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Gingivectomy: How to Improve the Appearance of Your Smiles

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According to the American Dental Association, nearly 48% of all adults over 30 years have some form of gum disease. The numbers are even more globally, with the World Health Organization claiming that approximately 14% of the global adult population (representing over a billion cases) suffers from severe periodontal diseases. 

One of the go-to solutions to such issues is gingivectomy, a dental surgical procedure performed to heal one from the effects of such periodontal diseases. It is also commonly referred to as periodontitis gingivectomy.

Read on to get further insights on this procedure, understanding what is gingivectomy, the different types available, who is a good candidate, costs, recovery, and much more. 

What Is a Gingivectomy?

Rendering of the gingivectomy procedure

In layperson’s terms, gingivectomy is a treatment that improves your smile by altering the shape and overall look of your gums and teeth. A gingivectomy, also known as gingival sculpting, gum contouring, or gum reshaping, basically involves a minor surgical procedure to reshape one’s gumline

This procedure involves the removal of gingiva (gum tissue) and is used to treat conditions such as gingivitis. Gingivectomy is done with a laser or traditional scalpel. Both types of gingivectomy have the same results but involve different steps.  

The Gingivectomy Procedure

Someone with gum disease can get treatment using either of the two types of gingivectomy — laser or scalpel (also known as traditional) gingivectomy. But how do these two procedures differ? Also, there are other related procedures that your dentist may recommend in place of a gingivectomy. 

Here’s all you may need to know about the two critical types of gingivectomy and the other related procedures:

Gingivectomy Laser vs Scalpel

Laser technology is getting more popular in dentistry, having been used for various reasons, including laser teeth whitening

During a laser gingivectomy, your dentist uses a low-frequency dental laser to remove gum tissue. The light energy is strong enough to cut through your gums and is also quite accurate, meaning any projections of your new smile before the procedure become exactly that. 

Traditional or scalpel gingivectomy involves using a scalpel by a surgical dentist to cut away gum tissue. Although the results from this procedure are still good, they are not as accurate as the use of laser technology. 

Laser gingivectomy is becoming more common due to the advances in laser technology. Furthermore, the ease of using and getting these tools makes it a more viable option for patients and dentists. They allow for a more precise cut and faster healing, mostly due to the laser’s heat. Moreover, there is a lower risk of infection when using this method, as there is no chance of using contaminated metal tools.

Laser gum contouring is generally more expensive than traditional methods. However, not all surgical dentists may offer laser gingivectomy, as they require additional training and experience before providing such services to patients. 

It would be prudent to inquire from your dentist if they also offer laser gingivectomy before getting the treatment from their clinic. If they don’t, you can simply search ‘gingivectomy near me’ online and filter out the results you get.

Gingivectomy or Gingivoplasty

As part of gum contouring procedures, gingivectomy and gingivoplasty are often used interchangeably. Both surgeries involve the removal of gum tissue. However, your dentist will guide you on choosing between gingivoplasty or gingivectomy, as they are two distinct procedures.

In simpler terms, gingivectomy refers to the removal of diseased gum tissue. During gingivectomy, your dental surgeon trims down and removes the diseased gum tissues, leaving the remaining ones to be reattached in or around the teeth. Gingivectomy gives you more freedom to remove calculus by removing the pocket walls, creating a more favorable environment for gingival healing.

Although gingivectomy was initially used to treat periodontal diseases, it has now become a popular alternative for cosmetic dentistry. However, your dentist should advise you on the best procedure based on your needs. 

On the other hand, gingivoplasty is done to reshape otherwise healthy gum tissues, mostly for cosmetic reasons. If your gums have an unusual shape or have not been formed usually, this may be an ideal solution for you. Regardless of why you require the procedure: due to your genes, disease, or trauma, gingivoplasty reshapes your gums to make them appear more natural. 

Either of these procedures is usually done alone or through a combination of both. Gingivoplasty can be performed alongside other dental procedures, such as a gum graft — a type of surgery that adds tissue to the gum line.

Crown Lengthening & Gingivectomy

Now that we have covered what gingivectomy is, most people also confuse this procedure with another one — crown lengthening. 

As the name implies, crown lengthening involves making the clinical portion of your crown longer. This procedure is done when one or several of your teeth has a severe dental cavity that only a tiny portion of your crown height remains. This portion is clinically considered to be inadequate for future crown retention.

A crown lengthening procedure increases the clinical crown height by removing surrounding bone and gum tissues. Doing so increases future crown retention. 

Dentists sometimes use crown lengthening during an altered passive eruption situation, where excessive amounts of gum tissue cover the teeth, mostly because of the underlying bony architecture. Jaw surgery vs braces are the other key procedures that involve altering the underlying bone architecture. 

Gingivectomy simply refers to the removal of gums to expose more tooth structure. This procedure only focuses on soft tissues, and the underlying bony structures are left untouched, unlike the hard-tissue crown lengthening procedure, giving you a clearer distinction between crown lengthening vs gingivectomy.

The Gingivectomy Process

You don’t have to worry about feeling pain or any discomfort when undergoing a gingivectomy. This is because your dentist uses local anesthetic or other sedation options to keep you comfortable throughout the procedure. In some cases, general anesthesia may be used for those not wholly comfortable staying awake during the procedure.

Gingivectomy is a relatively fast procedure and can be done at your dentist’s office. It is quite unlikely that you may be asked to spend the night at the clinic, so you should expect to head back home after the procedure.

Here are the key steps involved in gingivectomy to highlight your expectations: 

Before surgery

Your dentist marks up your gums to determine the areas that will need to be removed (or added). They will also share with you what the procedure looks like and respond to all your questions. You will also get an idea of how your new smile will look like after the treatment. If you are happy with the expected results, they can move forward with the treatment. 

