Gum Grafting: What the Procedure Involves, Recovery and When It Is Needed
A gum graft is minor oral surgery that takes a small piece of gum tissue — usually from the roof of your own mouth — and uses it to cover an exposed tooth root or to thicken gum that has become too thin. It is carried out under local anaesthetic, takes around an hour, and the sutures stay in for roughly one to two weeks, with healing continuing over a few weeks to a few months.
Two things are worth knowing before you read any further. Grafting treats the gum; it does not regrow lost jawbone. And a graft may not cover an exposed root completely — Leeds Teaching Hospitals NHS Trust lists exactly that among the recognised limitations of the procedure.
What a gum graft actually does
Cambridge University Hospitals NHS Foundation Trust describes soft-tissue grafting as a procedure that uses your own tissue from elsewhere in your mouth to repair areas of recession where tooth roots have become exposed. The trust lists its aims as prevention or reduction of sensitivity by covering the exposed root, facilitating your own home cleaning, minimising the risk of further recession, symmetry in your gum line, and creation of a suitable environment for implant placement if required.
That last point is why grafting sometimes comes up in an implant discussion rather than a gum one: where soft tissue at a planned implant site is thin, grafting may be a step in the sequence rather than a treatment in its own right.
What it does not do
Leeds Teaching Hospitals NHS Trust lists the types of periodontal surgery separately, and the distinction is the useful one: regenerative surgery aims to regrow lost bone support, while soft tissue grafting treats gum recession. Different operations, different goals. A graft placed over an exposed root improves the soft tissue covering it. It does not rebuild the bone already lost beneath.
It also does not treat the cause. If recession is being driven by active gum disease, grafting onto an untreated site is building on unstable ground. If bleeding or swelling is part of your picture, read about gum disease treatment first.
When grafting is considered
Cambridge University Hospitals sets out what soft tissue grafting is intended to achieve, and those stated aims are the practical indications. The trust lists them as:
- Prevention or reduction of sensitivity by covering the exposed root.
- Facilitating your own home cleaning.
- Minimising the risk of further recession.
- Symmetry in your gum line.
- Creation of a suitable environment for implant placement if required.
One widely repeated explanation deserves scrutiny. Aggressive brushing is routinely blamed for recession, and it may well contribute — but the evidence is weaker than the confidence with which it is asserted. A systematic review by Heasman and colleagues in the Journal of Clinical Periodontology concluded that the data to support or refute the association between toothbrushing and gingival recession remain largely inconclusive, although its meta-analysis did find greater recession at 12 months among manual toothbrush users than powered brush users. Worth knowing, but not the settled fact it is usually presented as.
The types of graft
Leeds Teaching Hospitals NHS Trust describes the main soft tissue procedures as follows.
Connective tissue graft
Tissue is taken from beneath the surface layer of the palate and tucked under the gum at the recession site. Leeds Teaching Hospitals describes it as used to try to cover gum recession, or to add bulk to the gum around one or more teeth or dental implants.
Free gingival graft
A piece of surface tissue is taken from the palate and placed at the recipient site to increase the band of hard-wearing gum.
Flap procedures and graft substitutes
Gum next to the recession can be loosened and repositioned to cover the exposed root, alone or combined with a graft. Donor-free materials also exist: the 2018 Cochrane review on root coverage assessed acellular dermal matrix, xenogeneic collagen matrix, enamel matrix proteins and guided tissue regeneration alongside connective tissue grafting, and noted acellular dermal matrix appeared to be the soft tissue substitute producing outcomes most similar to a connective tissue graft.
What happens on the day
Cambridge University Hospitals describes the procedure as taking around an hour: local anaesthetic, loosening the existing gum tissue to create room for the graft, harvesting tissue from a healthy site in the mouth, placing the graft under the gum at the recipient site, and suturing. Sutures are either dissolving or removed within 7 to 21 days. Leeds Teaching Hospitals confirms that periodontal surgery is carried out under local anaesthetic injections, that you are awake throughout, and that you can go straight home immediately afterwards.
If anxiety about dental treatment is a factor for you, raise it early rather than deferring care over it. IV sedation for anxious patients is available for treatment carried out at this practice, subject to clinical assessment.
Recovery: a realistic timeline
The first 48 hours. Expect discomfort, swelling and possibly bruising. Leeds Teaching Hospitals lists pain or discomfort, bleeding, swelling and bruising among the most common risks of periodontal surgery, and states that over-the-counter painkillers should be enough to manage it. The trust advises avoiding vigorous exercise and alcohol for 24 hours.
The first one to two weeks. Cambridge University Hospitals notes that pain, swelling and bruising may be experienced within one to two weeks. Leeds Teaching Hospitals advises avoiding toothbrushing at the surgical site until the stitches are removed, using chlorhexidine mouthwash twice daily in the meantime, and not removing any dressing pack early. Stitches are typically in place for one to two weeks.
The palate. Leeds Teaching Hospitals notes that periodontal dressing packs may be placed over the donor site in the roof of your mouth and over the area where the graft was placed. It is worth planning soft food around this rather than being surprised by it.
Weeks to months. Cambridge University Hospitals advises allowing a few weeks to a few months for healing, depending on each individual case. The same trust advises ongoing care: a soft toothbrush cleaning effectively yet gently around the tooth, avoiding abrasive toothpastes, and regular check-ups.
What the evidence shows about results
How much coverage is achievable relates to what has already been lost between the teeth. Cairo and colleagues, writing in the Journal of Clinical Periodontology in 2011, classified recession by the level of attachment in the gaps between teeth: RT1 has no loss of interproximal attachment; RT2 has interproximal loss less than or equal to that on the outer surface of the tooth; RT3 has greater interproximal loss than on the outer surface. They reported that the RT classification significantly predicted recession reduction at the six-month follow-up across 109 treated gingival recessions. What that means for your own case is a question for the clinician assessing you, not something a classification alone settles.
