A gingivectomy is a common outpatient dental procedure involving the surgical removal and reshaping of gum tissue, often performed by a periodontist or oral surgeon. This precise intervention is used to treat specific gum conditions or to improve the appearance of the smile.
Defining the Gingivectomy and Its Clinical Goals
A gingivectomy is the surgical removal or reshaping of excess or overgrown gum tissue (gingiva). The primary goals for this procedure are therapeutic necessity and cosmetic enhancement. Therapeutically, the procedure is often used to treat advanced gum disease, specifically periodontitis.
In periodontal disease, gums pull away from the tooth, creating deep periodontal pockets that harbor harmful bacteria. A gingivectomy removes the diseased tissue and eliminates these pockets, making the area accessible for effective cleaning and preventing further infection and bone loss. This intervention restores a healthier environment for the remaining gum tissue and underlying tooth structure.
The second major application is cosmetic, often referred to as gum contouring or crown lengthening. Some individuals have excessive gum tissue that makes their teeth appear short, known as a “gummy smile.” Precisely removing and contouring the excess tissue, the gingivectomy creates a more balanced and aesthetically pleasing proportion between the teeth and gums. This reshaping is also necessary to provide better access for dental restorations, such as placing a crown on a tooth with decay or a fracture below the gum line.
How the Procedure is Performed
The procedure begins with administering a local anesthetic to ensure the patient feels no discomfort in the surgical area. Before making incisions, the dental professional carefully measures the gum tissue and notes the depth of any periodontal pockets. This measurement determines the precise amount of tissue removed to achieve the therapeutic or aesthetic goal.
The removal of gum tissue can be accomplished using several techniques: a traditional scalpel, electrosurgery, or a dental laser. Laser gingivectomy uses concentrated light energy to cut and simultaneously seal the tissue, often minimizing bleeding and eliminating the need for sutures. After the excess tissue is removed, the remaining gum line is meticulously reshaped and contoured to create a smooth, natural-looking edge around the teeth.
In some cases, especially after removing diseased tissue, the surgical site may be covered with a periodontal dressing. This soft, putty-like material acts as a temporary bandage to protect the exposed area during healing. The dressing stabilizes the newly contoured gum line and provides a physical barrier against food debris and plaque.
Recovery and Immediate Aftercare
Following the gingivectomy, patients should expect a short recovery period, with healing taking about one to two weeks. It is normal to experience mild swelling, minor bleeding, and slight discomfort once the local anesthetic wears off. Over-the-counter pain relievers, such as ibuprofen or acetaminophen, are sufficient for managing this post-operative pain.
Dietary modifications are necessary to protect the surgical site during the first few days of recovery. Patients should consume soft, cool, or liquid foods and avoid anything crunchy, spicy, or excessively hot that could irritate the healing gums. Patients should also avoid using a straw for the first 48 hours, as the sucking motion can dislodge the blood clot and cause bleeding.
Oral hygiene requires specific modifications to prevent infection without damaging the treated area. Patients must brush gently with a soft-bristled toothbrush, carefully avoiding the surgical site as directed by the dentist. Dentists often prescribe an antibacterial mouthwash, such as chlorhexidine, for rinsing to keep the area clean and reduce the bacterial load. Following these detailed instructions is important for ensuring the healing process is smooth and successful.
Addressing Potential Complications
While a gingivectomy is generally a safe and routine procedure, patients should be aware of potential complications that require immediate attention. The most significant concern, though rare, is the development of an infection at the surgical site. Signs of infection include a persistent fever, increasing pain not relieved by medication, or pus draining from the gums.
Another complication is excessive or prolonged bleeding that does not stop with gentle pressure. A small amount of oozing is normal, but heavy, continuous bleeding should be reported immediately. Some patients may also experience temporary sensitivity on the newly exposed root surfaces of their teeth. This sensitivity occurs because the gum tissue covering the root has been reduced, and it is managed with specialized toothpastes or desensitizing treatments.