During surgery

Your dentist will apply local anesthesia to numb your mouth. You will remain awake during the procedure but won’t feel any pain. However, if you have a fear of needles or surgery, you can inquire with your dentist about the availability of other sedation options. The anesthesia kicks in after 5-10 minutes.

Depending on your preferred or available method, your dentist will use either laser technology or a traditional scalpel to perform the procedure.

The procedure generally takes between half an hour and 2 hours to complete. The total time taken mainly depends on the complexity of your situation. 

After surgery

Once the surgery is done, the dentist places a surgical dressing or pack around your teeth and gums. This stays on for the next week or as instructed by the dentist to help during the healing process. 

You will also be provided detailed instructions on taking care of your gums and teeth during and after recovery. This includes everything from what you should and should not do or what you should refrain from eating and drinking. The use of certain leisure drugs, such as alcohol and tobacco, will be prohibited during this period. Medical drugs such as aspirin may also be prohibited. 

You should note that you may experience moderate to intermittent sharp pain once the anesthesia wears off. Fortunately, your dentist will prescribe painkillers to help with the pain and discomfort. 

It is important to put on hold any cosmetic procedures you’d planned for until you get fully healed. For instance, while some of the best teeth whitening kits are made for sensitive teeth, exposure to open wounds may increase irritation. 

Who Is a Candidate for Gingivectomy?

People diagnosed with gingivitis are the ideal candidates for gingivectomy. This condition is often characterized by plaque buildup. 

When this plaque hardens over time, it becomes calculus or tartar. The next step would be for the gums to become inflamed, creating a loose connection around your teeth. At this phase, calculus may not be removed through regular brushing or flossing, making gingivectomy the ideal solution. 

Patients suffering from periodontitis can also benefit from gingivectomy. Periodontitis is also caused by a bacterial infection that makes the gum become inflamed. Patients suffering from periodontitis may experience damage to underlying bone structures or even tooth loss in extreme cases if not treated.

Sometimes it might be difficult to know if you have gum disease. However, if you experience any of the following signs and symptoms, your dentist may recommend a gingivectomy:

How Much Is a Gingivectomy?

On average, you should expect to pay between $200 and $400 per tooth for a gingivectomy. The total gum contouring cost may depend on your dentist and location, so you may expect to pay a little higher or lower. Moreover, you should note that if you’re getting a gingivectomy for cosmetic reasons, your insurance may not cover any costs, so you will have to bear everything out-of-pocket. 

However, some insurers may provide partial or complete coverage if your dentist necessitates the procedure due to periodontal disease or mouth injury.

What Are the Benefits of a Gingivectomy?

Gingivectomy is gaining popularity in the surgical dentistry industry due to its many benefits. Here’s why most dentists and patients prefer gingivectomy:

Gingivectomy Before and After Results

Gingivectomy has cured many smiles and prevented many from the adverse effects of poor oral health. This can also be evidenced by the number of people openly talking about their procedure results and even posting their pictures online. Here are a few gum contouring before and after images that we found online: 

Before (left) and after (tight) pictures of a gingivectomy.

Gingivectomy Aftercare

Gingivectomy recovery doesn’t take long, and most patients can return to their normal lifestyles within a few weeks after the procedure. 

You will most likely experience bleeding gums during the first few days. However, your dentist will have given you a pack of dressings, which you ought to keep on until the bleeding subsides. Follow their instructions keenly, especially if you have to change the dressings yourself.

You may experience jaw pain within the next few days after your surgery. Your dentist will recommend the right foods you should eat that won’t strain or irritate your gums as they heal. One of the at-home remedies to this pain would be to apply a cold compress to your cheeks. Use lukewarm salt water to keep the area free of bacteria, and avoid using mouthwash or any other antiseptic liquids.

Any pain or irritation should subside within a week. Depending on your dentist’s instructions, you may go back after a few weeks for a routine checkup to ensure everything is going smoothly.

FAQ

Most frequent questions and answers

A gingivectomy takes between 30 minutes to 2 hours, although there are some cases reported to have taken up to 3 hours. The amount of time spent depends on the complexity of your case. 

You can get a gingivectomy as you continue with your braces treatment. A gingivectomy only impacts your gum tissues and not your teeth, hence no conflict with your orthodontic treatment.

A gingivectomy does not hurt as you will be under anesthesia throughout the entire procedure. Your dentist will prescribe painkillers to counter any pain that will arise after the anesthesia wears out. 

Most patients tend to go back to their usual lifestyles less than a month after the procedure. You should speak to your dentist if you experience bleeding or persistent sharp pains after a month.

Your dentist will recommend a diet of soft foods, which you should follow until they give you the clearance to go back to your usual diet. You should also avoid highly seasoned, spicy, acidic, sticky, and hard foods.

Any gum tissues that were removed during a gingivectomy do not grow back. This longevity is one of the main reasons most patients and dentists prefer gingivectomy treatment. 

Stitches or sutures are not required after a gingivectomy. Your dentist will place a medical dressing over your gums, which naturally take to their new position within a few days. You will experience some soreness, but this one also subsides within a few days. 

Gingivectomy is a low-risk procedure, and you should not be concerned about any adverse effects. The only possible associated risk would be infection, only if proper after-care is not done. 

Only use a soft-bristled toothbrush to brush only the chewing surfaces of your teeth, especially in areas covered by a periodontal dressing. You should also avoid flossing in the operated areas, at least within the first week.

Going back to work the day after your procedure may not be recommended due to irritations and slight bleeding. Most people are able to go back to their work within the second day if absolutely necessary. However, they should abstain from straining their mouths or teeth until the wounds are healed. 

Sources

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