Soft Tissue Grafting: A Comprehensive Guide for Patients

by Rana Baroudi

Dr. Baroudi is a Board Certified Periodontist. She has successfully passed the American Board of Periodontology oral and written examinations covering all phases of periodontal disease, its treatment and dental implants. She is also an Associate Clinical Professor of Periodontology at UCSF where she enjoys teaching and lecturing on a bi-monthly basis.

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The pivotal dental procedure known as soft tissue grafting is designed to combat gum recession, a prevalent issue where gum tissue around the teeth erodes or recedes, exposing more of the tooth or its root. Such exposure can lead to a myriad of problems, including increased sensitivity, aesthetic dissatisfaction, and, if not addressed timely, the risk of tooth loss. This guide is dedicated to offering patients a detailed overview of soft tissue grafting, from understanding the various types and benefits to exploring the specifics of the procedure, recovery phases, and anticipated results. By providing a comprehensive understanding, this guide aims to ensure patients are thoroughly informed about soft tissue grafting, empowering them with the knowledge to make informed decisions about their dental health and the potential for a revitalized smile.

Understanding Gum Recession

Gum recession emerges as a commonly overlooked condition, given its gradual onset. The factors contributing to gum recession are manifold, encompassing periodontal disease, the impact of aggressive tooth brushing techniques, lack of adequate dental care, hormonal fluctuations, tobacco usage, and a genetic predisposition. For many, the realization of gum recession comes belatedly, often prompted by the sudden sensitivity of teeth to temperature extremes or the perception that their teeth appear unnaturally elongated. It’s these symptoms that serve as harbingers of underlying gum recession.

The Need for Soft Tissue Grafting

Soft tissue grafting is not merely a preventive measure; it is a corrective intervention aimed at halting further recession and bone loss, covering exposed roots to mitigate sensitivity, and safeguarding against the detrimental effects of bacterial invasion and physical trauma. Beyond its functional benefits, soft tissue grafting holds aesthetic value, particularly for individuals whose smiles have been compromised by a pronounced “toothy” appearance or an irregular gum line. Through this procedure, patients can not only enjoy the functional benefits of enhanced dental health but also the confidence that comes with a rejuvenated smile. This guide seeks to provide a thorough exploration of soft tissue grafting, ensuring patients are well-informed about their dental health options and the transformative potential of this treatment.

Types of Soft Tissue Grafts

Diving deeper into the realm of soft tissue grafting, it becomes evident that this procedure is not a one-size-fits-all solution. The choice of technique is tailored to address specific dental conditions and meet individual aesthetic preferences. The array of soft tissue grafts available allows for a customized approach to treating gum recession, each with its unique application and benefits.

  1. Free Gingival Grafts: One such technique is the free gingival graft. This approach involves the meticulous removal of a thin strip of tissue from the roof of the mouth, which is then transplanted to the area affected by gum recession. Primarily, this method is utilized to augment the thickness of the gum tissue, offering a solution when a substantial amount of healthy, robust gum tissue is required to combat recession or prepare the mouth for further dental procedures.
  2. Connective Tissue Grafts: Among the most prevalent choices for addressing the exposure of tooth roots is the connective tissue graft. This procedure entails creating a small flap in the skin on the roof of the mouth to access and remove a piece of the underlying connective tissue. This harvested tissue is then meticulously sutured onto the gum area needing repair, providing a highly effective means to cover exposed roots and enhance the gum’s appearance and health.
  3. Pedicle Grafts: The pedicle graft represents another technique, distinct in its approach by utilizing gum tissue adjacent to the recession site. Instead of harvesting tissue from the palate, a flap of gum tissue is carefully incised and moved over to cover the exposed root. This method hinges on the availability of sufficient gum tissue in the vicinity of the tooth needing treatment and can offer the advantage of maintaining blood supply to the grafted area, promoting faster healing.
  4. Allograft: An innovative approach to soft tissue grafting is the use of allografts. This method employs human tissue that has been donated and processed, making it a viable option for grafting without the necessity of harvesting tissue from the patient’s own palate. Allografts present a valuable alternative for patients seeking a less invasive option or for those in need of extensive grafting, as it bypasses the discomfort and healing process associated with tissue removal from the mouth’s roof.

