In a free gingival graft, a small strip of flesh is removed from the roof of the mouth (palate). The tissue, called the "graft," is then stitched to the gum tissue in the area being treated. A free graft is often used for people who naturally have little gum tissue around their teeth and need to have the gums enlarged.

In a connective-tissue graft, a flap is cut in the roof of the mouth. The flap forms a "trap door" shape. Some tissue from under the flap is removed. The flap is then stitched back down. The tissue that was removed is known as subepithelial connective tissue. This graft tissue is slipped under the gum tissue that surrounds an exposed root. Then it is stitched into place. This is the most commonly used procedure for treating root exposure.

A pedicle graft uses a flap of tissue from the gum of a tooth next to the one with recession. The flap is partially cut away, with one edge still attached. This flap is called a pedicle. It is slid sideways to cover the exposed root and stitched into place. A pedicle graft may be more successful than a free gingival graft. That's because at least some of the blood vessels that feed the grafted section remain in place. However, a pedicle graft can be done only in certain cases. There must be a tooth next to the one being treated that has enough gum tissue to "share."

With all of these procedures, many periodontists will use a periodontal dressing. This is a soft material with a texture like modeling clay. It will be used to cover and protect the grafted tissue for the first week or two of healing.