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What Happens During Gum Graft Surgery? Gum Graft Explained Step-by-Step + Recovery Timeline

If you’ve been told you need a gum graft, you’re probably wondering what actually happens during the procedure. What does gum grafting surgery involve? Where does the graft come from? And what will your mouth look like when you leave the office?

In this video, we walk through a real gum graft surgery step by step, using patient photos to explain the entire process from start to finish.

This patient had significant gum recession on a lower molar, which exposed the root surface and caused tooth sensitivity. A gum graft was recommended to cover the exposed root and thicken the gum tissue, helping protect the tooth and improve long-term gum health. Below is exactly what happens during the procedure.

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Preparing the Gum Tissue

Once the area is completely numb, small incisions are made where the gum meets the tooth. These incisions are made around the tooth being treated and the neighboring teeth so the gum tissue can be gently lifted. Using microsurgical instruments, the gum tissue is carefully released and elevated. This creates the flexibility needed to move the gums upward and cover the exposed root surface. Once the site is prepared, the next step is to collect the graft tissue.

Taking the Graft from the Roof of the Mouth

The graft tissue is taken from the roof of the mouth (palate) using a very small, precise incision that is about the width of a scalpel blade. Even though the photos can look intimidating, the incision is extremely minimal, and the tissue edges come together neatly once sutured. Dissolvable sutures are placed to close the site. To explain how the graft is taken, imagine opening an envelope with a letter opener. A small incision is made, the tissue underneath is gently elevated, and the graft is removed from within that pocket. The outer layer of the palate remains intact, which helps the area heal quickly.

Placing the Gum Graft

Once the graft is harvested and the palate is closed, the graft tissue is moved to the surgical site. The previously lifted gum tissue creates a small pocket, similar to the pocket on a sweatshirt. The graft is placed inside this space beneath the gum tissue. Dissolvable sutures secure the graft to the surrounding tissue. Additional sutures are placed to hold the gums in a slightly elevated position, covering the exposed root and keeping the graft stable while it heals. These sutures help ensure the graft integrates properly and stays in place as the tissue heals.

The Two-Week Post-Op Visit

At the two-week follow-up appointment, the graft is already beginning to incorporate into the surrounding tissue. The gums appear thicker, and the root coverage is significantly improved compared to the starting point. The sutures remain in place at this stage to allow the tissue to mature and stabilize further. You may notice some plaque buildup in the area, which is completely normal. Patients are instructed not to brush the surgical site during early healing to prevent disrupting the graft. Instead, antimicrobial rinses are used to keep the area clean until brushing can safely resume. The donor site on the roof of the mouth is also healing nicely at this stage. The dissolvable sutures are gone, and the incision is already filling in. Most patients report very little discomfort and often say they barely notice the area after the procedure.

The Four-Week Post-Op Visit

At the four-month visit, the remaining sutures are removed, and the final outcome becomes more visible. Compared to the beginning, the improvement is dramatic. The exposed root that once caused sensitivity is now covered with thick, healthy gum tissue. This added tissue thickness helps protect the tooth and provides a much more stable, long-term result. The patient experienced significant relief from sensitivity and was very happy with the outcome.

Gum graft surgery helps:

✅ Reduce tooth sensitivity

✅ Protect exposed root surfaces

✅ Prevent further gum recession

✅ Improve long-term tooth stability

✅ Strengthen thin or fragile gum tissue

If gum recession is left untreated, it can lead to:

⚠️ Tooth sensitivity

⚠️ Root exposure

⚠️ Increased risk of cavities on the root

⚠️ Progressive gum and bone loss

⚠️ Tooth loss

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District Dental Surgery Locations

District Dental Surgery is a premier dental practice dedicated to providing top-tier oral healthcare across two convenient locations—Washington, DC, and Bethesda, MD.

Washington, DC

1828 L St NW, Suite 860 Washington, DC 20036

Call Us (202) 393-6154

Bethesda, MD

5626 Shields Drive, Bethesda, MD 20817

Call Us (301) 493-6200

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Washington, DC

1828 L St NW Suite 860 Washington, DC 20036

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Bethesda, MD

5626 Shields Dr, Bethesda, MD 20817

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Please select the location you’d like to visit

Washington, DC

1828 L St NW, Suite 860 Washington, DC 20036

(202) 791-4197

Bethesda, MD

5626 Shields Drive, Bethesda, MD 20817

(301) 450-8577

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Washington, DC

(Formerly Known as District Perio)

Bethesda, MD

(Formerly Known as Bethesda Dental Implant Center)

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