Gum Graft Surgery

Overview

What is a gum graft?

A gum graft is a type of dental surgery. It treats gum recession, a condition where your gums pull away from your teeth and expose the roots underneath. Exposed teeth roots increase your risk of tooth decay, sensitivity and bone loss around teeth. Gum grafting replaces the lost tissue around your teeth and improves your overall oral health.

Gum grafting surgery is usually done by a periodontist (a gum specialist). In the U.S., a periodontist receives three additional years of focused training after graduating from a four-year dental school.

Who needs to have gum grafting?

Your dentist will likely recommend gum grafting if you have gum recession. In many cases, receding gums are a symptom of severe gum disease, but people can also be genetically prone to thinning gums. You can also develop gum recession if you brush too aggressively.

How common is gum graft surgery?

Gum grafting is one of the most common periodontal procedures performed in the U.S.

Procedure Details

What happens before gum grafting?

If your dentist suspects that you need gum grafting, they’ll refer you to a periodontist for an examination. Your periodontist will check the health of your gums and measure the pockets around your teeth. They’ll also check to see how much recession you have around each tooth.

Depending on the severity of your condition, your periodontist may want to monitor the recession. Or they may recommend moving ahead with gum graft surgery. Your periodontist will discuss your treatment options with you in detail during your consultation.

What happens during gum graft surgery?

There are many gum grafting techniques and materials available. Periodontists commonly take tissue from your palate (the roof of your mouth) and move it to the area of recession. In some cases, though, they may use a substitute grafting material, which they can purchase from a licensed bone and tissue bank.

During a gum graft surgery, your periodontist will:

  1. Give you local anesthesia. This numbs your teeth and gums in that area. Many periodontists also offer sedation dentistry options for your comfort, including nitrous oxide, oral sedation and IV sedation. Be sure to ask about your options during your initial visit.
  2. Prepare the site. Once you’re comfortable, your periodontist makes an incision (cut) and creates a small flap in your gums. They’ll also thoroughly clean your teeth roots.
  3. Harvest the gum graft. Next, your surgeon creates another incision on the roof of your mouth and removes a small wedge of inner tissue. The outer layer remains intact. They’ll close the site using sutures or periodontal dressing. (If your surgeon decides to use donated tissue, they’ll skip this step.)
  4. Place the gum graft. Next, your surgeon places the gum graft over your exposed teeth roots (the area of recession).
  5. Place sutures. Finally, your surgeon repositions your gum tissue and stitches it into place. Your periodontist might use stitches that fall out on their own. Or you might need to have them removed at your follow-up visit.

How long does gum graft surgery take?

It depends on how many teeth have gum recession. If you only need one gum graft, it usually takes about an hour. If you need multiple grafts in different areas of your mouth, it could take longer.

Does gum graft surgery hurt?

You’ll be numb during your gum graft surgery, so you won’t feel anything during the procedure. You’ll probably have mild soreness after your procedure, but your periodontist will give you medications and post-surgical instructions to help minimize your discomfort.

What happens after gum grafting?

After your gum graft surgery, you’ll probably have gauze and dressing in place. Typically, you can remove the gauze after about 30 minutes. The dressing may fall out on its own during the first few days or your provider may remove it at your next appointment. Your surgeon will monitor you until it’s safe for you to go home. If you had sedation for your procedure, you’ll need a trusted friend or family member to drive you.

Your periodontist will provide you with detailed post-surgical guidelines. You should follow these closely to reduce your risk of pain and infection.

What’s the gum graft recovery timeline?

Your surgeon will probably want to check on your gum graft one week later. Then, you’ll have routine follow-ups until your periodontist releases you back to your general dentist for continuing care.

During this time, they’ll provide you with specific instructions. In general, here’s what you can expect:

The first day

Following your procedure, you’ll experience some bleeding, swelling and discomfort. To manage these side effects, take all medications exactly as prescribed by your surgeon. Get lots of rest and avoid strenuous activities.

Eat soft, cool foods, such as yogurt, pudding or smoothies.

Keep the surgical area clean using an antibacterial mouthwash. Don’t brush or floss directly on the gum graft, as this can damage it and lead to failure. (You can brush and floss your other teeth as your comfort level allows.)

The first week

Bleeding should subside within the first 24 hours to 48 hours. Swelling will continue for three to four days. You may also develop bruising during this time. These side effects are normal and should subside within the week. Continue taking all medications as prescribed.