Each of these grafting techniques offers a tailored solution to address gum recession, balancing the need for functional dental health improvements with the desire for aesthetic enhancement. By understanding the specifics of each type, patients can engage in informed discussions with their dental professionals to select the most appropriate method for their unique dental landscape.

The Procedure

The specific steps of a soft tissue grafting procedure vary depending on the type of graft but generally involve the following:

  • Preparation: The initial phase of the procedure focuses on preparation. The dental professional will administer a local anesthetic to the treatment area, ensuring that the patient experiences no discomfort during the process. This step is crucial for patient comfort and is carefully done to numb only the specific areas involved in the grafting process, allowing the patient to remain awake and aware, but without pain.
  • Tissue Harvesting (if applicable): In cases where an autograft is the chosen method, the next step involves the harvesting of tissue from the donor site, which is often the roof of the mouth. This step is conducted with precision to extract a suitable amount of tissue while ensuring the donor site’s rapid healing and minimal discomfort. The harvested tissue is then meticulously prepared for transplantation to the area affected by gum recession.
  • Graft Placement: Following the harvesting, the focus shifts to the placement of the graft. The dental surgeon positions the harvested or donor tissue precisely at the recession site. Sutures of a delicate nature are then employed to secure the graft in place, ensuring it remains stable and correctly oriented for optimal integration with the surrounding gum tissue. This step is pivotal, as the correct placement and securing of the graft are essential for the success of the procedure and the aesthetic outcome.
  • Healing: The final stage of the soft tissue grafting procedure is the healing process. After the graft placement, a period of healing is essential for the graft to fully integrate with the surrounding tissue and for the site to recover fully. During this time, patients may be advised to follow specific care instructions, including dietary restrictions, oral hygiene practices, and possibly the use of medications to manage discomfort and prevent infection. The integration of the graft with the existing tissue is a gradual process, and the site’s appearance and functionality improve progressively over time.

Recovery and Aftercare

Recovery from a soft tissue graft can vary but generally involves a period of 1-2 weeks for initial healing, with complete tissue maturation taking several months. Patients are advised to follow a soft diet, avoid brushing or flossing the treated area directly, and possibly use special mouthwashes to aid healing and prevent infection. Pain, swelling, and minor bleeding may occur but can be managed with medications prescribed by the dentist or periodontist.

Benefits of Soft Tissue Grafting

The decision to undergo soft tissue grafting is often motivated by the procedure’s array of significant benefits, which include:

  • Reduced Sensitivity: Covering exposed tooth roots dramatically lessens sensitivity to temperature extremes, making eating and drinking more comfortable.
  • Improved Gum Health: The procedure aids in halting further gum recession and bone loss, contributing to a healthier oral foundation.
  • Aesthetic Enhancements: Many patients find that correcting gum recession not only improves the health of their gums but also the overall appearance of their smile, leading to increased confidence.
  • Protection Against Decay: By covering exposed roots, the grafting helps shield the teeth from decay, reducing the risk of cavities and associated dental issues.

Risks and Considerations

While soft tissue grafting is highly successful and complications are rare, it is important for patients to be aware of potential risks such as infection, bleeding, and the chance of graft failure. Adhering closely to the dental professional’s aftercare instructions and attending scheduled follow-up appointments are critical steps in mitigating these risks and ensuring the best possible outcome.


Soft tissue grafting is a reliable and effective solution for treating gum recession. By understanding the types of grafts available, the procedure, and what to expect during recovery, patients can make informed decisions about their dental health. With the advancements in dental technology and techniques, soft tissue grafting has become a routine procedure with a high success rate and minimal discomfort. If you’re experiencing gum recession, discussing soft tissue grafting options with your dentist or periodontist can be the first step towards improving your oral health and achieving a smile you’re proud to show off.