Gingivectomy

What is Gingivectomy?

Gingivectomy is surgical removal of gum tissue, or gingiva. Gingivectomy can be used to treat conditions like gingivitis. It’s also used to remove extra gum tissue for cosmetic reasons, such as to modify a smile.

Before Gingivectomy

Who’s a candidate for gingivectomy?

A dentist may recommend gingivectomy if you have gum recession from:

. Aging

. Gum diseases, like gingivitis

. Bacterial infections

. Gum injury

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Gingivectomy for gum disease

If you have gum disease, a dentist may recommend this procedure to prevent future gum damage as well as give your dentist easier access to the teeth for cleaning.

Gum disease often creates openings at the bottom of the teeth. These openings can lead to a buildup of:

. Plaque

. Bacteria

. Hardened plaque, known as calculus or tartar

Those buildups can then lead to further damage.

Your dentist may also recommend this procedure if they discover gum disease or infection during a check-up or cleaning, and want to stop its progression.

Elective gingivectomy

Gingivectomy for cosmetic reasons is totally optional. Many dentists don’t recommend it unless the risks are low or if they specialize in cosmetic procedures.

Talk to a dentist about this procedure first to be aware of the pros and cons of an elective gingivectomy.

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Possible Risks and Complications

Gingivectomy is associated with the following risks and complications:

. Bleeding, which can occur during and after the procedure

. Pain and swelling of gums

. Infection at the surgical site. In some rare cases, the infection could travel into the bloodstream and sepsis could occur.

. Blood clot

. Bone necrosis can occur in chemosurgery patients

. Abscess in the periodontal area

. Damage to the surrounding healthy cells if electric current or chemicals are used

. Damage to the nearby nerves

. Tooth sensitivity to cold temperature

. Plaque buildup recurrence, especially if the diseased gum tissue was not totally removed.

The greatest risk of a gingivectomy is getting an infection either in the gums themselves or systemically. This is because the surgical procedure may allow harmful bacteria to gain access through the gums into the bloodstream. For patients who have conditions that put them at increased risk of infection, the doctor may prescribe antibiotics to be taken both before and after surgery. This group includes patients who have:

. Heart conditions

. Damaged immune systems

. Certain heart problems

. Undergone recent surgeries

Patients with heart problems may be at increased risk of developing a heart infection known as endocarditis and individuals who have had recent surgeries involving joint replacement may be more vulnerable to other infections.

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During Gingivectomy

What to expect during the procedure

A gingivectomy takes 30 to 60 minutes, depending on how much gum tissue your dentist removes.

Minor procedures involving a single tooth or several teeth will probably only take a single session. Major gum removal or reshaping may take several visits, especially if your dentist wants one area to heal before they move onto the next.

Here’s how the procedure works:

1. Your dentist injects local anesthetic into the gums to numb the area.
2. Your dentist uses a scalpel or laser tool to cut away pieces of gum tissue. This is called soft tissue incision.
3. During the procedure, your dentist will likely keep a suction tool in your mouth to remove excess saliva.
4. Once the tissue has been cut away, your dentist will likely use a laser tool to vaporize remaining tissue and shape the gumline.
5. Your dentist puts a soft putty-like substance and bandages on the area to protect your gums while they heal.

How do scalpel and laser procedures compare?

Laser gingivectomies are increasingly common because advances in laser technology continue to make tools cheaper and easier to use. Lasers are also more precise and allow faster healing and cauterization due to the heat of the laser, as well as a lower risk of infections from contaminated metal tools.

Laser procedures are more expensive than scalpel procedures and require more training, so your dentist may offer a scalpel gingivectomy if they’re not trained or don’t have the right equipment.

After Gingivectomy

Recovery

Recovery from gingivectomy is typically quick. Here’s what to expect.

. The first few hours

You should be able to go home right away. Your dentist will probably use local anesthesia only, so you can usually drive yourself home.

You may not feel pain right away, but as the numbing wears off a few hours after the procedure, the pain may be more sharp or persistent. An over-the-counter pain medication like acetaminophen (Tylenol) or ibuprofen (Advil) may help ease the pain.

Your gums will probably also bleed for a few days. Replace any bandages or dressings until bleeding stops or until your dentist advises that your gums can be exposed again.

Your dentist or a dentist assistant should explain how to change your bandages or dressings before sending you home. If they didn’t explain it or if you’re unsure about the instructions, call their office to ask for instructions.

. The next few days

You may have some jaw pain. Your dentist will likely tell you to eat only soft foods so that eating doesn’t irritate or damage your gums as they heal.

Try applying a cold compress to your cheeks to soothe any pain or irritation that spreads into your mouth.

Use a warm saltwater rinse or saline solution to keep the area free of bacteria or other irritating substances, but avoid mouthwash or other antiseptic liquids.

You may also need to take antibiotics to prevent gum infections.

. Long-term

Any pain and soreness will subside after about a week. See your dentist again to make sure the area’s healing well and that you can resume a normal diet.

Lastly, take good care of your teeth. Brush and floss twice per day, avoid smoking, and cut back on foods with a lot of sugar.

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When to see your dentist

See your dentist right away if you notice:

. Bleeding that doesn’t stop

. Excessive pain that doesn’t get better over time or with home treatment

. Abnormal pus or discharge

. Fever

Outlook

Gingivectomy is a low-cost, low-risk procedure for taking care of damaged gum tissue or to change the appearance of your smile.

It doesn’t take long to recover and the outcome is often positive.

How do gingivectomy and gingivoplasty compare?

. Gingivectomy is the removal of gum tissue.

. Gingivoplasty is the reshaping of gums to improve functions, such as to prevent cavities or improve your ability to chew foods, or to change your appearance.

Gingivoplasty is less common as a treatment for gum disease, but may be done if your gums are affected by a genetic condition or as part of other dental procedures to restore tooth and gum function, especially as you lose gum definition and teeth over time.