This procedure is designed to replace or enhance the amount of gum supporting a tooth. Coverage of root surfaces exposed due to previous recession is also possible to achieve. These procedures are performed when there is inadequate gum remaining to help support a tooth or excessive recession has occurred exposing the root of the tooth. There are basically TWO types of Gum Grafts (Free gingival grafts): Sub-marginal Graft: This type of graft is the most predictable and is not meant to cover the root surface that has been exposed. It is meant to be placed at the current gum margin and to protect the underlying bone with a layer of tougher keratinized gum tissue that has been transplanted from another site. (usually the roof of the mouth). Root Coverage: This type of gum graft is designed to cover the root surface. It is not as predictable as the sub-marginal graft and is meant to be placed in areas that are highly visible such as the upper front teeth. This type of graft can be performed in several ways and may sometimes take two surgical steps. The most common method is a Connective Tissue Graft. The gum is taken from the palatal sub-mucosal tissue and then placed directly over the root; there tends to be more discomfort post-surgically. Recently, there has been developed synthetic tissue without the need for a donor area (palate); this makes the procedure much more pleasant, but again is not fully predictable.