Surgical — 6 min read
Periodontal Plastic Surgery
Gum tissue does not grow back on its own. Once recession exposes root, only surgery restores the cover — and the window for a simple repair narrows every year.
Screened and introduced free, usually within a few hours. Sunny Isles Beach, Florida and the surrounding corridor.
Indications
A periodontist should look at this if
Periodontal plastic surgery covers the procedures that reshape or rebuild gum and bone: connective tissue grafts for recession, crown lengthening for short teeth or deep decay, pocket reduction where cleaning cannot reach, and gum reshaping for uneven smile lines.
- Teeth look longer than they used to, with a notch or step at the gum line
- Cold water produces a sharp jolt at one specific spot
- A tooth has broken close to or below the gum and cannot be crowned as it is
- Pockets measured at 5mm or deeper that have not responded to deep cleaning
- A gummy smile, or gum heights visibly uneven between front teeth
- A dark line or exposed metal margin at the edge of an older crown
Good candidate if
- Recession is progressing, or roots are exposed and sensitive
- Pockets have not closed after non-surgical therapy
- A restoration needs more tooth structure exposed to be viable
- You are a non-smoker, or will stop through healing
No cost, no obligation, no lead list.
The detail
Grafting, reduction and lengthening
Gum tissue does not grow back on its own. Once recession exposes root, only surgery restores the cover — and the window for a simple repair narrows every year.
Recession is treated with a graft. The traditional approach takes a strip of connective tissue from the palate and tucks it under the gum at the recession site. Pinhole and tunnel techniques achieve similar coverage through a small access point with less palatal discomfort, and donor tissue can replace the palate harvest entirely in suitable cases. Coverage rates for single-tooth recession are high when the bone between the roots is intact.
Pocket reduction is a different problem. Where a pocket is too deep for a brush or a hygienist to reach, bacteria persist and bone continues to be lost. Surgery folds the gum back, cleans the root surface directly, reshapes or regenerates the bone defect, and closes the gum at a level you can actually maintain. Crown lengthening, meanwhile, removes a controlled amount of gum and bone to expose enough tooth for a crown to grip — without it, restorations placed too close to bone stay chronically inflamed.
The sequence
What actually happens, in order.
Timings vary between practices and cases. The order does not — and a plan that skips a step is worth asking about.
Charting and imaging
Full-mouth pocket depths at six points per tooth, recession measurements, and radiographs or CBCT for bone architecture.
Non-surgical first
Scaling and root planing, then reassessment at six to eight weeks. Many sites resolve without surgery — good periodontists try this first.
Surgical phase
Grafting, pocket reduction or lengthening under local anaesthetic. Usually 60 to 90 minutes per quadrant.
Healing
Sutures out at seven to fourteen days. Soft diet and no brushing of the site for two weeks; a prescribed rinse instead.
Maintenance
Three-monthly periodontal maintenance for at least the first year. This is what keeps the result.
Getting the right hands
Who should be doing your periodontal surgery.
This is the variable that decides your result, and it is the one you have least ability to assess from the outside.
Not years in dentistry. How many of these they do in a month, and what the difficult ones looked like.
Anyone can photograph a result on delivery day. We want to see it after it has been used.
CBCT, microscope, scanner, printer — whichever this case genuinely requires, on site rather than referred out.
For anything ceramic, the technician is half the result. A dentist who cannot name theirs is outsourcing blind.
Periodontal Surgery FAQ
What people ask us about periodontal surgery.
Including the cost question, answered with a real range rather than a request to call.
The surgery is painless under local anaesthetic. The palate donor site is the sore part for three to five days and is usually managed with over-the-counter analgesics and a protective stent. Tunnel and pinhole techniques that avoid a palatal harvest are considerably more comfortable.
In South Florida, roughly $900 to $1,600 per tooth for a connective tissue graft, and less per tooth when several adjacent sites are treated in one session. Because it is medically necessary, dental insurance often contributes — worth checking before assuming otherwise.
Recession does not self-correct and generally continues. Left long enough, root decay, sensitivity and eventual bone loss follow, and the tooth becomes harder and more expensive to save. Early single-site grafts are far simpler than late multi-site ones.
The tissue looks pink and settled at three to four weeks, and reaches its final contour by three to six months as it matures and blends with the surrounding gum.
Not if the cause is addressed. Aggressive brushing, an untreated grinding habit or a tooth positioned outside the bone envelope will all cause relapse. A good periodontist treats the cause alongside the defect.