Dental & oral health

Three Kinds of Gum Graft and What Each Runs

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Not every receding gum is fixed the same way. A periodontist chooses among three grafting techniques based on how much tissue has been lost, how thick the surrounding gum already is, and whether nearby tissue can be shifted into place instead of taken from elsewhere — a decision that shapes both the surgery and its cost.

Last updated: July 2026

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The Three Techniques, and Why the Choice Matters

A gum, or gingival, graft rebuilds tissue over a tooth root that has become exposed as the gum has receded, and periodontists use one of three main techniques to do it. A connective tissue graft takes tissue from beneath the surface of the palate, leaving the outer layer intact, and is the most commonly used technique because it heals predictably and matches the surrounding gum color well. A free gingival graft takes a thin layer of tissue directly from the surface of the palate and is generally reserved for people who need thicker, more resilient gum tissue rather than root coverage alone. A pedicle graft, sometimes called a lateral or rotational flap, does not use palate tissue at all — it shifts gum tissue from next to the affected tooth over to cover the exposed root, which only works when there is enough healthy tissue immediately adjacent to borrow from. Gum recession itself is common, most often caused by aggressive brushing or by periodontal disease that has damaged the tissue and bone supporting the teeth 1.

Connective Tissue Graft: The Default Option

A connective tissue graft is the technique most periodontists reach for first, because it reliably covers exposed root surfaces and blends in color and texture with the surrounding gum better than the alternatives. Tissue is taken from just under the surface of the palate through a small incision, then stitched over the receded area, and the palate incision closes on its own without leaving an open wound the way a surface graft can. A connective tissue graft commonly costs $700 to $1,200 per tooth, with the total rising when several adjacent teeth are treated in the same surgical session, since some of the surgical setup and recovery is shared across sites rather than duplicated for each one. Because it is the most versatile of the three techniques, suitable for both root coverage and general tissue thickening, it is also the one most often used as the reference point when comparing gum graft cost more broadly.

Free Gingival Graft: When Thickness Matters More Than Color Match

A free gingival graft takes a thin sheet of tissue from the surface of the palate, rather than from beneath it, and transplants it directly onto the area that needs more gum tissue. It tends to be chosen less often for cosmetic root coverage, since the graft can look slightly different in color and texture from the surrounding gum, and more often when the real problem is thin, fragile tissue that needs bulk and resilience rather than root coverage alone — for example, around an implant or a tooth prone to further recession from brushing pressure. The price is generally comparable to a connective tissue graft, commonly landing in a similar $600 to $1,200 per site range, though the palate donor site tends to heal as a more noticeable open wound for one to two weeks, which is the main tradeoff patients weigh against the similar cost.

Pedicle Graft: No Donor Site Needed

A pedicle graft is the one technique of the three that does not require taking tissue from the palate at all. Instead, a periodontist loosens gum tissue immediately next to the recession and slides or rotates it over to cover the exposed root, keeping the tissue attached at one end so it retains its own blood supply throughout healing. This avoids a second surgical site on the palate entirely, which usually makes recovery more comfortable, but it only works when the tooth next to the recession has enough healthy, thick gum tissue to spare — a limitation that rules it out for many patients before cost even becomes a factor. When a pedicle graft is possible, it is not a lesser option chosen to save money — it is simply the best fit for that specific site and typically costs in a similar range to a connective tissue graft, sometimes slightly less because there is only one surgical site to manage instead of two.

What Determines Which Technique — and What Else Adds to the Bill

The choice between these three techniques comes down mostly to anatomy: how much tissue has already been lost, how thick the gum around the neighboring teeth is, and whether the palate has enough donor tissue to spare. A periodontist typically makes this call during an in-person exam, since photographs alone rarely show tissue thickness accurately. Beyond the base technique, a few things commonly add to the total bill regardless of which graft is used: the number of teeth being treated in one session, whether a bone graft is also needed at the same site because underlying bone has also been lost, and whether the surgeon uses a donor allograft membrane instead of the patient's own palate tissue, an option that raises the material cost but eliminates the second surgical site.

