What Is Gum Grafting? A Complete Guide to Surgery & Recovery in Toronto

Hearing the term “gum grafting” from your dentist can raise questions, and some concern is understandable. What is gum grafting? In practice, gum grafting is a well-documented periodontal procedure used to treat gum recession, with very high clinical success rates. It restores tissue over exposed roots, reduces sensitivity or further damage to the surrounding bone and teeth
In this guide, we’ll explain what gum grafting is, how the procedure works, the different types of grafts available, and what you can expect during recovery. Keep reading. 

What Is Gum Graft Surgery? (Step-by-Step)

Gum graft surgery is a periodontal procedure we perform to cover exposed tooth roots and rebuild lost gum tissue. It’s typically carried out by a periodontist, a dentist with advanced training in treating the gums and the supporting structures around your teeth. In most cases, only one tooth or a small area needs treatment, and the procedure is usually completed in about an hour.

Here’s what you can expect during your appointment:

1. Numbing the treatment area. We begin by applying a local anesthetic to completely numb the gums and teeth around the treatment site, so you stay comfortable throughout the procedure. If you feel anxious about dental treatment, we can also discuss sedation options, such as nitrous oxide, oral sedation, or IV sedation, during your consultation (check: Top Types of Dental Sedation Options for Patients).
2. Preparing the recession site. Once the area is numb, we make a small incision and carefully create a tiny flap in the gum tissue. We then carefully clean the exposed root surface to remove bacteria and debris, creating the best possible foundation for the graft to attach.
3. Obtaining the graft tissue. Depending on your needs, we may use a small piece of tissue taken from the roof of your mouth (the palate) or a donor tissue material from a certified tissue bank. We’ll explain which option is most appropriate for your case before treatment.
4. Placing the graft. The graft is carefully positioned over the exposed tooth root to restore the lost gum tissue and protect the area.
5. Securing the graft. Finally, we stitch the graft into place. Some stitches dissolve naturally, while others are removed during a follow-up appointment as the area heals.

One of the most common concerns patients have is whether the procedure hurts. Because the treatment area is fully numb, you shouldn’t feel pain during the surgery itself. Any mild discomfort is more likely to occur afterward during the healing process, which we’ll discuss later in this guide.

Related topic: The Complete Guide to Periodontal Surgery: Everything You Need to Know

The 3 Types of Gum Grafts (And Why We Recommend Each One)

Not every case of gum recession requires the same type of treatment. We choose the most appropriate gum graft based on several factors, including how much gum tissue has been lost, where the recession is located, and the overall condition of your gums.

1. Connective Tissue Graft

This is the most common type of gum graft and is often the best choice for covering exposed tooth roots. During the procedure, we take connective tissue from beneath the surface of the palate and place it over the recessed area. Because the outer layer of the donor tissue remains intact, the graft typically blends naturally with the surrounding gum tissue as it heals.

Research Note: Success rates vary depending on the type of graft and severity of recession, but research (PMC) shows connective tissue grafts can achieve root coverage as high as 98%, while long-term studies report that gains are maintained in the majority of cases for decades.

2. Free Gingival Graft

We usually recommend a free gingival graft when your gums are naturally thin and need additional thickness rather than just root coverage. This technique strengthens the gum tissue, making it more resistant to future recession. While the final color may not always match the surrounding gums as closely as a connective tissue graft, it provides excellent long-term support in the right cases.

3. Pedicle Graft

Instead of using tissue from another area of your mouth, a pedicle graft uses healthy gum tissue located right next to the recession. Because the tissue remains attached to its original blood supply, it often heals very well. However, this technique is only possible when there’s enough healthy gum tissue surrounding the affected tooth.

What If You Don’t Want Tissue Taken From the Roof of Your Mouth?

Many patients are concerned about having tissue removed from the palate, since this donor site is often responsible for most of the discomfort after surgery. Fortunately, harvesting tissue from the roof of the mouth isn’t always necessary.

Depending on your situation, we may be able to use donor tissue from a licensed tissue bank instead. One commonly used option is AlloDerm®, an acellular dermal matrix that serves as an alternative to tissue taken from your palate. Using this type of graft eliminates the need for a second surgical site, which can make recovery more comfortable for many patients.

Read more: Different Types of Oral Surgery Procedures: A Comprehensive Guide

Are there alternatives to traditional gum grafting?

