Quick answer
A soft tissue graft is the tissue used to cover a receded gum line. It can come from the patient's palate, be moved from nearby gum, or be a processed donor matrix. Most single-root cases can achieve substantial coverage, but final results are judged at 8–12 weeks.
“Soft tissue graft” is the clinical umbrella. “Gum graft” is what most patients call it. Both describe moving tissue onto a site that has lost gum — usually to cover an exposed root, sometimes to thicken a thin band of attached gum before orthodontics or an implant.
The distinctions that matter are where the tissue comes from and what the graft is expected to achieve.
The four donor options
Connective tissue from the palate
The surgeon removes a strip of tissue from beneath the surface of the palate and places it over the root. The surface stays intact. This is the most common approach for root coverage because the graft is thin, adaptable and has a good blood supply.
Free gingival graft from the palate surface
A surface piece, including the epithelium, is moved to the recipient site. It is thicker and paler than a connective tissue graft. It is used mainly to increase attached, keratinized gum rather than to cover a deep root.
Pedicle or laterally positioned flap
Gum next to the defect is partially released and moved over the root. No donor site, but limited by the amount and health of the neighbouring tissue.
Acellular dermal matrix
A processed donor-tissue sheet replaces the patient’s own connective tissue. It avoids a palate wound and can cover a large area. It is a material cost and may behave differently in a thin biotype.
What the graft is actually for
There are two different goals, and they are often confused:
- Root coverage. The graft covers the exposed root to reduce sensitivity, protect against caries and improve appearance.
- Attached gum width. The graft creates a firmer band of keratinized tissue so the gum margin can withstand brushing and functional forces.
A connective tissue graft is usually chosen for goal 1. A free gingival graft is usually chosen for goal 2. A pedicle flap can serve goal 1 in the right anatomy. A matrix can serve either, depending on how it is used.
If your surgeon recommends a free gingival graft for a front tooth with a deep root exposure, ask why. It may be the right call if attached gum is the priority, but it is worth understanding the trade-off in appearance and coverage.
What root coverage is realistic?
The honest answer is: it depends. Factors that favour good coverage:
- A single, narrow, shallow-to-moderate defect.
- Thick gum tissue (thick biotype).
- Intact gum between the teeth.
- No active periodontal disease.
- No smoking.
- Good plaque control.
Factors that make complete coverage harder:
- Wide or deep defects.
- Multiple adjacent teeth.
- Thin biotype.
- Loss of the interdental papilla.
- Active periodontal disease or smoking.
- A root that is prominent or restored.
Cleveland Clinic describes gum grafting as having a good success rate, over 90%, while noting that results vary. That figure is about graft survival, not perfect root coverage. A graft can survive and still leave part of the root exposed.
The three-month judgement
The graft goes through phases: initial healing (1–2 weeks), tissue maturation (4–8 weeks), and stabilization (8–12 weeks). The gum line at day seven is not the final gum line. It may look bulky, pale or uneven, then settle.
A surgeon should measure the final coverage at 8–12 weeks and compare it with the preoperative measurement. Ask for both numbers. “It looks good” is not a measurement.
Risks and failure signs
The main risks are:
- Graft failure or partial loss. The graft does not integrate and sloughs.
- Infection. Uncommon but possible.
- Bleeding or haematoma.
- Palate donor-site pain or delayed healing.
- Scarring or an uneven gum line.
- Recurrence of recession if the cause is not controlled.
- Altered sensation at the palate, usually temporary.
Signs to call about: a graft that turns black and is painful, increasing swelling after day three, fever, pus, or bleeding that will not stop. The recovery guide has the full list.
Soft tissue graft versus bone graft
A soft tissue graft covers a root. A bone graft rebuilds bone. They are different tissues for different problems. A patient with periodontal disease can need both, at different sites or at different times. The comparison guide explains the distinction.
Cost
A soft tissue graft is priced like a gum graft: roughly $550–$1,600 per tooth, depending on the technique, plus material and sedation. Donor matrix sits at the upper end. The cost hub has the table, and the per-tooth guide explains multi-tooth pricing.
Questions for the consultation
- Which soft tissue graft are you recommending, and what is the goal?
- What coverage do you expect, in millimetres or percent?
- What are the alternatives, including monitoring?
- What is the plan if the graft fails?
- How will you measure the result, and when?
The bottom line
A soft tissue graft is a repair, not a regeneration. It can restore coverage and thickness, reduce symptoms and protect a root, but it works best when the cause is controlled and the technique matches the defect. Judge the result at three months, not three days.
Frequently asked questions
Is a soft tissue graft the same as a gum graft?
Essentially yes. A gum graft is a soft tissue graft used to cover a root or add attached gum. The term 'soft tissue graft' is the broader clinical name; 'gum graft' is the patient-facing name for the same family of procedures.
What are the types of soft tissue graft?
The main types are connective tissue graft (from under the palate), free gingival graft (surface palate), pedicle or laterally positioned flap (nearby gum), and acellular dermal matrix (processed donor tissue).
How much root coverage can I expect?
Coverage depends on the defect, the technique and the biotype. Many single-root defects achieve substantial coverage, but complete coverage is not guaranteed. Your surgeon should give you a realistic estimate before surgery rather than a promise.
Does a soft tissue graft stop recession?
It can stop recession at the treated site by restoring tissue thickness and coverage, but it does not remove the underlying cause. Gum disease, hard brushing, grinding and smoking can still damage the graft and neighbouring gums.