Gum Graft Explained & What to Expect

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Dental Health

Written by Whitney DiFoggio MA, RDH

Medical Reviewed on Oct 17, 2023

byDr. Matthew Hannan DDS

🔬 Evidence Based

A healthy mouth relies on healthy gum tissue (“gingiva.”) When your gums are tightly attached around the root of your tooth, it reduces the risk for mobility and tooth loss, sensitivity, root-surface cavities, and aesthetic or cosmetic issues.

Whenever your gum tissue isn’t up “high” enough on your tooth, a gum graft can restore the gumline. Gum graft surgery involves repositioning or grafting new gingiva over the exposed root surface to correct the soft tissue defect. This helps to stop the progression of gum recession and protects the roots of the teeth, making them less vulnerable to further recession. Even if gum graft surgery sounds like an elective procedure, it’s often an essential part of preserving your smile’s long-term health.

What Is a Gum Graft?

Gum augmentation is frequently referred to as “gum graft surgery.” It’s a procedure where your dentist or a dental specialist (like a periodontist or oral surgeon) grafts new, nearby healthy gum tissue onto an area of your mouth where there isn’t enough gingiva. Like a skin graft or grafting plants onto one another, you’re basically taking tissue and moving it somewhere else, so that it re-attaches and is healthy in a location different from where it originated.

A gum graft helps you keep your gum levels healthy. After all, your gums have attachment fibers inside of them that are responsible for anchoring your tooth and connecting it with the bone structure underneath. Without healthy gum levels, you can’t have healthy teeth or bone.

Gum graft surgery can be for health or cosmetic purposes. Essentially, it is rebuilding the level of gingiva back to where it’s supposed to be through surgical intervention.

Why Would I Need A Gum Graft?

Since the roots of teeth aren’t covered by enamel, they’re weaker, more sensitive, and highly prone to decay when they’re exposed to the outside elements.

You might need a gum graft if you:

Have exposed root surfaces
Recovered from advanced gum disease
Have gum recession
Are undergoing ridge augmentation (a type of bone graft)

Gum grafts are also used to manage tooth sensitivity, root-surface cavity risk, planning for dental implants, or for aesthetic reasons. For example, if you’re “long in the teeth” because of aggressive tooth brushing or bruxism causing receding gums, gum graft surgery will help correct your gum levels to keep your teeth healthy and more attractive. But you might also need a gum graft if you’re managing tissue loss from gum disease or after a sinus lift before placing implants.

Because gum graft surgery plays so many different roles, it’s ultimately up to you and your dentist or dental specialist to discuss the pros and cons related to your situation.

Types of Gum Grafts

Traditionally, there are four main types of gum graft surgery that you’ll find used in dental practices. There are also non-surgical alternatives like “Pinhole Rejuvenation,” where the gums are gently stretched over the exposed areas, instead of placing a separate piece of gingiva over that area. But for simplicity’s sake, a gum grafting techniques will usually fall into one of the following three types of augmentation surgeries:

1. Connective Tissue Grafts

A connective tissue graft is frequently used when there are cosmetic issues and the gum tissues need to match one another or cover a wider surface area. For this type of graft, a piece of tissue is usually removed from the palate (roof of the mouth) by flapping back the tissue, harvesting a sample of connective tissue underneath, closing the flap, and then suturing it into place around the teeth. Due to the location of the donor tissue, this type of graft can result in fairly significant post-operative discomfort.

2. Free Gingival Grafts

A free gingival graft is less cosmetic and more functional, like if you have thin or receding gum tissues around teeth and dental implants. Like connective tissue grafts, free gingival grafts involve removing a portion of donor tissue from the roof of the mouth. But instead of a flap being created, the surface tissue is removed and transferred to the area receiving the graft. Free gingival grafts do tend to be uncomfortable during the recovery process because of the tissue removed at the donor site.

What if you could use the gum tissues right next to your receding gumlines to cover the exposed part of your tooth? That’s exactly what a pedicle graft is! Instead of removing gingiva from elsewhere in your mouth, a small area of gums is retracted and tugged to reposition them around your tooth. They’re usually sutured in place until they heal.

3. Alloderm Grafts

Donor tissue for gum grafting is called an Alloderm graft. This gum graft procedure is non-surgical and slips under the edge of your existing gingiva, fusing with your gums while you avoid more surgical grafting techniques.

How Do Gum Grafts Work?

When your dentist places new gum tissue over your exposed tooth or bone, it physically attaches to that structure and fuses with the adjacent gingiva, like you would see if a cut was healing back together.

You can think of your gums as a special protective layer over your tooth. When it’s missing, a gum graft repairs that area to protect what’s underneath it. The gingiva naturally fuses and integrates with the gums around them, almost as if they were always there to begin with. Your body should naturally “take” to the graft as long as you care for that area properly and give it time to heal.

