Gum grafting is a periodontal surgical procedure in which soft tissue is transplanted to areas of gingival recession, covering exposed tooth roots and augmenting the zone of attached gingiva. The primary goals are to halt further recession, reduce root sensitivity, and restore both function and esthetics to the periodontium.
Why Gum Grafting Matters
When the gingival margin recedes, the cementum and underlying dentin become exposed to the oral environment. This creates several compounding clinical problems: heightened thermal and tactile sensitivity, increased susceptibility to root caries, compromised esthetics, and progressive loss of the alveolar bone support that anchors teeth. Left untreated, recession tends to accelerate, making early intervention the most tissue-conserving approach.
Common Causes of Gingival Recession
- Aggressive or improper toothbrushing technique
- Chronic periodontal disease and associated bone loss
- Thin gingival biotype with insufficient attached gingiva
- Orthodontic tooth movement beyond the alveolar envelope
- High frenal attachments or aberrant muscle pull
Types of Gum Grafts
The most widely performed techniques each offer distinct advantages depending on recession depth, available donor tissue, and patient anatomy:
- Connective tissue graft (CTG): A subepithelial graft harvested from the palate; considered the gold standard for root coverage due to superior color blending and predictable outcomes.
- Free gingival graft (FGG): Full-thickness palatal tissue used primarily to increase the width of attached gingiva rather than achieve complete root coverage.
- Coronally advanced flap: Adjacent gingival tissue is advanced over the recession site, often combined with a CTG or acellular dermal matrix for improved coverage.
- Acellular dermal matrix (ADM): A processed donor allograft that eliminates the palatal donor site, reducing postoperative discomfort without sacrificing predictability.
Procedure and Recovery
Gum grafting is performed under local anesthesia in a periodontal or general dental setting. The recipient site is prepared by elevating a flap or creating a pouch, the graft material is secured with sutures, and a protective dressing is placed over the surgical area. Healing takes approximately four to six weeks, during which patients follow a soft diet and modified oral hygiene protocols. Root coverage success rates for connective tissue grafts exceed 85% in favorable clinical cases.
Early identification of recession and timely referral to a periodontist significantly improve outcomes and minimize the extent of grafting required.