TechniqueTypical range per tooth
Connective tissue graft$700-$1,200
Free gingival graft$600-$1,200
Pedicle graft$600-$1,100
Additional teeth, same visitOften a reduced per-tooth add-on

How Insurance and Medicaid Typically Handle a Gum Graft

Dental insurance usually classifies a gum graft as a major periodontal procedure, which typically means lower coinsurance than preventive care and, in many plans, a waiting period before the benefit applies at all 2. Roughly 27% of US adults have no dental insurance at all, nearly three times the uninsured rate for medical care 3, which is part of why a gum graft, needed by a meaningful share of the estimated 42% to 47% of adults over 30 who have some form of periodontal disease 4, is so often paid for directly. Medicaid dental benefits for adults vary sharply by state, from none to a fairly complete set of services, and a state-by-state benefit table is the fastest way to check what a specific state's program actually covers 5 rather than assuming coverage either way.

Common questions

A connective tissue graft is the technique used most often, because it reliably covers exposed roots and blends in with the surrounding gum better than the alternatives. It takes tissue from beneath the surface of the palate, leaving the outer layer intact, which also tends to make the donor site more comfortable during healing than a free gingival graft.

Not dramatically. A pedicle graft typically costs a similar amount to a connective tissue graft, sometimes slightly less since there is only one surgical site instead of two. The bigger factor is that it only works when the tooth next to the recession has enough healthy tissue to shift over, which rules it out for many patients regardless of price.

A free gingival graft is generally chosen when the main problem is thin, fragile gum tissue that needs bulk and resilience, rather than cosmetic root coverage. It can look slightly different in color from the surrounding gum, which is why it is used less often for a visible front-tooth recession, where a connective tissue graft's better color match is usually preferred.

Yes. When bone has also been lost beneath the receded gum, a periodontist may recommend a bone graft alongside the soft-tissue graft, and each procedure is typically billed separately. Combining them in one surgical visit is common and usually costs less in total than scheduling two separate appointments.

Most dental insurance covers a medically necessary gum graft regardless of the underlying cause, classifying it as a major periodontal procedure with its own coinsurance rate and often a waiting period. What insurance will not usually cover is a purely cosmetic graft requested for appearance alone when there is no meaningful recession or root exposure to justify it.

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Signs a Graft Site Needs Attention

  • —Bleeding from the palate donor site or the graft site that does not slow after gentle, steady pressure
  • —The graft tissue looking pale, gray, or clearly separated from the surrounding gum in the days after surgery
  • —Facial or gum swelling that spreads toward the eye or under the jaw, especially with fever

Facial swelling that reaches the eye or under the jaw, fever, or bleeding that will not stop with steady pressure after graft surgery needs an emergency room rather than a wait for the next office visit.

This article is educational and does not replace an evaluation, diagnosis, or treatment plan from a licensed dentist or periodontist.

References

  1. 1.American Dental Association (JADA For the Patient) (2014). Gingival recession. Journal of the American Dental Association. linkSupports that gum recession is commonly caused by aggressive brushing or periodontal disease that damages the supporting tissue and bone, and that grafting is a treatment option.
  2. 2.American Dental Association (2024). Types of Dental Plans. ADA MouthHealthy. link ✓Supports the definitions of dental insurance coinsurance and waiting periods that shape how a plan treats a major procedure like a gum graft.
  3. 3.CareQuest Institute for Oral Health (2022). Americans Are Not Getting the Dental Care They Need, According to a National CareQuest Institute Survey. CareQuest Institute for Oral Health. link ✓Supports that roughly 27% of US adults lack dental insurance, nearly three times the uninsured rate for medical care.
  4. 4.National Institute of Dental and Craniofacial Research (2024). Periodontal Disease in Adults (Age 30 or Older). NIDCR (NIH) Data & Statistics. link ✓Supports the prevalence figure of roughly 42% to 47% of US adults aged 30 and older having some form of periodontal disease.
  5. 5.KFF (Kaiser Family Foundation) (2024). Medicaid Benefits: Dental Services. KFF State Health Facts. link ✓Supports that adult Medicaid dental benefit levels vary by state and that a state-by-state table is the source for checking a given state's coverage level.

5 sources, numbered by first appearance. General health information, not medical advice. AI-assisted editorial content — citations link their sources. Editorial policy

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