Gingivectomy

What is a gingivectomy?

Gingivectomy is surgery to remove excess or overgrown gum tissue (gingiva). Periodontists (gum specialists) use gingivectomy to treat some forms of periodontal (gum) disease. Gingivectomy is also a common cosmetic dentistry procedure used to fix a “gummy smile” (when excess gum tissue makes your teeth look short or “boxy”).

Types of gingivectomy

There are two main types of gingivectomy:

• Traditional gingivectomy. A surgeon uses a scalpel to remove excess gum tissue. In some cases, they may need to remove a small amount of underlying bone. They may use stitches to close any incisions and slow bleeding.
• Laser gingivectomy. A surgeon uses a handheld laser to remove excess gum tissue. Since lasers also cauterize (seal) gum tissue, you may not need stitches.

Who is a candidate for gingivectomy?

A gingivectomy procedure may be right for you if you have:

• Gingivitis.
• Periodontitis.
• A “gummy smile” that makes your teeth look too short.
• Periodontal pockets (areas where your gums have pulled away from your teeth).
• Braces or other orthodontic appliances.
• Tooth malposition (the position of your tooth results in excess gum tissue).

Certain medications can result in excess gum tissue, too. Examples include amlodipine for high blood pressure or cyclosporine as an immunosuppressant. If you develop puffy, overgrown gums after starting a particular medication, be sure to tell your healthcare provider. They may be able to switch medications or change your dosage.

How should I prepare for gingivectomy?

Before your gingivectomy, your periodontist will talk with you about what to expect. You usually don’t need to do anything else to prepare.

However, if you opt for sedation dentistry, be sure you bring a trusted friend or family member to drive you to and from your appointment.

What happens during gingivectomy surgery?

Here are the steps you can expect during a gingivectomy procedure:

1. Anesthesia. Before getting started, your surgeon will give you local anesthesia to numb your gums. (If you opted for sedation, they’ll also give you specific medications to help you relax.)
2. Removal of excess gum tissue. Using a scalpel or laser, your surgeon will remove any excess or overgrown gum tissue.
3. Gum reshaping. Once your surgeon removes the excess gum tissue, they’ll reshape your remaining gums. This ensures that your gums are proportionate to your teeth.
4. Bone reshaping. In some instances, your surgeon may need to reshape the underlying bone. To do this, they’ll need to make small incisions along your gum line.
5. Stitches. Your surgeon will use stitches to close the incisions and slow bleeding. (If you’re having laser gingivectomy, they may skip this step.)
6. Dressing. Your surgeon may place a soft putty over the surgical area to protect it. This dressing usually falls out on its own. If it doesn’t, your surgeon will remove it at your first follow-up appointment.

How long does a gingivectomy take?

In most cases, it takes between 30 and 60 minutes to complete a gingivectomy procedure. If you need gingivectomy on several teeth, it may take a little longer.

What should I expect after gingivectomy?

Gingivectomy is an outpatient procedure, so you’ll be able to go home the same day. Your surgeon will give you a list of post-operative instructions to keep you comfortable during recovery at home.

What are the benefits of gingivectomy?

Gingivectomy offers a number of benefits. The procedure:

• Removes excess or overgrown gum tissue.
• Fixes a “gummy smile.”
• Reduces harmful oral bacteria.
• Decreases periodontal pockets around your teeth.
• Makes brushing and flossing more effective because it helps you reach problems areas more easily.
• Helps you maintain healthy teeth and gums.

What are the risks or complications of gingivectomy?

Like all surgical procedures, you can expect some side effects following gingivectomy, including:

• Bleeding.
• Mild discomfort.
• Swelling.
• Bruising.
• Teeth sensitivity.

The side effects listed above are normal and should fade within three to four days.

Rarely, people may develop complications such as:

• Infection at the surgical site.
• Severe pain that doesn’t improve with medication.
• Abscess.
• Nerve damage.
• Sepsis (a complication of infection).

How long does it take for your gums to heal after a gingivectomy?

On average, it takes about one week for your gums to heal following gingivectomy.

How can I take care of myself during recovery?

After gingivectomy, your surgeon will give you a list of detailed post-operative instructions. You should follow these guidelines closely. Here are some basic recommendations for gingivectomy aftercare:

• Keep the surgical site clean. While you’ll want to avoid brushing too hard, you’ll still need to clean the surgical area. Brush gently and soak the area with an antibacterial mouthwash. Brush and floss all other teeth normally.
• Take all medications as directed. Your surgeon may prescribe antibiotics or pain medication. Be sure to take these exactly as directed. You can also take over-the-counter (OTC) pain relievers, such as acetaminophen or ibuprofen.
• Use an ice pack. Place a cold compress on your outer jaw to help reduce swelling and inflammation.
• Stick with soft foods. Avoid hard, crunchy foods for at least one week. Instead, choose foods like yogurt, mashed potatoes, cooked veggies and scrambled eggs.
• Avoid touching the surgical area. Though it may be tempting, don’t touch the surgical area with your fingers or tongue. This can disturb the healing process.

When can I go back to work or school?

Most people can return to work or school in a day or two. But keep activity light. If your job requires a lot of physical labor, you may want to stay home for at least three days.

Be sure you avoid strenuous exercise or heavy lifting for at least 48 hours. An elevated heart rate could cause more pain, bleeding and swelling.

Can you eat after gingivectomy?

Yes, you can eat after a gingivectomy procedure. But to avoid discomfort, you should wait until the numbness from the anesthesia wears off.

Start with liquids or soft foods. After a few days, introduce more solid foods as your comfort level allows.

When should I call my healthcare provider?

Call your surgeon right away if you’ve recently had a gingivectomy and develop:

• A fever higher than 101 degrees Fahrenheit (38.3 degrees Celsius).
• Bleeding that doesn’t stop.
• Pus or drainage coming out of your surgical site.
• Pain that doesn’t get better with medication.

What makes gingivectomy different from other gum procedures?

Gingivoplasty and crown lengthening share some similarities with gingivectomy. But these three procedures have different purposes:

Gingivectomy vs. gingivoplasty vs. crown lengthening

These are all periodontal procedures, but they’re slightly different:

• Gingivectomy is the removal of excess or overgrown gum tissue.
• Gingivoplasty is the reshaping of your gum line.
• Crown lengthening involves contouring and reshaping the bone underneath of your gums. Your dentist may recommend crown lengthening when your tooth is too short to hold a crown or when a cavity or filling sits below your gum line.

Periodontists may perform these as standalone treatments or in combination with one another, depending on your unique needs.

How painful is a gingivectomy?

You can expect to have some degree of discomfort following gingivectomy. You can manage pain and other side effects with over-the-counter pain relievers.

If you’ve taken your medication as directed and you’re still having pain, call your surgeon.

Do I need a gingivectomy with braces?

The vast majority of people with braces don’t need gingivectomy. However, some people develop swollen and puffy gums after they get braces. Most of the time, you can prevent this with improved brushing and flossing at home. But some people may require gingivectomy. Your orthodontist can tell you if gingivectomy would be beneficial for you.

Do gums grow back after gingivectomy?

No, gingivectomy results are permanent when a skilled surgeon performs the procedure.

A note from Cleveland Clinic

Gingivectomy is the surgical removal of gum tissue. People with gingivitis or periodontitis may need gingivectomy to reduce bacteria and improve oral health. Many people also choose gingivectomy to improve the appearance of a “gummy smile.” Talk to your dentist or periodontist to learn more about gingivectomy and find out if this procedure is right for you.