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Periodontal plastic surgery · UK

Gum grafting, by a specialist periodontist.

Root coverage for gingival recession - CTG, FGG, coronally-advanced flap, allograft ADM or the pinhole surgical technique.

A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What private gum grafting costs in the UK.

Indicative ranges across our partner periodontal practices.

In short

£750–£1,400, home the same day.

Procedure Indicative range
Specialist periodontist consultation and work-up £180–£320
Single-tooth CTG (connective tissue graft) £750–£1,400
Multi-tooth CTG (2 to 4 adjacent teeth) £1,400–£2,800
Pinhole surgical technique (PST), full mouth £3,500–£6,500
Allograft ADM (AlloDerm) or xenograft, per site £950–£1,600
Coronally-advanced flap (CAF), per site £600–£1,100

Prices vary by clinic (The Wellington Dental Sedation Suite, Elleven Dental Periodontology, Portman Dental Care Advanced Periodontal, Wimpole Dental), by which periodontist does the case, by graft type and by the number of teeth.

The journey

From consultation to healing - what happens, in order.

One team from first message to maintenance - including the hygiene follow-ups that keep the graft where it belongs.

  1. 03

    Before

    Specialist consultation and work-up

    Probing depths, keratinised tissue width, biotype thickness, radiographs, occlusal analysis and photographs. Sometimes ortho alignment first.

  2. 04

    On the day

    Arrival at the practice

    A quiet room, local anaesthetic and a chat with the periodontist. Sedation is available for anxious patients or multi-tooth cases.

  3. 05

    On the day

    The graft itself

    1 to 2 hours under local. CTG harvested from the palate and tunnelled beneath the gum, or a pinhole entry with collagen strips for PST.

  4. 06

    On the day

    Home the same day

    A palatal stent for the donor site, written aftercare and a soft-food plan. Ibuprofen and paracetamol usually manage discomfort.

  5. 07

    After

    Healing checks and maintenance

    Reviews at 1, 2 and 6 weeks. Ultra-soft brushing at 3 to 4 weeks. Three-monthly hygiene visits for the first year.

Typical end-to-end: 2–3 weeks to surgery. Soft tissue heals over 6 weeks. Maturation over 6 months.

When it helps

When grafting is the right step - and when it is not.

The reasons patients come to us, plus the signs that mean we address bruxism, ortho or active periodontitis first.

  • Exposed root surface with sensitivity

    Cold, sweet or brush-touch pain from exposed dentine on the root - the commonest reason patients come for grafting.

  • Aesthetic concern in the smile line

    A visibly long tooth, black triangles or a stepped gum margin in the upper front teeth affecting confidence when smiling.

  • Thin gingival biotype

    A translucent, delicate gum where the root outline is visible - prone to progressive recession and difficult to graft without soft-tissue augmentation.

  • Orthodontic-related recession

    Recession that has appeared or worsened during or after fixed appliances or aligners, often at lower incisors pushed labially.

  • Brushing trauma or high frenal pull

    V-shaped notches from aggressive scrubbing with a hard brush, or a high frenum tugging the gum away from the tooth.

  • Increased root caries risk

    Exposed root cementum decays faster than enamel - covering it protects the tooth long-term, not just the appearance.

  • Recession before implant or veneer work

    A thin, receded margin next to a planned implant or veneer will show up as a grey line - augment the tissue first, restore second.

  • Red flag: active periodontitis first

    Bleeding, deep pockets and bone loss must be stabilised with non-surgical periodontal therapy before any grafting is attempted.

Procedure options

Gum grafting is a family of techniques.

What each option involves and which fits which case. For Cairo RT3 defects, we may recommend a limited augmentation plan rather than promise full root coverage.

  • CTG - connective tissue graft

    Autogenous connective tissue from the palate, tunnelled or placed in an envelope beneath the gum and sutured coronally. The gold standard, with 90%+ root coverage in Cairo RT1.

  • FGG - free gingival graft

    A full-thickness palatal graft used mainly to build keratinised tissue width rather than for aesthetics - more visible, but sometimes the right call for lower incisors.

  • Coronally-advanced flap (CAF)

    A partial-thickness flap raised and moved coronally over the recession, with no donor site. Works well for isolated RT1 defects where keratinised tissue is already adequate.

  • Allograft and xenograft options

    Acellular dermal matrix (ADM, AlloDerm), porcine collagen (Mucograft) or Emdogain enamel matrix derivative as adjuncts - avoid a palate donor site, with slightly lower coverage.

