What is a gum graft and who needs one?
A gum graft is a minor surgical procedure that adds or moves gum tissue to cover an exposed root or thicken thin gum where it has receded. It may be considered when recession is getting worse, roots are sensitive or decaying, or the gum is too thin to stay stable. Many people with receding gums never need one. At Creative Arts in Dubai your dentist finds the cause first and explains whether a graft suits you.
Who treats you here Dr. Duaa Ameen General Dentist · Dr. Taban Ameen Dentist
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What does a gum graft actually do?
When gum recedes, the root surface below the enamel is exposed. Roots are covered by a thinner, softer layer than enamel, so they can be sensitive to cold, wear away with brushing and decay more easily. Gum that has receded does not grow back by itself.
A gum graft addresses this in one or both of two ways. It can cover the exposed root, partly or fully, so the tooth looks less long and the root is protected. And it can thicken the gum, adding a band of firm tissue so a thin, fragile gum line is less likely to keep receding. Which aim matters most decides which kind of graft is chosen.
What a graft does not do is remove the cause. Recession usually has one or more reasons behind it: brushing too hard, gum disease, thin gum by nature, a tooth positioned towards the lip, grinding, or a lip or cheek attachment that pulls on the gum. If the cause is still there, recession can continue next to, or even under, a graft. That is why the cause is always dealt with first; our page on receding gums sets out the causes and how each is managed.
What types of gum graft are there?
In general terms, these are the main techniques. The dentist or surgeon chooses according to the aim, the amount of recession and the gum next to the tooth.
| Technique | How it works | Often chosen for | Second wound in the palate? |
|---|---|---|---|
| Connective tissue graft | A thin layer of tissue is taken from under the surface of the palate and placed under a flap of gum over the root | Covering exposed roots, often on visible teeth | Yes, usually small and covered |
| Free gingival graft | A strip of surface tissue from the palate is placed directly where the gum is thin | Thickening very thin gum, often on lower front teeth | Yes, an open area that heals over a couple of weeks |
| Pedicle or flap technique | Gum next to the receded area, or above it, is moved over the root while still attached | Recession next to plenty of healthy gum | No |
| Graft substitute (donor or collagen matrix) | Processed donor tissue or a collagen material replaces tissue from the palate | Several teeth at once, or when a second wound is to be avoided | No |
Techniques are often combined, for example a flap moved over a connective tissue graft. Which one is suggested depends on your gums, not on a menu.
Palate tissue or donor tissue: which is better?
Tissue from your own palate has the longest track record. The trade-off is a second wound: the palate is often the sorer of the two sites for the first days, and there is a limit to how much tissue can be taken. Donor tissue and collagen substitutes avoid that second wound, which can make treating several teeth at once more practical, but they behave differently and may not suit every situation.
The largest summary of the research, a Cochrane review of 48 randomised trials published in 2018, found that most root coverage procedures improved gum recession, and that connective tissue grafts showed a slight advantage when the goal was both covering the root and gaining firm gum. The authors rated the quality of the evidence as low to very low, mainly because of how the trials were designed. In practice, that means there is no single best graft for everyone; the choice is made case by case, and it is reasonable to ask why a particular technique is being suggested for you.
When may a gum graft be considered?
A graft is more likely to be discussed when recession is causing a problem or is likely to, rather than simply because it is visible.
Recession that is getting worse
Measurements or photographs over time show the gum line moving, despite the cause being addressed.
Thin, fragile gum
Very thin gum with little firm tissue, especially before orthodontic treatment or around a crown margin, may be thickened to keep it stable.
Sensitivity that does not settle
Exposed roots that stay sensitive despite desensitising toothpaste and other measures.
Root decay or wear
Exposed roots that are decaying or wearing, where covering them may help protect the tooth.
Appearance
Long-looking teeth on the smile line that bother you, once the gums are healthy and the cause is under control.
What are the alternatives to a gum graft?
From conservative to more involved. Many people with receding gums are well served by the first few rows.
| Option | What it does | When it fits |
|---|---|---|
| Monitoring | Records the gum line to see whether it is stable | Mild recession with no symptoms |
| Brushing technique and a soft brush | Removes the most common mechanical cause | Recession on the side you brush hardest, often canines and premolars |
| Treating gum disease | Cleaning or deep cleaning to stop inflammation-driven loss | Bleeding gums or pockets |
| Desensitising treatment | Toothpaste or varnish that calms exposed roots | Sensitivity is the main complaint |
| Composite bonding over the root | Covers and protects an exposed root surface with tooth-coloured material | Notched or sensitive roots where a graft is not wanted or not suitable |
| Night guard or orthodontics | Addresses grinding or a tooth positioned too far towards the lip | When these are contributing |
| Gum graft | Covers the root and/or thickens the gum | Progressing recession, thin gum or persistent problems, in selected cases |
A gum graft may be considered for some cases; your dentist will explain whether it suits you and, if so, who carries it out and where.
What is recovery from gum graft surgery like?
A gum graft is done under local anaesthetic, and how long it takes depends on the technique and the number of teeth. Afterwards, discomfort for the first few days is common, and when tissue is taken from the palate that site is often more tender than the graft itself. Over-the-counter pain relief, taken as directed on the pack, usually helps; your dentist will tell you what suits your health.
Typical advice for the first one to two weeks includes soft, cool food, chewing on the other side, not brushing the graft area until you are told to, using any prescribed rinse, and not pulling the lip to look at the area, which can disturb the graft. Stitches are often removed or dissolve within one to two weeks. The graft can look pale or patchy at first and blends in over the following weeks, with the final result judged after a few months.
Smoking and shisha reduce blood supply to the graft and are linked to poorer results, so stopping, at least during healing, makes a real difference. Contact the clinic if bleeding does not settle with gentle pressure, if swelling keeps increasing after the third day, or if you develop a fever.
Not sure whether your receding gums need anything more than better brushing? See how the cause is found and every option compared, from monitoring and bonding to grafts.
Receding gums optionsDoes gum grow back after a graft, and how much root can be covered?
A graft does not make your own gum regrow; it adds tissue to the area. How much of the exposed root can be covered depends largely on the bone and gum between the teeth. When that support is intact, full or near-full coverage is often achievable; when gum disease has already reduced the bone between the teeth, partial coverage is a more realistic aim, and thickening the gum may be the main goal. Your dentist can tell you which applies after measuring the area.
Results are usually stable when the cause has been dealt with and the gum is kept healthy, which is where your own brushing technique and regular cleaning come in. If you are weighing whether the underlying gum disease can be turned around, our guides to gingivitis vs periodontitis and whether gum disease can be reversed explain what is and is not possible. And if you are wondering who usually treats recession, our guide to gum specialists in Dubai explains the roles.