Gum recession is one of those conditions that arrives slowly and then announces itself suddenly. For months or years, the gum line may be gradually retreating from the base of the teeth — exposing more of the root surface, creating sensitivity, changing the aesthetic proportion of the smile — without causing acute pain. Then a patient looks in the mirror one morning, or a dentist mentions it at a check-up, and what seemed like a manageable cosmetic issue becomes an urgent clinical concern.
Left untreated, significant gum recession exposes the root surface of the tooth to increased risk of decay (root surfaces do not have the protective enamel layer that crown surfaces do), sensitivity that worsens over time, and ultimately bone loss that can threaten the tooth’s long-term survival.
Gum grafting — the procedure that addresses both the structural cause and the aesthetic consequence of recession — is performed by NovoCare’s specialist periodontist at the Tesfaye Gizaw Building.
What Causes Gum Recession?
Recession has multiple causes, and identifying the cause matters because it affects how the graft is planned and what preventive measures will protect the result.
Aggressive or incorrect brushing. The most common cause of recession in patients who otherwise have good oral hygiene. Brushing too hard or using a hard-bristled toothbrush causes mechanical abrasion of the gum margin over time, particularly on the outer surfaces of the canine and premolar teeth. This type of recession typically appears symmetrically at multiple teeth.
Periodontal (gum) disease. Bacteria at the gum line cause inflammation that destroys both the soft tissue of the gum and the bone supporting the tooth. Recession caused by periodontal disease is often accompanied by bone loss and cannot be successfully grafted until the underlying infection is fully treated. Gum disease treatment must be completed before grafting is considered.
Anatomical factors. Thin gum tissue, minimal keratinised (attached) gingiva, and close proximity of the tooth root to the outer bone plate all increase the biological tendency toward recession. These are not things a patient has done wrong — they are genetic and anatomical predispositions that make grafting both more likely to be needed and more beneficial when performed.
Orthodontic treatment. In some cases, tooth movement during orthodontic treatment — particularly where a tooth is moved outside the bone envelope — can thin the overlying gum tissue and initiate recession. This is one reason NovoCare’s orthodontic team communicates closely with the periodontal team before and during treatment in at-risk patients.
Bruxism (grinding). The lateral forces produced during grinding create conditions that accelerate recession in susceptible tissue.
When Is Gum Grafting Indicated?
Not every recession requires grafting. Mild recession in a patient with sufficient remaining keratinised gingiva and stable (not progressing) tissue may be monitored rather than immediately treated. Grafting becomes indicated when:
The recession is progressing — getting worse over time, rather than stable. Root surface is exposed to a degree that creates sensitivity that is affecting quality of life or that places the root at significant decay risk. Insufficient keratinised (attached) gingiva remains around the affected tooth — less than 2 mm is generally considered a risk threshold. The aesthetic appearance is causing the patient concern and the clinical situation supports grafting as a predictable solution.
The Gum Grafting Procedure at NovoCare
The most commonly performed gum grafting technique — and the one with the strongest evidence for coverage of exposed root surfaces — is the connective tissue graft.
The connective tissue graft: A small incision is made in the roof of the mouth (palate). A thin layer of connective tissue is harvested from beneath the surface of the palate — not from the surface itself, which heals over the harvest site within 2 to 3 weeks. This connective tissue graft is transferred to the recession site, where it is positioned over the exposed root surface and sutured into place beneath a thin flap of the existing gum tissue. Over the following 6 to 8 weeks, the graft integrates with the recipient site and new gum tissue grows to cover the root surface.
Where a patient does not wish to have tissue taken from the palate, alternative graft sources — processed collagen matrices (acellular dermal matrix) from a tissue bank — can be used. This eliminates the palatal harvest site, though some periodontists consider autogenous tissue (the patient’s own palatal tissue) to produce slightly better root coverage outcomes.
What to expect after gum grafting
The palatal harvest site (if used) is the primary source of discomfort after the procedure — a dull burning sensation similar to a pizza burn on the roof of the mouth, which typically resolves within 2 weeks. The grafted site itself should be left undisturbed — no brushing of that area for the first 2 weeks, soft foods only, and a chlorhexidine rinse as directed.
Sutures are typically removed at 2 weeks. Significant root coverage is visible at 6 to 8 weeks. Full graft maturation takes 3 to 6 months. Follow-up appointments at 2 weeks, 6 weeks, and 6 months confirm healing and coverage progress.
Can Gum Grafting Be Combined With Other Treatment?
Yes, and in many cases it should be. Gum grafting is often performed in combination with crown lengthening (to create a more aesthetic proportion between gum and tooth), with preparation for veneer placement (where the graft thickens thin tissue before the veneer prep), or as part of a comprehensive smile makeover where the gum line needs to be both raised in some areas (laser contouring) and augmented in others (grafting).
NovoCare’s periodontist and cosmetic team plan combined cases together so that the sequence of procedures produces the most aesthetic and structurally sound result.
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