  • Pinhole surgical technique (PST)

    The Chao technique: no scalpel, no sutures. A mini pinhole entry lets an instrument slide the gum coronally, with collagen strips placed underneath. Less invasive, single-session, multi-tooth.

  • Emdogain and biologics as adjunct

    Enamel matrix derivative applied to the root surface promotes periodontal attachment and can improve outcomes when combined with CTG or CAF.

  • Ortho pre-treatment

    When a root sits labially outside the bony housing, aligner or fixed ortho to move it back into the envelope can dramatically improve graft prognosis before any surgery.

  • Second-opinion review

    A specialist review of your photographs, records and treatment plan - sometimes the answer is bruxism management or brushing retraining, not another operation.

Safety and recovery

What to expect afterwards - honestly.

Gum grafting is a well-established outpatient procedure. Worth planning: the palate donor site, the soft-food fortnight, and the brushing routine that protects the graft for years.

  • Local anaesthetic and optional sedation

    Almost all grafts are done under local. Oral or IV sedation is available for anxious patients or multi-tooth pinhole cases where longer chair time is expected.

  • Palate donor site tenderness

    The palate is the sorest part for 1 to 2 weeks. A custom palatal stent protects the wound, and cold soft foods keep it comfortable.

  • Soft-food diet for 2 weeks

    Pasta, eggs, soups and smoothies. Avoid crusty bread, seeds, nuts and anything crunchy that could catch the sutures or the healing graft margin.

  • Gentle brushing at 3 to 4 weeks

    No brushing over the surgical site for 3 to 4 weeks - a chlorhexidine mouthwash keeps it clean. Resume ultra-soft brushing gradually.

  • Realistic root-coverage outcomes

    85 to 95% coverage for Cairo RT1, 50 to 75% for RT2, and poor coverage for RT3 where interproximal bone is lost. Discussed before you consent.

  • Long-term stability

    With good oral hygiene and no aggressive brushing, root coverage is stable at 5 to 10 years in most patients - especially with keratinised tissue gained.

  • Managing bruxism and occlusion

    A night guard for grinders and adjustment of any traumatic occlusal contact - untreated, they will pull the graft margin down again.

  • Ultra-soft brushing for life

    A modified Bass technique with an ultra-soft or electric brush on gentle mode. No horizontal scrubbing, ever.

  • Red flags after surgery

    Uncontrolled bleeding, spreading swelling, fever or a graft that turns dark grey and lifts - call the practice or attend A&E the same day.

Frequently asked

Everything we get asked about gum grafting.

Quick answers on Cairo class, PST, pain, costs and long-term stability.

  • What is gum grafting and when do I need it?

    Gum grafting is periodontal soft-tissue surgery to cover a receded root surface, thicken a thin gum or add keratinised tissue. It is offered when recession causes sensitivity, aesthetic concern, increased root-caries risk, or when a thin biotype is likely to progress. Active periodontitis must be treated first.

  • What is the difference between Cairo RT1, RT2 and RT3?

    Cairo (Miller) RT1 has no loss of interproximal bone and full root coverage is achievable, typically 90%+ with CTG. RT2 has partial interproximal loss and partial coverage of 50 to 75% is realistic. RT3 has severe interproximal bone loss and root coverage prognosis is poor - grafting may still improve tissue thickness but not restore the root.

  • How much does gum grafting cost privately in the UK?

    A single-tooth CTG runs £750 to £1,400, multi-tooth CTG £1,400 to £2,800, and full-mouth pinhole PST £3,500 to £6,500. Allograft ADM sites are around £950 to £1,600. Consultation and work-up is £180 to £320.

  • What is the pinhole surgical technique (PST)?

    PST, developed by Dr John Chao, uses a small pinhole entry rather than a scalpel and sutures. An instrument slides the existing gum coronally over the recession, with collagen strips placed underneath. It treats several teeth in one session with less swelling and no palate donor site, but costs more and is not suited to every case.

  • How painful is it and how long does recovery take?

    Discomfort is usually mild and managed with ibuprofen and paracetamol. The palate donor site is the sorest part for 1 to 2 weeks and is protected by a custom palatal stent. Soft foods for 2 weeks, gentle brushing at the site from 3 to 4 weeks, and normal function by 6 weeks.

  • Will the recession come back after grafting?

    With good oral hygiene, ultra-soft brushing technique, three-monthly hygiene visits initially and management of bruxism or traumatic occlusion, root coverage is stable at 5 to 10 years in most patients. Recession recurs mainly when aggressive scrubbing, an unaddressed labial root position or untreated grinding continue after surgery.

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