A gingivectomy is a common periodontal procedure involving the surgical removal of gum tissue (gingiva). A specialist, typically a periodontist, performs the procedure to eliminate excess or diseased tissue surrounding the teeth. The primary goal is to reshape the gumline to create a healthier environment or to improve the overall appearance of a person’s smile. This intervention recontours the soft tissue to a more appropriate level around the tooth.
Reasons for Needing the Procedure
Gingivectomy is needed for two main reasons: improving oral health or enhancing the smile’s appearance. The therapeutic application focuses on addressing advanced gum disease, specifically when deep pockets form between the teeth and gums. These periodontal pockets are difficult to clean with routine brushing and flossing, allowing bacteria to thrive and potentially leading to bone loss. A gingivectomy removes the infected soft tissue, reducing the pocket depth and creating a clean surface that can be maintained more effectively.
The procedure is also used to treat gingival overgrowth, a condition where the gums become enlarged, sometimes due to certain medications. Removing this excess tissue helps prevent the buildup of plaque that the overgrowth can trap, reducing the risk of further infection. Cosmetically, the procedure is often performed to correct a “gummy smile,” where excessive gum tissue makes the teeth appear short or disproportionate. Reshaping the gum line exposes more of the tooth surface, creating a more balanced and symmetrical appearance.
What Happens During the Surgery
The gingivectomy procedure is typically an outpatient service, often completed in one visit depending on the extent of the area being treated. The process begins with the administration of a local anesthetic to numb the gum tissue surrounding the targeted teeth, ensuring the patient remains comfortable during the surgery.
Once the area is fully numb, the specialist proceeds to remove the excess or diseased tissue. This is traditionally done using a scalpel, but modern techniques often utilize a high-frequency electrocautery unit or a dental laser. A laser offers the advantage of simultaneously sealing the blood vessels, which minimizes bleeding at the surgical site.
After the tissue is removed, the remaining gum margin is contoured and sculpted to achieve the desired shape and height. The entire process usually takes between 30 minutes to an hour for a localized area. A periodontal dressing, a soft putty-like material, is often placed over the treated area to protect the fresh tissue and aid initial healing.
Managing the Healing Process
The first 24 to 48 hours are the most delicate, and patients should expect minor swelling, tenderness, and slight bleeding. Discomfort is managed with over-the-counter pain relievers, though prescription medication may be provided for extensive procedures. Applying a cold compress to the outside of the face in 10 to 15-minute intervals helps reduce initial swelling and discomfort.
Maintaining a soft and cool diet for the first few days prevents irritation and mechanical damage to the healing gums. Foods like yogurt, mashed potatoes, and smoothies are recommended, while hot, spicy, or crunchy foods should be avoided until the tissues stabilize. Patients must also refrain from using a straw, as the sucking action can dislodge the blood clot and disrupt healing.
Oral hygiene requires careful attention; patients should gently brush untreated areas but avoid direct contact with the surgical site for the first few days. Gentle rinsing with warm salt water two to three times a day is encouraged after the initial 48 hours to keep the area clean and soothe the tissue. The protective periodontal dressing may fall off within a week or be removed by the dentist during a follow-up appointment. Complete healing and stabilization of the gum tissue typically take between four to eight weeks, though the gums feel significantly better within the first week. Patients should contact their dentist immediately if they experience persistent, heavy bleeding, or if pain and swelling worsen after the first three to five days.