Gum graft surgery: treating receding and thin gums
Gum graft surgery is one of the restorative and cosmetic procedures used in periodontics, the branch of dentistry that cares for the gums and the tissues supporting the teeth. At the clinic, gum grafting is part of gum disease treatment, alongside conservative care, and is performed by a periodontics specialist who treats patients at the clinic.
Every treatment plan takes into account your medical history, your dental history and your cosmetic and functional goals. Careful planning supports normal healing and a more predictable result. At the first consultation, your gums are assessed, the suitable options are explained and your questions about each procedure are answered.
What is a gum graft?
A gum graft is a surgical procedure that restores gum tissue that has receded or been damaged by gum disease, trauma or other causes.
Contrary to what some patients think, a gum graft has nothing to do with dental implants: it places healthy gum tissue where the gum has receded or disappeared.
The main methods use either autogenous tissue (taken from another part of your own mouth) or biological materials that act as tissue substitutes. The right method for you depends on your clinical situation, the extent of the recession and other factors weighed during planning. The procedure is done under local anesthesia and in strict sterile conditions, with attention to your comfort.
When is a gum graft recommended?
Gum recession is a common condition in which the gum gradually shrinks back and exposes the tooth roots. As it progresses, it can cause sensitivity and cosmetic concerns and, in severe cases, threaten the stability of the tooth and increase the risk of root decay. In these cases, gum graft surgery may be the right solution.
The main situations in which a gum graft is considered:
- Significant gum recession exposing the tooth roots
- Tooth sensitivity caused by exposed roots
- Cosmetic concerns such as "long teeth" or an uneven gum line
- Loss of gum tissue around dental implants
- Preventing further recession and bone loss
Treating gum recession is not only cosmetic: it helps protect your teeth in the long term. Healthy gums protect the roots and the surrounding bone, which helps you keep your natural teeth.
Types of gum grafts and how they differ
In a free gingival graft, gum tissue is taken from your palate and placed in the area of recession; it is particularly suited to increasing the band of firm (keratinized) gum around a tooth. A subepithelial connective tissue graft gives a better cosmetic result and is mainly used to cover exposed roots. According to a Cochrane systematic review (2018), a connective tissue graft combined with a coronally advanced flap reduced recession more than guided tissue regeneration, with no clear difference compared with an acellular dermal matrix or enamel matrix proteins.
Tissue substitutes such as an acellular dermal matrix or collagen membranes avoid taking tissue from the palate and may therefore reduce discomfort after surgery. When indicated, a platelet-rich fibrin concentrate (PRF), prepared from your own blood in a centrifuge at the clinic, is added to support healing.
| Criterion | Free gingival graft | Connective tissue graft |
|---|---|---|
| Main use | Increasing the firm (keratinized) gum around the tooth | Covering exposed roots |
| Tissue and result | Thick, resistant tissue | Good cosmetic result |
| Color match | May blend less well | Natural color match |
Preparing for gum graft surgery
Good preparation matters for the success of a gum graft and for smooth healing. The assessment includes an examination of the gum tissue, X-rays when needed and careful planning of the surgery.
If you smoke, stop as early as possible before the procedure, as your surgeon advises: smoking slows healing and increases the risk of infection. Tell the dentist about any medical conditions (such as diabetes or heart disease) and regular medications, especially blood thinners: the dentist will decide, with your physician if needed, whether special preparation is required. Never stop a medication on your own.
Planning looks at the thickness of the gum, the extent of the recession and the condition of the palate, where the tissue is usually taken. The type of graft and the technique are then chosen, and the procedure and expected recovery are explained to you.
Antiseptic mouth rinses before surgery are used only if the dentist prescribes them. It is a good idea to eat a light meal beforehand and, if possible, to come with someone who can help you get home.
How is gum graft surgery done?
Gum graft surgery is done under local anesthesia, so you should not feel pain during the procedure. It uses either your own gum tissue or carefully processed donor tissue.
The surgeon makes a small incision in the gum and prepares a space to receive the graft. Depending on the type of graft, tissue is taken from another part of your mouth (usually the palate) or a processed substitute is used. The graft is placed carefully and secured with very fine stitches, which dissolve on their own or are removed at a follow-up visit.
Examination, treatment plan and price quote
detailed and personalized
During the consultation, Dr Haim Aseriel examines your teeth, explains all the options and gives you a transparent price quote, with no obligation. The clinic is at 12 HaTnufa Street, Jerusalem.
Gum graft recovery, step by step
Recovery after a gum graft directly affects the long-term success of the surgery. Mild swelling and minor bleeding are common in the first hours and days and are normal reactions to the procedure; the graft then integrates over the following weeks, at a pace that depends on the extent of the surgery and on the patient.
The first week
Eat soft, cool foods, avoid strenuous exercise and rinse gently only as instructed. Do not brush the surgical area directly in the first days; follow the specific cleaning instructions you receive instead.
The follow-up visit
A follow-up visit checks healing and removes stitches if needed. It is also a chance to ask questions and get further instructions. Most patients return to normal function within a few weeks, when the first results of the procedure become visible.
After full healing
Once healing is complete, you receive guidance on keeping your gums healthy: correct flossing, a soft toothbrush and, if recommended, a suitable mouthwash. Check-ups and professional cleanings are scheduled at the frequency your dentist sets according to your gum condition and personal risk.
