A periodontist is the type of dentist who performs gum grafts. Periodontists are dental specialists who complete two to three years of additional training beyond dental school, focused entirely on the gums, the bone that supports your teeth, and the placement of dental implants. While some general dentists do perform gum grafts, the vast majority of these procedures are done by periodontists, and most general dentists will refer you to one if you need grafting.
What a Periodontist Does Differently
Every periodontist starts as a general dentist, then enters a residency program specifically for gum and bone diseases. During those extra years, they perform hundreds of soft tissue surgeries, including multiple types of gum grafts. This volume of specialized training matters because gum grafting requires precise handling of delicate tissue, and outcomes depend heavily on surgical technique.
General dentists learn the fundamentals of periodontal treatment in dental school, and some pursue continuing education in soft tissue grafting. A general dentist who regularly performs gum grafts can be perfectly capable, but if your case involves multiple teeth, severe recession, or areas near the front of your mouth where cosmetic results matter most, a periodontist is the safer choice. If your general dentist identifies gum recession during a routine exam, they’ll typically write you a referral rather than handle the graft themselves.
How You Get Referred for a Gum Graft
The process usually starts at your general dentist’s office. During a cleaning or checkup, your dentist or hygienist measures the depth of the pockets around your teeth and checks how much gum tissue has pulled away from the tooth surface. Recession is graded on a scale from Class I (mild, with the gum pulling back but still above a key tissue boundary) to Class IV (severe, with significant bone and tissue loss between teeth). Class I and II cases respond well to grafting surgery. Class III and IV cases are harder to correct surgically because the supporting bone between teeth has already been lost.
Your general dentist makes the initial assessment, but the periodontist does a more detailed evaluation. They’ll look at the thickness of your remaining gum tissue, the health of the surrounding bone, whether you grind your teeth, and how many sites need treatment. All of this determines which grafting technique they recommend.
Types of Gum Grafts a Periodontist Performs
There are three main approaches, and the one your periodontist recommends depends on the location, severity, and number of teeth involved.
- Connective tissue graft: The most common type. The periodontist takes a small piece of tissue from beneath the surface of the roof of your mouth and stitches it over the exposed root. This works well for single teeth or small areas and produces natural-looking results.
- Free gingival graft: Instead of taking tissue from under the surface, the periodontist removes a thin layer directly from the roof of the mouth. This technique is often used when you need to thicken existing gum tissue rather than cover an exposed root. Long-term studies show free gingival grafts maintain their results in about 83% of cases even after 35 years.
- Allograft (donor tissue): Rather than harvesting tissue from your own mouth, the periodontist uses processed donor tissue or a collagen membrane. This eliminates the second surgical site on the roof of your mouth, which reduces pain, but outcomes can vary compared to using your own tissue.
The Pinhole Technique: A Newer Alternative
Some periodontists offer a minimally invasive option called the Pinhole Surgical Technique. Instead of cutting and stitching a graft into place, the periodontist makes a tiny hole in the gum tissue above the recession and uses specialized instruments to loosen and reposition the existing gum downward over the exposed root. Small collagen strips are placed through the pinhole to hold everything in position.
The recovery difference is significant. Traditional grafts take one to two weeks of initial healing with moderate swelling peaking around days three through five. With the pinhole technique, most patients are nearly fully healed by day three to five, with only minor swelling on day two. There are no stitches to remove, and many people return to normal activities within a day or two. The cosmetic improvement is visible immediately after the procedure. Not every case qualifies for this approach, though. Your periodontist will tell you if the pinhole technique is appropriate based on the type and extent of your recession.
What Recovery Looks Like
For traditional gum grafts, healing happens in stages. The first 24 to 48 hours involve the most discomfort, and you’ll stick to cold, soft foods and avoid brushing near the surgical site. During the first week, swelling gradually decreases and the graft begins to establish a blood supply from the surrounding tissue. Weeks two through four bring noticeable improvement as the graft tissue starts blending with your natural gum. Full integration, where the graft becomes indistinguishable from the tissue around it, takes one to three months.
You’ll have a follow-up visit, usually within the first two weeks, so your periodontist can check that the graft is healing properly. Most people take a few days off work for a traditional graft, though desk jobs are manageable sooner than physically demanding ones.
Success Rates and How Long Grafts Last
Gum grafts are one of the more reliable procedures in dentistry. Overall success rates run above 90%. Root coverage, meaning how much of the previously exposed root gets covered by the new tissue, averages about 89% after one year. That number does decline over decades, settling around 52% after 27 years, but this reflects gradual changes over a very long timeline rather than graft failure. Most grafts, when properly maintained with good oral hygiene, last for decades.
Cost and Insurance Coverage
The national average for gum graft surgery in the United States is around $2,742, with costs ranging from roughly $2,120 to nearly $5,000 depending on the number of teeth treated, the technique used, and your geographic location. Periodontists in major metro areas tend to charge more than those in smaller markets.
Dental insurance coverage is inconsistent. Some plans cover gum grafts only when a specific threshold of recession is documented. Others may cover half the cost, and most plans cap annual benefits, so if your procedure exceeds that cap you’ll pay the difference. It’s worth checking with your medical insurance as well. When gum disease is severe enough to pose a broader health risk, medical plans sometimes cover the surgical portion, particularly if the procedure is classified as medically necessary rather than purely dental.
How to Find the Right Periodontist
Start with your general dentist’s referral. They’ll typically recommend one or two periodontists they trust and have worked with before. If you want to explore options on your own, the American Academy of Periodontology has an online directory searchable by zip code that lists board-certified specialists. Board certification means the periodontist has passed additional examinations beyond their residency training.
During your consultation, ask how many gum grafts they perform per month, which techniques they offer, and whether they think your case is straightforward or complex. A periodontist who performs grafts regularly will give you a confident, specific answer about what to expect for your particular situation. If the pinhole technique interests you, ask whether you’re a candidate, since not all periodontists are trained in it and not all recession patterns are suitable for it.