Quick answer
One gum graft usually costs $550–$1,600. A second adjacent tooth often adds $300–$800 rather than a full fee, so a two-tooth quadrant may total $1,000–$2,200. Ask for both the total and the per-tooth equivalent before comparing quotes.
“Gum graft cost per tooth” is the question patients type into a search engine, but it is not how every office prices the work. Some quote per tooth, some per quadrant, and some per surgical site. The difference matters when you compare two estimates that look similar at the top line.
The single-tooth range
For one tooth, the national planning range is:
| Technique | Typical single-tooth range |
|---|---|
| Pedicle flap | $450 – $1,100 |
| Free gingival graft | $550 – $1,200 |
| Connective tissue graft | $700 – $1,600 |
| Donor matrix (material added) | $800 – $1,900 |
These are cash-pay ranges before insurance. They include the surgeon’s time and standard sutures; they usually exclude the consultation, sedation, imaging and any separately billed material.
A single tooth in a high-cost metro, with IV sedation and donor matrix, can exceed the top of the range. A pedicle flap in a smaller city, with local anaesthesia only, can sit below it. That is why a range is more honest than an “average.”
Why the second tooth is not a full fee
A graft on two adjacent teeth is not two independent operations. The surgeon numbs the same quadrant, opens one surgical field, harvests one strip of donor tissue and closes one donor site. The additional tooth adds time, sutures and a larger graft, but not a second full setup.
Many practices therefore price the first tooth at the full fee and each additional tooth at roughly 40–60% of it. A two-tooth connective tissue graft might be quoted as:
- First tooth: $1,100
- Second tooth: $500
- Total: $1,600
Four teeth might be quoted as a quadrant fee of $2,200–$3,200 rather than four times $1,100. The exact structure varies by practice and by how much tissue is needed.
Per tooth, per quadrant, per site
Three pricing models appear in real quotes:
- Per tooth. Each tooth has its own fee. Transparent, but can overstate the work for adjacent teeth.
- Per quadrant. One fee covers all treated teeth in a quadrant. Simpler, but the fee may not change much whether two or four teeth are treated.
- Per surgical site. One fee per contiguous graft, regardless of how many teeth it covers. Common when a single graft spans several roots.
None is inherently unfair. The problem is comparing a per-tooth quote with a quadrant quote without converting them to the same basis. Ask: “What is the total, and what is the average per tooth?”
What adds cost beyond the tooth count
- Donor tissue. A matrix or allograft can add $200–$600 or more.
- Sedation. Nitrous may be $50–$150; oral sedation $150–$400; IV sedation $300–$800, varying widely.
- Bone graft. If bone loss is being treated at the same time, add $650–$1,500 per site.
- Crown lengthening or frenectomy. A combined procedure adds a separate fee.
- Consultation and imaging. $100–$300, sometimes credited toward surgery.
- Follow-up visits. Often included for the first check, sometimes billed after that.
How to compare two quotes
Ask each office for a one-page estimate with:
- The CDT code for every procedure.
- The tooth numbers treated.
- Whether the fee is per tooth, per quadrant or per site.
- The graft material and whether it is included.
- Sedation type and fee.
- Follow-up visits included.
- The insurance estimate and the patient portion.
Then calculate the total for the same number of teeth. A quote that is $300 lower but excludes the $400 matrix is not lower.
What insurance does to the per-tooth number
Dental plans typically pay a percentage of an allowed fee, not of the dentist’s full charge. If the allowed fee for a connective tissue graft is $900 and the plan pays 60%, the plan pays $540 and you pay the difference between the practice fee and the allowed amount, plus the 40% coinsurance. The annual maximum can cap the benefit before the second tooth is reached.
The insurance guide explains pre-treatment estimates and annual maximums. The cost hub has the full technique comparison.
Is it worth treating several teeth at once?
Usually yes, if they share the same problem and the same surgical field. One recovery, one round of anaesthesia, one donor site and a lower per-tooth cost. The trade-off is a longer appointment and a larger immediate bill.
There are cases where staging is better: a long procedure in an anxious patient, a medical condition that limits chair time, or a need to see how the first graft heals before committing to more. A periodontist should be willing to discuss both.
The bottom line
One tooth: $550–$1,600. Two adjacent teeth: roughly $1,000–$2,200. A full quadrant: roughly $1,500–$3,500. Those are planning ranges, not quotes. The only number that matters is the written estimate for your teeth, with the codes and the material spelled out.
Frequently asked questions
Is a gum graft billed per tooth or per quadrant?
Both exist. A single tooth is usually billed per tooth. Several adjacent teeth are often billed per quadrant or per surgical site, with the first tooth at full fee and each additional tooth at a lower fee. Ask the office which model it uses.
Why is the second gum graft cheaper?
The surgical setup, anaesthesia and donor-site harvest are shared. Once the palate is open and the patient is numb, adding an adjacent tooth takes less additional time and material, so many practices discount the second and third tooth.
How much does a four-tooth gum graft cost?
A quadrant graft covering four adjacent teeth commonly falls between $1,500 and $3,500, depending on the technique and city. That is not four times the single-tooth price, but it is not a small bill either. Get the total and the per-tooth breakdown in writing.
Does insurance pay per tooth?
Many dental plans pay a percentage of the allowed fee per procedure code, and some codes are defined per tooth while others are per quadrant. The annual maximum usually matters more than the per-tooth calculation.