Pain during and after a gum graft
Pain is one of the most common concerns before a gum graft. The procedure itself is done under local anesthesia, so you usually feel no pain during surgery. Once the anesthesia wears off, most patients report mild to moderate discomfort. For pain relief, ask your dentist or pharmacist which medication and dose suit you. If pain is stronger than expected, the dentist will look for the cause and adjust treatment.
Other measures help: cold compresses on the outside of the face in the first days to reduce swelling, avoiding hot, spicy or hard foods, and getting enough rest. Pain is subjective: some patients feel little discomfort after a couple of days, others for longer, and it usually fades gradually into mild tenderness.
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Smokers' risk of gum disease compared with non-smokers (CDC)
Smoking also makes gum treatment less successful, which is why avoiding tobacco during healing, and ideally for good, protects your graft.
Contact the clinic without delay if you have unusual pain that does not respond to treatment, swelling that gets worse after the first few days, persistent bleeding or a fever. Swelling spreading toward the eye or neck, or difficulty swallowing or breathing, requires going to the emergency room immediately.
What to eat after a gum graft
Diet after gum surgery plays an important role in healing. In the first week, a soft, cool diet avoids irritating the surgical area and lets the tissue heal properly.
Recommended foods
Soups (not too hot), yogurt, soft cheese, eggs, porridge, mashed potatoes and protein-rich foods that need little chewing.
Foods to avoid
Avoid hard, crunchy or very hot foods during the first stage of healing. Nuts, chips, popcorn and spicy dishes can damage the surgical area or irritate it.
You can return gradually to a normal diet as healing progresses and as your dentist advises, while keeping up careful oral hygiene.
How to make your gum graft last
Long-term success after a gum graft rests on careful oral hygiene, regular follow-up and healthy habits. Brush at least twice a day with a soft toothbrush and a gentle technique that does not damage the gum, and clean between your teeth every day.
Periodic check-ups include a professional cleaning and an assessment of the gums, so that problems are found and treated early. Your follow-up plan is tailored to your personal risk factors and gum anatomy; check-up frequency depends on your oral health and personal risk: for many people it is every six months, for others more or less often.
Avoiding tobacco is another key recommendation. According to the US Centers for Disease Control and Prevention (CDC), smokers have twice the risk of gum disease of non-smokers, and gum treatment works less well for them. When grinding puts extra pressure on the teeth, a night guard may be recommended for added protection.
Gum graft cost: what affects the price?
The cost of a gum graft depends on several factors: the extent of the procedure, the materials used and the surgical technique suited to your case. A graft in a small area of the mouth does not require the same resources as treatment covering several teeth or whole sections of the mouth, and tissue substitutes or other biological materials, when they are indicated, also change the cost.
The clinic does not publish a price list: after the examination, you receive a detailed treatment plan with a written estimate before anything starts, and itemized receipts that you can submit to your insurer (coverage depends on your policy).
Gum graft: consultation in Jerusalem
A gum graft is a significant decision, so every surgical step is discussed beforehand. The clinic team, led by Dr Haim Aseriel, assesses your mouth in English, explains the preparation, the procedure, the expected recovery and the likely result, and recommends non-surgical treatment whenever it is possible. The clinic is at 12 HaTnufa Street in Talpiot, south Jerusalem; opening hours: Sun 8:00–19:00 · Mon 9:00–19:00 · Tue–Wed 9:00–21:00 · Thu 8:30–21:00 · Fri 8:00–14:00.
Gum graft: frequently asked questions
A gum graft is a surgical procedure that restores gum tissue lost to recession, gum disease or trauma. Despite the name, it does not involve dental implants: healthy gum tissue, usually taken from the palate, or a tissue substitute is placed where the gum has receded, to cover exposed roots or thicken thin gums.
A gum graft is mainly recommended for significant gum recession that exposes tooth roots, tooth sensitivity caused by exposed roots, cosmetic concerns such as "long teeth" or an uneven gum line, loss of gum tissue around dental implants, and to stop recession from progressing.
A free gingival graft takes surface tissue from the palate and is mainly used to thicken the gum and increase the band of firm (keratinized) gum around a tooth. A subepithelial connective tissue graft is taken from a deeper layer of the palate, blends in better and is mainly used to cover exposed roots, where it is one of the best-documented methods.
Gum graft recovery happens in stages: discomfort and swelling are greatest in the first days, the graft then integrates over the following weeks, and the final appearance of the gum settles gradually after that. The exact timeline depends on the extent of the procedure and on the patient.
A gum graft is done under local anesthesia, so it is usually not painful during surgery. Once the anesthesia wears off, most patients feel mild to moderate discomfort, mainly at the palate where tissue was taken. Ask your dentist or pharmacist which pain reliever and dose suit you.
Sources
- Chambrone L et al., Cochrane Database of Systematic Reviews, 2018 – View the study
- Centers for Disease Control and Prevention, Smoking, Gum Disease, and Tooth Loss – View the page
- Carrasco-Labra A et al., Journal of the American Dental Association, 2024 – View the study
- Fee PA et al., Cochrane Database of Systematic Reviews, 2020 – View the study
