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Gingival Grafting


A tooth is surrounded by two types of tissue. The first is gingiva (gum), which is pink, thick and dense. It is also called keratinized tissue. Gingiva forms a tight seal around the tooth which serves as a barrier against the penetration of bacteria to the underlying bone. The gingiva also helps to withstand trauma from brushing, eating, etc. The other type of tissue, mucosa, found directly below the gingiva, is red, thin and loose or elastic. It does not seal tightly around the tooth, nor does it withstand trauma well (as shown by how easily you can "scratch" the floor of the mouth).

When gum recession occurs, the body loses a natural defense against both bacterial penetration and trauma. When there is only minor recession, some healthy gingiva often remains and protects the tooth, so that no treatment other than gentle oral hygiene is necessary. Recession can be caused by genetically thin bone and gum, overscrubbing or toothbrush bristles that are too stiff, or by clenching and grinding habits.

Before Gingival GraftBefore Gingival Graft
After Gingival Graft
After Gingival Graft


When recession reaches the mucosa, the first line of defense against bacterial penetration is lost. No matter how meticulously the patient tries to control the bacteria, there is a greater chance of it penetrating and affecting the underlying supporting bone. In addition, gum recession may result in root sensitivity as well as an unsightly appearance to the gum and tooth.

Some people genetically have extremely thin gingiva and require grafting to prevent recession before it starts. This is quite common when orthodontic tooth movement is planned.

A gingival graft is designed to solve these problems. A thin piece of tissue is taken from the roof of the mouth, or moved over from adjacent areas, to provide a stable band of dense gingiva around the tooth.

Long Teeth or Exposed Roots


Some people genetically have extremely thin gingiva and require grafting to prevent recession before it starts. This is quite common when orthodontic tooth movement is planned. When recession reaches the mucosa, the first line of defense against bacterial penetration is lost. No matter how meticulously the patient tries to control the bacteria, there is a greater chance of it penetrating and affecting the underlying supporting bone. In addition, gum recession may result in root sensitivity as well as an unsightly appearance to the gum and tooth.

Before Gingival GraftBefore Gingival Graft
After Gingival Graft
After Gingival Graft


A connective tissue graft is a technique used to help cover the exposed portion of the root. It offers more predictable root coverage and better color matching but is a more technically difficult procedure. It is the preferred technique for upper teeth and for severe recession.

Dr. Layport makes a stent, which looks like the older-style orthodontic retainer, to protect the roof of the mouth during healing, greatly reducing soreness and complications after surgery. There are also donor and engineered products that eliminates taking gum from the roof of the mouth.

The visit to perform a gingival graft is about 60 minutes long. The stitches are removed approximately one week later in a 5-10 minute visit. A 5 minute check-up verifies the final result 6 weeks later.

Gingival graft procedures are quite predictable. The color of the graft and the amount of root coverage is more variable.

Indentations in the gums and jawbone:


Sometimes when you lose one or more teeth, you can get an indentation in your gums and jawbone where the tooth used to be. Your periodontist can fill in this "defect" with a procedure called ridge augmentation. A new tooth can then be created that is natural looking, easy to clean and beautiful.



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