You can incorporate more soft foods into your diet as you’re able, including things like eggs, pasta, fish and cooked vegetables.

Gently brush your teeth near the surgical site, but don’t brush directly on your gums. Don’t brush or floss around the gum graft until your surgeon says it’s safe.

The second week

Swelling and bruising should begin to fade, and your comfort level should continue to improve. Ask your surgeon when it’s safe to begin decreasing your medication dosage.

As your comfort level improves, you can incorporate more solid foods. However, you should still avoid hard, crunchy or spicy foods until your surgeon clears you.

Once your surgeon says it’s safe to do so, you can resume normal brushing and flossing.

Risks / Benefits

What are the advantages of gum grafting?

Gum tissue grafts offer a number of benefits. For example, they can:

  • Reduce your risk of gum disease.
  • Reduce your risk of cavities. (Exposed teeth roots are vulnerable to decay.)
  • Decrease teeth sensitivity.
  • Improve the appearance of your smile.

What are the risks or complications of gum graft surgery?

Complications following gum graft surgery are uncommon, but they can happen. Possible complications include:

  • Infection.
  • Excessive bleeding.
  • Rejection of the gum graft (failure).

If you notice heavy bleeding, pus or anything else that doesn’t look right, contact your surgeon right away.

What are gum graft failure symptoms?

If your gum graft failed, you’ll probably notice a large patch of white tissue that has come off of your tooth. Its lack of color means that the gum graft lost blood supply and is dying. If you notice this or have other concerns, such as pus at the surgical site or a fever over 101 degrees Fahrenheit (38.33 degrees Celsius), call your surgeon immediately.

Recovery and Outlook

How long does it take to recover from a gum graft?

Every person heals differently. But on average, gum graft recovery takes one week to two weeks. If you had multiple areas treated at once, recovery might take a little longer. Your periodontist can tell you what to expect.

When can I resume normal routines?

You should avoid exercise, heavy lifting and other strenuous exertions for at least the first week. These activities increase your heart rate and can lead to more discomfort, bleeding and swelling. Be sure to clear it with your surgeon before you resume these activities.

Most people can return to work or school in one day to two days.

Is gum graft surgery worth it?

Gum grafting boasts high success rates of over 90%. This procedure gives you the best chance of treating gum recession and improving your overall oral health.

Left untreated, gum recession can result in cavities, severe gum disease, tooth mobility and even eventual tooth loss.

When to Call the Doctor

When should I see my dentist?

Call your dentist if you have thin, painful, bleeding gums or if your teeth roots are visible. In the meantime, be sure to practice good oral hygiene and visit your dentist for routine dental cleanings. These appointments help keep your teeth and gums healthy and allow your dentist to detect issues early on, before they lead to other oral health problems.

A note from Cleveland Clinic

Hearing that you need gum graft surgery might feel scary. The good news is that it offers a number of benefits, including high success rates and a fairly quick recovery. Gum grafting is the leading treatment for gum recession. There are many different gum grafting techniques and materials available that can help replace and regenerate lost gum tissue. Your dentist or periodontist can explain your treatment options in detail during a consultation.

Last reviewed by a Cleveland Clinic medical professional on 07/18/2022.

References

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  • American Academy of Periodontology. Surgical Procedures. (https://www.perio.org/for-patients/periodontal-treatments-and-procedures/surgical-procedures/) Accessed 7/18/2022.
  • Imber JC, Kasaj A. Treatment of Gingival Recession: When and How? (https://pubmed.ncbi.nlm.nih.gov/34024328/) Int Dent J. 2021 Jun;71(3):178-187. Epub 2021 Jan 29. Accessed 7/18/2022.
  • Jankovic S, Aleksic Z, Klokkevold P. Use of platelet-rich fibrin membrane following treatment of gingival recession: a randomized clinical trial. (https://pubmed.ncbi.nlm.nih.gov/22292152/) Int J Periodontics Restorative Dent. 2012 Apr;32(2):e41-50. Accessed 7/18/2022.
  • Kaufmann ME, Wiedemeier DB, Zellweger U, et al. Gingival recession after scaling and root planing with or without systemic metronidazole and amoxicillin: a re-review. (https://pubmed.ncbi.nlm.nih.gov/31938962/) Clin Oral Investig. 2020 Mar;24(3):1091-1100. Epub 2020 Jan 15. Accessed 7/18/2022.

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