My Gum Graft is Turning White as It Heals, Reasons Week by Week

If you've recently undergone a gum graft procedure, you may have noticed some intriguing color changes and a white appearance during the initial healing process.

Don't fret - this is perfectly normal! It's all part of the natural course of healing.

Think of it this way: Just like a painting, a gum graft needs time to settle and reveal its true colors. It's only after enough time has passed that we can make a final judgment about its success.

So, be patient and let the healing process run its course. Remember, appearances can be deceiving in the early stages, but with time, the true outcome of the graft will come to light.

Is a White Gum Graft a Sign of Failure?

A gum graft turning white is not necessarily a sign of failure, especially in the first few weeks. In fact, it's a normal part of the healing process that the graft must go through to properly take hold.

In the initial 4 to 6 weeks following the procedure, it's too early to judge the success or failure of the graft. During this time, the graft may change in color and size as it undergoes a stabilizing phase.

The most well-known technique that causes the graft to turn white and peel is called free gingival grafting. In this procedure, a piece of soft tissue is taken from your own palate and attached to your gums.



The good part is that because the graft is from your own body, the chances of success are higher as your body recognizes and accepts the tissue without any risk of rejection.

However, your gum tissues will not return to their normal appearance overnight. The healing process can be lengthy and involves complex biological reactions.

One of the initial changes you may observe is that the outer layer of the graft will turn white and gradually shed off. This is a normal process that typically starts within the first few days.

While this white appearance may seem concerning, it does not indicate graft failure.

In reality, the inner layer, known as the connective tissue, is the most crucial part of the graft. It provides the foundation for healing and maturation. In the first few days, this connective tissue will set firmly and will gradually be covered by new, healthier skin that fits better.

True graft failure, or graft necrosis, occurs when the entire thickness of the graft fails to adhere and survive on the recipient site. The telltale signs include a looser graft that turns white and detaches entirely from the recipient bed.

The good news is that, when properly done, gum grafts are less likely to fail, and most patients are satisfied with the results they achieve.

How to Determine if a Gum Graft Turning White is Failing or Healing?

Again, you cannot tell whether a gum graft is failing or healing during the initial healing phase. You can only make a final judgment about the graft after it has had enough time to settle and show its true appearance.

This usually happens around weeks 4 to 6 of the healing process. So, be patient and give it the time it needs to mature properly.

Before this maturation period, it's normal for the graft to have an unpleasant or different appearance. In fact, within the first 15 days, gum grafts usually appear as if they are failing.

Therefore, avoid constantly checking the surgical site during this critical phase. Instead, focus on following your dentist's instructions and being patient.

While monitoring the healing process, some early signs may indicate a risk of graft failure. These include:

• Mobilized or loose graft: If the graft becomes mobile or loose, it can occur due to accidental trauma, contact with a toothbrush, tongue movement, or premature removal of a stitch. The key to successful healing is for the graft to remain stable in its position without any movement. Any disturbance to its position may disrupt the healing process and lead to graft failure.


• Foul odor or pus from the graft: While some degree of bad breath or taste is normal after oral surgery, if it persists for an extended period or is accompanied by other symptoms such as pus discharge, severe pain, or persistent redness and swelling that do not improve over time, it may indicate an infection or graft failure.

Gum Graft Turning White in the First Week: Understanding the Reasons

When the graft is taken from the donor site, it is disconnected from its blood vessels. After it is stitched in place, its survival in the first two days depends mostly on the recipient site. The graft receives its nourishment mainly through the plasmatic circulation underneath.

As a result, the inner layer of the graft, which is in direct contact with the recipient site, will survive and turn red, indicating the development of new blood vessels.

However, the outer layer, farthest from the recipient site, does not receive sufficient nutrients and will undergo necrosis. This causes it to turn white and peel away from the surgical site by the second or third day.

This process is entirely normal and can be expected to extend over the first two weeks of healing. Overall, this is how the healing progresses over time:

Gum Graft is White in the Third Week: Is This Normal?

Firstly, the color of gums is influenced by factors such as blood vessels, melanin (pigmentation), and tissue thickness.

In the third week of healing, the graft is still undergoing maturation, and the final thickness of the tissue has not yet been established.

Consequently, the color and appearance of the graft may be inconsistent at this stage.

As the graft continues to heal and mature, its final color will gradually become more even.

However, many people complain about the paler or lighter color the graft takes on after healing. This is because one particular characteristic of the graft is that it takes on the color of the area from where it was harvested.

In the case of a free gingival graft, the skin from the palate is often lighter and whiter than the gums. As the graft matures, it may adopt the whiter color of the palate, which can result in a less aesthetically pleasing outcome.

In other cases, if you notice that the graft is loose and appears to be sloughing off in the third week, it is advisable to consult your dentist.

Although this is unusual in this stage of healing, don't stress about it. In the worst-case scenario, if the graft is failing, it may be only a partial failure, meaning that some portions of the graft may have managed to survive. This can facilitate any necessary follow-up procedures in the future.

What Should a Mature Gum Graft Look Like?

When a gum graft has reached maturity, it should be well-integrated and resemble healthy gum tissue. Here are some of the characteristics of a mature gum graft:

• Color: A mature gum graft typically exhibits a natural pink color, similar to the surrounding gum tissue. It should no longer appear white or discolored.


• Consistency: The graft should have a firm and stable consistency. It should feel similar to the adjacent gum tissue when touched or pressed gently.


• Texture: The texture of a mature gum graft should be smooth and uniform. It should not have any rough or irregular areas.


• Contour: A mature gum graft should follow the contour of the adjacent gums seamlessly. Any noticeable difference or irregularity needs to be addressed by a surgical procedure called gingivoplasty or gum contouring.


• Size: After healing, the graft may experience slight shrinkage from its initial volume. However, its size should be proportional to the area where it was placed. It should maintain a balanced thickness, neither too thick nor too thin.