of discomfort. At least now the pain is free. ugh.

I'll check in later today or tomorrow to let you all know what the periodontist has to say. I realize that this is not a pioneering move as a member of the forum but if I can help anybody else in the future by keeping a report here of the stages of the procedure I'm more than happy to contribute. I know that dental work can be daunting for any brass player amateur or professional so anything I can do to help ease the discomfort and uncertainty may be welcome.

Check in later.
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Peter Collins
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Hamilton Philharmonic Orchestra
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« Reply #9 on: Mar 27, 2008, 06:13AM »

Thanks, Peter. Good luck!
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Christine (red hot - that's what!)
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« Reply #10 on: Mar 27, 2008, 11:51AM »

I had the graft procedure about 10 years ago. The healing process was complete in about 2 weeks. I also had an apicoectomy and laser-assisted uvulopalatoplasty (LAUP). The apicoectomy took about the same time to heal. The LAUP involved about 4 cuts spaced out, each taking about 3 days to heal. As others have already said, the healing time and impact on playing varies depending on specific situations. Definitely wait until after HPO season and auditions are done. The mouth usually heals pretty fast, so you should not have to wait long before you're back on your horn.
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peter_trb3

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« Reply #11 on: Mar 27, 2008, 09:34PM »

So here's an update for you.

Had a great appointment this morning with the periodontist. An extremely pleasant woman who was able to explain everything that were going to do in very straight forward language and was able to answer all my questions. She certainly seemed to perk up when I told her I was a professional trombonist.  Good!

Basically what they are going to be doing is making two incisions on the roof of my mouth and removing some of the tissue that is underneath. This is the tissue they use for the graft. The will be tucking that in under the gum (or in a little kangaroo pouch in the gum in the periodontist's words) to make the graft. The incisions will be stitched up and covered with a removable, plastic, retainer-type appliance to stop my tongue messing with the incisions and the stitches.

She said to allow about 10 days for healing of both areas. There will be some discomfort which can (and likely will ;-) ) be dealt with with pain killers. No brushing of the area for the 10 days but DO brush the unaffected areas as normal. Success rate is high and in my case she sees no problems at all with the procedure and it is also not an emergency procedure.

When I spoke about my season and auditions and stuff she also mentioned that she is pregnant and won't be around for the summer and that I could do the procedure in June or in September upon her return. June seemed fine so I booked the appointment for then and will get it done at that point.

BUT... then I get home and discover an email booking me for a show from June 1-23!! Life is just soooo interesting. Looks like a call is in order tomorrow to the periodontist to see how late in June I can do this and to have a look at my season for next year to see when things are starting up.

Sheesh! It's never simple, is it?
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Peter Collins
Bass Trombone
Hamilton Philharmonic Orchestra
www.wesmoredigital.ca
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