What is a Gingivectomy?
A gingivectomy is a surgical procedure where excess or overgrown gum tissue is permanently removed. Gum specialists or periodontists can use a gingivectomy in the treatment of gum disease in some cases. Gingivectomy is also a common cosmetic dentistry procedure used to improve the appearance of a patient’s smile.
There are two different types of gingivectomy procedures which are summarized below.
- Traditional gingivectomy: The surgeon will use a scalpel and remove gum tissue. The surgeon may also need to remove a small amount bone in some cases. Stitches are typically used to close the incisions and minimize the amount of bleeding.
- Laser gingivectomy: A handheld laser is used by the surgeon. Lasers cauterize or seal the gum tissue which often eliminates the need for stitches.
The following conditions may make a patient a good candidate for a gingivectomy:
- Braces and other types of orthodontic appliances
- Gingivitis
- Gummy smile or teeth which appear short
- Periodontal pockets or gaps where the gums pull away from the teeth
- Periodontitis
- Malposition of the teeth which can cause excess gum tissue
Some patients who take certain types of medications can also have excess gum tissue. This may include medication such as cyclosporine which is an immunosuppressant and amlodipine which is used for high blood pressure. Patients who notice a change in their gums after taking medication should follow up with their dentist and doctor right away. There may be alternate medications or dosage modifications which can be used to reduce the side effects.
Prior to the gingivectomy, the periodontist will discuss what to expect with the procedure and review any applicable post-op instructions. In most cases, patients do not need to do anything to prepare for the surgery. Patients who opt to undergo sedation during the procedure should arrange for transportation to and from the appointment.
A summary of the gingivectomy procedure is outlined below.
- Anesthesia: The surgeon will begin by using a local anesthesia to numb the gums. Patients who opt to use sedation will receive specific medication to ensure they are relaxed and remain comfortable.
- Excess gum tissue removal: The surgeon then uses a laser or scalpel to remove the gum tissue.
- Gum reshaping: When the excess gum tissue has been removed, the surgeon will then reshape the gums to ensure that they are proportional to the teeth.
- Bone reshaping: Sometimes the surgeon needs to reshape the underlying bone. They will make small incisions along the gum line to access and modify the bone.
- Stitches: Stitches are then used to close the incisions and reduce bleeding. Stitches are not usually needed with a laser gingivectomy as the laser cauterizes the gum tissue.
- Dressing: A soft putty material may be placed over the surgical site to ensure it is protected while the gums heal. In most cases, the dressing will naturally fall out, however, the surgeon can remove during the follow-up appointment if needed.
Gingivectomy procedures typically take about 30-60 minutes. The duration of the procedure can depend on the location of the work and the number of teeth which are affected. A gingivectomy is considered an outpatient procedure, meaning patients will return home the same day of the procedure. Patients will receive post-operative instructions which should be closely followed.