What To Expect From Gum Grafting Procedure

Your gum graft treatment isn’t anything to feel nervous about! Just like other routine soft tissue therapies, it’s predictable and performed in a gentle manner. For patients who need complex tissue augmentation, sedation will probably be available upon request.

Before

You and your dentist will select the type of gum graft that you need. If different options are available, you can weigh the pros and cons of each and then select the specific tissue you’re going to use.

During

At the time of the grafting procedure, your dentist will need to numb your mouth with local anesthesia. But if it’s a type of graft where no incisions or tissue harvesting are needed, numbing might not be required. This will vary case by case, so talk to your dentist about what to expect during the initial treatment planning process.

After

Your home care instructions are the most important part of your recovery. Some people are placed on a soft diet for a week or more, while others have sutures that need to be removed a week later. Again, check with your dentist on this one! More invasive gum graft surgeries will probably result in some moderate discomfort for at least a few days afterward.

Are Gum Grafts Painful?

Depending on which type of gum graft you’re getting, there may not be any pain afterward or there could be significant discomfort. The types of grafts that tend to be the most painful are those where the graft tissue is removed from the roof of your mouth. Technically it’s not the graft itself that hurts, but where the graft was harvested from (think a pizza burn on the roof of your mouth, times 10.)

Fortunately, other types of gum grafts offer little irritation after the procedure. If there is any discomfort, it can usually be managed with an over-the-counter pain reliever like Motrin or a cool compress.

What to Expect During Recovery

It’s extremely important to be gentle with your gum graft and donor site after an augmentation appointment. Any irritation—whether it’s brushing your teeth or eating something too crunchy—could displace the tissue graft and cause it to fail or delay the healing process in the donor area.

Plan to eat soft foods for the first several days. Cold foods like yogurt, cottage cheese, or cooled mashed potatoes, are all great soft foods that are filling and gentle on your mouth. Be sure to avoid anything that’s too hot (temperature-wise) or spicy.

In instances where your dentist uses a medicated dressing or sutures, do your best to avoid touching them. Keep your follow-up appointment to have any stitches or dressings removed by your dental team.

If your dentist prescribes any medication, be it prescription or over-the-counter, take it as directed. Doing so will significantly influence your recovery, post-op discomfort, and success of the grafting procedure.

Gum Grafting Risks & Complications

The biggest risk with gum tissue grafts is that it doesn’t take. Or that your body rejects the graft tissue. Gum graft surgery has about a 90% success rate, so there’s about a 1-in-10 chance that it could fail. Thankfully, caring for that area properly will reduce the risk of infection or trauma that might contribute to any complications.

There’s also a chance that the gum graft just doesn’t work as well as you and your dentist hoped that it would. Maybe the tissue is attached, but it doesn’t cover as high up over the tooth as what the goal was.

Pain, swelling, or irritation are not uncommon after a gum graft surgery, but if symptoms persist more than a day or so, you will need to see your dentist for a follow-up.

Does Insurance Cover Gum Grafting

“Will my dental insurance cover gum grafting surgery?” Bring a copy of your insurance card to your dental exam, and the insurance coordinators will get a breakdown of your unique benefits package to know what is covered and how much insurance will pay for it. Remember, every plan is different, and even policies under the same company vary, depending on what you or your employer agreed to when purchasing the package.

For the most part, dental insurance usually covers gum grafting surgery, at least when it’s needed for health reasons (maybe just not cosmetic ones.) Your dental provider will work up a care plan to itemize all of the fees for you before the treatment is scheduled.

Cost Of Gum Graft Surgery

Average Cost: $1,000

Depending on where you live, the type of dentist or specialist you’re seeing, how many teeth are involved, and the type of gum graft you’re getting, the cost for treatment can easily range anywhere from $600 to $2,500 or more. When multiple teeth are involved, it can cost as much as $5,000 or greater. Just remember, every case is unique, so the only way to know exactly how much a gum graft will cost is to physically see a dentist and have them look at your mouth. They cannot even “guesstimate” the gum tissue graft cost over the phone because of how unique this procedure actually is.

Talk With Your Dentist About Gum Graft

A gum graft can be one of your last options if you have major tissue loss from gum disease or trauma to that area. If you need gum graft surgery but don’t get it, you could be sacrificing your dental health in the long run. Always talk to your dentist about what options there are and the pros and cons of a gum graft for your situation. They can always refer you to a specialist if you need more complex care or want to have the procedure completed under sedation. The better you care for your graft area after treatment, the better the outcome will usually be.

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Written by Whitney DiFoggio MA, RDH"Teeth Talk Girl," is a registered dental hygienist. She started her dental health journey on YouTube, educating the public through videos.