A gingivectomy is a common surgical procedure performed by a dentist or periodontist, a dental specialist focusing on gum health. The process involves the precise removal of a portion of the gingiva, or gum tissue, from around the teeth. Its purpose is to treat gum diseases by eliminating diseased tissue or to reshape the gum line for a more balanced smile. This outpatient procedure is a straightforward and effective way to restore gum health and enhance the overall appearance of the teeth.
When a Gingivectomy is Necessary
Gingivectomy is performed for two categories of need: therapeutic and cosmetic. The therapeutic application treats periodontal disease that has progressed beyond standard non-surgical treatments like deep cleaning. When gum disease creates deep pockets between the teeth and gums, these spaces become difficult to clean, allowing bacteria to thrive and cause further damage. Removing the diseased tissue eliminates these deep periodontal pockets, making the area accessible for better hygiene and preventing infection from reaching the underlying bone structure.
Other medical reasons include removing excess gum tissue grown due to certain medications (drug-induced gingival overgrowth) or hormonal changes. This excess tissue can cover too much of the tooth surface, making it difficult to brush and floss effectively, which further contributes to inflammation and disease. The procedure restores a healthier gum contour that is easier to maintain and less susceptible to recurrent infection.
The cosmetic indication often addresses a “gummy smile,” where excessive gum tissue is visible above the teeth. This can make the teeth appear unusually short or disproportionate to the gums, even when the teeth themselves are of normal length. Reshaping the gum line can correct this imbalance, exposing more of the natural tooth surface and creating a more harmonious smile. The procedure also corrects uneven gum margins, where tissue surrounding neighboring teeth is at different heights, creating an asymmetrical look.
Detailing the Procedure
Before the procedure begins, the area is prepared by administering a local anesthetic to ensure the patient remains comfortable and pain-free throughout the surgery. The dentist or specialist first marks the gum tissue to be removed, carefully outlining the new, healthier gum line. This precise marking dictates the final shape and contour of the gums.
The excess or diseased gum tissue is then removed using one of two primary methods: a traditional surgical scalpel or a laser. The conventional scalpel technique uses surgical blades to carefully trim the tissue to the marked line. While effective, this method often requires stitches to close the incision and may result in more post-operative bleeding.
A laser gingivectomy utilizes a high-intensity light to cut away the tissue, a method popular due to its benefits. The laser automatically seals the blood vessels as it removes the tissue, resulting in minimal to no bleeding during the procedure and often eliminating the need for sutures. This cauterizing action also provides immediate sterilization of the surgical site, which can reduce the risk of post-operative infection. Laser-based procedures may also be associated with less post-operative pain and swelling.
Regardless of the method used, the final step involves contouring the remaining gum tissue to smooth and shape the new gum line, a process referred to as a gingivoplasty. After the tissue is removed and shaped, a protective dressing (a soft, putty-like material) is typically placed over the surgical area. This dressing protects the healing tissue from irritation and aids in the recovery process.
Recovery and Long-Term Results
Healing after a gingivectomy is quick, with the initial recovery period lasting about one to two weeks. Patients may experience mild discomfort, swelling, and slight bleeding in the first few days, managed effectively with over-the-counter pain relievers. The protective periodontal dressing will remain in place for about a week, after which it will be removed by the dental professional during a follow-up visit.
During the initial recovery phase, patients are advised to adhere to a diet consisting of soft foods and avoid items that are hard, crunchy, or excessively hot, as these can irritate the surgical site. Maintaining oral hygiene is important, but gentle care must be taken around the operated area, often involving an antibacterial mouthwash or a soft-bristled toothbrush. Strenuous physical activity should be limited for the first few days to prevent increased blood flow to the area, which could cause further bleeding.
The long-term results of a gingivectomy are permanent, as the removed gum tissue does not grow back. The procedure results in a healthier, firmer gum line that is easier to keep clean, significantly reducing the risk of recurring periodontal disease. For cosmetic cases, the outcome is a more balanced smile with teeth that appear longer and more proportionate to the gums. Regular follow-up appointments and diligent at-home oral care are necessary to ensure the health and stability of the newly contoured gums.