Yes, some periodontists offer less invasive techniques, such as the pinhole surgical technique, which repositions existing gum tissue through a small entry point instead of taking tissue from the palate. The suitability of this option depends on your gum condition and the severity of your recession. Your periodontist can evaluate your case and determine if this approach is appropriate for you.

Gum Graft Recovery Timeline & Tips

Every person heals a bit differently, but gum graft recovery generally follows a predictable pattern. Knowing what to expect at each stage makes it much easier to tell normal healing from something that actually needs attention.

First 24 Hours

The first day is mostly about protecting the graft and staying ahead of discomfort. You’ll likely have gauze in place right after surgery, which you can usually remove after about 30 minutes. Some bleeding, swelling, and soreness are normal during this window; take any prescribed medication exactly as directed rather than waiting for pain to build up.

A few things to keep in mind for this first day:

• Stick to soft, cool foods like yogurt, pudding, or smoothies, nothing hot, crunchy, or chewy
• Avoid brushing or flossing directly on the surgical site (you can still care for the rest of your teeth normally)
• Rest and skip strenuous activity
• If you had sedation, arrange for someone to drive you home

If tissue was taken from the roof of your mouth, that donor site is often the more uncomfortable spot during this period, sometimes more than the graft site itself.

Days 2–7

Bleeding typically settles within the first day or two, while swelling and bruising can continue for another three to four days before starting to fade. This is a normal part of gum graft recovery, not a sign of a problem.

During this week:

• You can gradually add more soft foods (eggs, pasta, cooked vegetables)
• Keep using an antibacterial mouthwash to keep the area clean
• Continue avoiding brushing or flossing directly over the graft site until your periodontist clears you to resume
• Watch for anything unusual, like a spreading white patch with no color at all, pus, or a fever; these warrant a call to your surgeon rather than waiting it out

Most people feel comfortable enough to return to work or school within one to two days, even while the deeper healing is still underway.

Long-Term Recovery

Initial healing generally takes one to two weeks, but full integration of the graft with the surrounding tissue takes longer, often extending to a couple of months. Swelling and bruising should be noticeably better by the second week, and your periodontist will let you know when it’s safe to resume normal brushing, flossing, and your regular diet.

Exercise and heavy lifting are usually best avoided for at least the first week, since raising your heart rate can increase bleeding and swelling at the surgical site. Your periodontist will confirm when it’s safe to return to your normal routine.

Related post: How to Avoid Tooth Decay: Tips for a Healthy and Lasting Smile

What factors affect gum graft success?

Smoking, poorly controlled diabetes, and trauma to the site in the first 24–48 hours are the main factors that can affect how well a gum graft heals. Following your periodontist’s aftercare instructions closely gives the graft the best chance of success.

Read more: Severe Impact of Smoking on Dental Health: Dentists’ Warning!

Warning Signs: When to Call Your Periodontist

Mild soreness and swelling are normal, but contact your periodontist or an emergency dental clinic if you notice pain that gets worse after the third day, bleeding that won’t stop with gentle pressure, pus, fever, or the graft tissue detaching from the site. Catching these early makes them far easier to manage through bleeding gums treatments.

Related topic: Causes of Tooth Sensitivity

How Much Does Gum Graft Surgery Cost?

There’s no fixed price for gum grafting; it depends on the type of graft used, how many teeth are involved, the severity of the recession, and your provider’s fee structure .

At Elmwood Park Dental, pricing follows the Ontario Dental Association (ODA) Fee Guide, so you get transparent, standardized rates rather than arbitrary pricing. Many dental insurance plans also offer partial coverage, since grafting is considered medically necessary rather than cosmetic.

For an accurate number, the best step is a short consultation where your periodontist can assess your case and give you a personalized estimate.

Addressing Your Gum Recession in Toronto

If you’ve noticed your gums receding or your teeth becoming more sensitive, it’s worth having the area evaluated before the problem progresses. At Elmwood Park Dental, we assess the cause of your gum recession, explain whether gum grafting is appropriate, and discuss all suitable treatment options based on your specific needs.

Our team has been caring for patients in Toronto for more than 15 years and offers sedation options for those who feel anxious about dental treatment, along with direct billing to most major insurance providers. Schedule a periodontal consultation with our experts.

FAQ

Have questions about gum grafting or your own recovery experience? Drop a comment below. We’d love to hear from you and help you.