Two things go wrong after a gum graft more often than patients expect: a claim denied because the code and the operative note do not match, and worry in week one about whether the graft looks normal. This page handles both.
The American Academy of Periodontology explains that exposed roots result from gum recession, and that in gum graft surgery the periodontist takes tissue from the palate or another donor source to cover the root, on one or several teeth, which may reduce sensitivity. The aim is also protective: what a gum graft is explains how covering the root helps prevent further recession and decay.
Recession has several causes, and the cause matters for the long-term plan. NIDCR describes gum disease as an infection that inflames the tissues holding the teeth, usually driven by plaque that hardens into tartar only a professional cleaning can remove.
| CDT code | Technique | Ask the office |
|---|---|---|
| D4270 | Pedicle flap or soft tissue graft, one tooth | Is this what the operative note will describe? |
| D4271 | Free gingival graft, one tooth | Allowed fee under my plan? |
| D4273 | Autogenous connective tissue graft, one tooth | Palate as donor site? |
| D4275 | Non-autogenous connective tissue graft (donor matrix), one tooth | Is donor material covered? |
| D4276 | Combined connective tissue and pedicle graft | |
| D4277 / D4278 | Free soft tissue graft, first and each additional tooth | How many teeth? |
The gum graft insurance guide notes that many plans cover 50% to 80% when the graft treats periodontal disease rather than appearance, after a deductible and up to an annual maximum that is often $1,000 to $2,000, and that a claim whose code does not match the operative note invites denial.
| Day | Pain 0 to 10 | Swelling | Graft colour | Bleeding | Notes |
|---|---|---|---|---|---|
| 1 | |||||
| 2 | |||||
| 3 | |||||
| 4 | |||||
| 5 | |||||
| 7 | |||||
| 10 | |||||
| 14 |
Grafts depend on a fragile blood supply. According to gum graft risks, partial loss can happen in the first two weeks, and risk factors include smoking, poor plaque control, a thin gum type and a large defect. A graft that turns black and painful, or swelling that is getting worse after day three, is a reason to call the surgeon rather than wait for the review.