Gum Grafting

A gum graft covers an exposed root and rebuilds the band of firm tissue around a tooth. Recession has several causes: brushing too hard, gum disease, naturally thin tissue, grinding and orthodontic movement. At Pearl32 Dentistry and Wellness in Laguna Hills, grafting is performed by the visiting periodontist here in Suite 450. Most people are comfortable within two to three weeks. The goal is coverage and stability, and we explain what coverage is realistic beforehand.

Why do gums recede?

Recession has more than one cause, and the cause changes the plan. Brushing hard with a stiff brush wears the gum and the root surface. Gum disease destroys the attachment from underneath. Thin tissue over a prominent root has little to lose in the first place.

Grinding adds flexing force at the gum line. Orthodontic movement can push a root toward the outer plate of bone, where the covering is thin. We look at all of these before grafting, because a graft placed over an unresolved cause recedes again.

When does recession need a graft?

Not all recession needs treatment. Three things push toward a graft: sensitivity that has not responded to varnish and desensitizing toothpaste, recession that is measurably getting worse over one to two years, and a root that is wearing or decaying.

Appearance is a fair reason as well, particularly on upper front teeth. We photograph and measure the recession, then compare at the next visit. A stable three millimeter recession with a healthy band of firm tissue is often watched rather than treated. See periodontal treatment for the disease side of this.

Connective tissue graft or free gingival graft?

A connective tissue graft is the usual choice when root coverage is the goal. A thin layer of tissue is taken from under the surface of the palate and tucked under the gum at the recession site. The surface of the palate stays closed, which keeps that area more comfortable.

A free gingival graft takes a thicker piece from the palate surface and places it directly. It builds a wider band of firm tissue but covers less root and matches color less closely. It suits lower front teeth that have almost no attached tissue left.

Where does the tissue come from?

Three options exist. Your own palate gives the most predictable result and is used most often. Donor tissue from a tissue bank is processed and sterilized, and it avoids a second surgical site, which many people prefer. A tissue stimulating protein product can be added in selected cases.

Each option is discussed with the visiting periodontist before the appointment, with the tradeoffs named. Your own tissue means a sore palate for about a week. Donor tissue means no palate site and a slightly less predictable amount of coverage. You choose with the facts in front of you.

What does healing look like?

Expect two to three weeks for comfortable healing and several months for the tissue to mature. The first three days involve swelling and soreness that responds to over the counter anti-inflammatories. A protective dressing or a palatal guard is often placed.

You will avoid brushing the site for one to two weeks and use a prescribed rinse instead. Eat soft, cool food at first. Do not pull on the lip to look, which is the instruction people break most. Sutures come out or dissolve at one to two weeks. We are at Suite 450, reached by elevator; see directions and parking.

What a gum graft will not do

A graft will not always cover the full amount of exposed root. Coverage depends on how much bone and tissue remain between the teeth. Where the bone between teeth is intact, full coverage is a reasonable expectation. Where it is lost, partial coverage is the honest target, and we show you which category your tooth is in before you agree to anything.

It will not correct the cause. If you brush hard, we change the brush and the technique. If you grind, we make a night guard. If gum disease is active, we treat that first, because a graft on an infected site fails.

What does gum grafting cost?

Cost depends on the number of teeth treated, the technique and the donor source, and it is quoted in writing, itemized, after an examination. Grafting several adjacent teeth in one session usually costs less per tooth than doing them separately, and we will say when that applies to you.

We are in network with most major PPO plans and Delta Dental HMO. Coverage depends on whether the plan considers the graft functional or cosmetic, so we send a predetermination. Third party financing is available and the practice is not the creditor, through CareCredit, Cherry, Sunbit and Happen Bank (formerly LendingClub). See financing.

Questions people ask about gum Grafting

Does gum grafting hurt?

The procedure is done under local anesthetic and is comfortable. The sore part afterward is usually the palate, not the grafted area, and it settles within about a week. Over the counter anti-inflammatories handle it for most people. Nitrous oxide, oral sedation and IV sedation are available if the idea of the appointment is the problem.

Will my gums grow back without surgery?

No. Gum tissue that has receded does not regrow on its own, and no toothpaste or rinse restores it. What you can do without surgery is halt the progression: change your brushing technique, treat active gum disease, and protect the teeth if you grind. If sensitivity is the main complaint, fluoride varnish and desensitizing toothpaste often solve it.

How long does a graft last?

Most grafts hold long term when the cause is corrected. Studies following connective tissue grafts report stable coverage at five and ten years in the majority of cases. The failures cluster around continued hard brushing, untreated gum disease and heavy grinding. We review technique at each maintenance visit and measure the site so any change is caught early.

Can several teeth be done at once?

Usually yes, and it is often the sensible way. Adjacent teeth in the same area can be treated in a single session, which means one healing period rather than several. Sites on opposite sides are normally separated so you have a comfortable side to chew on. The visiting periodontist plans the sequence at your consultation.

How soon can I go back to work?

Most people return the next day. Expect swelling for two to three days and visible sutures for one to two weeks. Speaking is normal, though a palatal dressing feels odd at first. Avoid hard exercise for about three days, since raised blood pressure can disturb the site. Our hours are Monday to Friday, 8 AM to 5 PM.

This page is general information, not a diagnosis. What is right for you can only be decided after an examination.