The overall evidence base is less certain than marketing suggests. The 2018 Cochrane review by Chambrone and colleagues pooled 48 randomised controlled trials involving 1,227 participants. It found a greater reduction in gingival recession for connective tissue grafting with a coronally advanced flap than for guided tissue regeneration with a resorbable membrane (mean difference −0.37 mm; 95% CI −0.60 to −0.13; P = 0.002; 3 studies; 98 participants) — but rated that evidence low quality, with 47 of the 48 trials at unclear or high risk of bias and only one at low risk overall. Its conclusion was that connective tissue grafts, coronally advanced flaps alone or with other biomaterials, and guided tissue regeneration may all be used for root coverage, and that where both root coverage and a gain in the width of keratinised tissue are expected, connective tissue grafts show a slight improvement in outcome.
Anyone quoting you a precise success percentage for gum grafting should be asked where it comes from.
Who is not a good candidate
Leeds Teaching Hospitals is direct on one point in particular: if you smoke, periodontal surgery is not usually suitable, due to the negative effects of smoking on your gums. The NHS lists stopping smoking among the measures for managing gum disease.
The trust also notes that grafts may not completely cover exposed root surfaces. Failure of the procedure is listed among the recognised risks, alongside recession, sensitivity and the possibility of needing further surgery.
Active, untreated gum disease is the other common reason to postpone. The NHS describes gum disease as caused by plaque that builds up and irritates the gums when it is not removed by brushing and cleaning between the teeth. Where recession sits on top of that, the disease is treated first.
Suitability for treatment depends on a clinical assessment. This treatment may not be appropriate for every patient.
Is gum grafting available on the NHS?
Sometimes. The NHS states that it provides clinically necessary treatment needed to keep your mouth, teeth and gums healthy, and that cosmetic treatments usually need to be obtained privately. Periodontal surgery, including soft tissue grafting, is carried out within NHS hospital services — Leeds Teaching Hospitals NHS Trust is one example.
The practical distinction is between grafting proposed to protect a deteriorating, sensitive or uncleanable site and grafting proposed purely to improve the look of the gum line. Where a given case falls is a clinical judgement, not something a web page can settle.
Assessment and next steps
Soft tissue grafting is periodontal surgery, and it is carried out within hospital periodontal services. Horsforth Smile Clinic does not provide gum grafting.
What we can do is assess recession, treat the underlying causes that fall within our own scope of practice — gum disease treatment sets out what that involves — and discuss with you whether an onward opinion is appropriate. A new patient consultation is from £55, subject to clinical assessment (price correct as of July 2026); our full price list is published openly.
If recession is being assessed as part of a wider plan to replace missing teeth, dental implants in Leeds sets out how soft tissue condition affects that treatment.
Frequently asked questions
Does a gum graft hurt? The procedure itself is carried out under local anaesthetic, so the site is numb. Afterwards, Leeds Teaching Hospitals NHS Trust lists pain or discomfort among the common risks and states that over-the-counter painkillers should be enough to manage it. Cambridge University Hospitals notes that it is normal to experience some pain and discomfort following the procedure.
How long until I can brush normally? Leeds Teaching Hospitals advises avoiding toothbrushing at the surgical site until the stitches are removed, typically one to two weeks, using chlorhexidine mouthwash twice daily in the interim.
Will the graft cover the root completely? Not always. Leeds Teaching Hospitals notes that graft procedures may not completely cover exposed root surfaces. Cairo and colleagues reported that their classification, based on attachment level between the teeth, significantly predicted recession reduction at six months.
Can a gum graft bring back lost bone? No. Soft tissue grafting and regenerative surgery aimed at regrowing lost bone support are described by Leeds Teaching Hospitals as separate procedures with different objectives.
Can receded gums be treated without surgery? Non-surgical care is directed at controlling the cause and preventing further loss — plaque control, treating gum disease, managing sensitivity. Whether surgery adds anything beyond that depends on the site, the symptoms and the assessment.
What if the graft fails? Leeds Teaching Hospitals lists failure of the procedure among the recognised risks, and notes further surgery may be required. This belongs in the consent discussion before treatment, not after.
Sources
- Cambridge University Hospitals NHS Foundation Trust. Gum grafting procedure. https://www.cuh.nhs.uk/patient-information/gum-grafting-procedure/
- Leeds Teaching Hospitals NHS Trust. Periodontal surgery. https://www.leedsth.nhs.uk/patients/resources/periodontal-surgery/
- Chambrone L, Salinas Ortega MA, Sukekava F, et al. Root coverage procedures for treating localised and multiple recession-type defects. Cochrane Database of Systematic Reviews 2018;10:CD007161. https://pmc.ncbi.nlm.nih.gov/articles/PMC6517255/
- Cairo F, Nieri M, Cincinelli S, Mervelt J, Pagliaro U. The interproximal clinical attachment level to classify gingival recessions and predict root coverage outcomes: an explorative and reliability study. Journal of Clinical Periodontology 2011;38(7):661-666. https://pubmed.ncbi.nlm.nih.gov/21507033/
- Heasman PA, Holliday R, Bryant A, Preshaw PM. Evidence for the occurrence of gingival recession and non-carious cervical lesions as a consequence of traumatic toothbrushing. Journal of Clinical Periodontology 2015;42(Suppl 16):S237-S255. https://pubmed.ncbi.nlm.nih.gov/25495508/
- NHS. Gum disease. https://www.nhs.uk/conditions/gum-disease/
- NHS. What dental services are available on the NHS? https://www.nhs.uk/nhs-services/dentists/what-dental-services-are-available-on-the-nhs/
