When you look in the mirror and smile, do you also feel that your gums are more visible than your teeth? Sometimes this can cause a little unhappiness and even embarrassment. Or do your gums bleed when you brush your teeth or eat something spicy? Today, we are going to talk about a special surgery used in dentistry as a solution to such problems.
What is Gingivectomy simply?
Gingivectomy, simply put, is the surgical removal of excess or overgrown tissue from your gums. This is usually done by periodontists. There are two main reasons for this surgery.
1. Medical reasons: This is done as a treatment for some periodontal diseases. If the gums are too swollen and have gaps around the teeth that can trap bacteria, this surgery helps to remove that extra tissue and bring the gums back to a healthy level.
2. Cosmetic reasons: Some people have a "gummy smile" where their gums are more exposed than their teeth when they smile. This can make their teeth look smaller and shorter. This surgery is done to remove this extra gum tissue and give the teeth a nice, balanced look.
What are the main methods of performing this surgery?
There are two main methods for performing gingivectomy. Your doctor will choose the method that is most suitable for you based on your condition.
| Surgical method | How it happens |
|---|---|
| Traditional Gingivectomy | In this procedure, the dentist uses a special surgical instrument (scalpel) to cut away excess gum tissue. Sometimes, a small amount of bone beneath the gum may also need to be removed. Stitches are usually used to close the incisions and control bleeding. |
| Laser Gingivectomy | This is a modern method. Here, the surgeon uses a hand-held laser device to remove excess gum tissue. The laser beam burns and closes the wound as it removes the tissue. This results in very little bleeding. In most cases, this method does not require stitches . |
Who needs a gingivectomy?
Your dentist is the best person to decide whether this surgery is right for you. This surgery may generally be recommended for people with the following conditions:
- Gingivitis: The initial stage of gum disease is when the gums become swollen, red, and bleed when you brush your teeth. Sometimes, this swelling can lead to the formation of extra tissue.
- Periodontitis (gum disease): This is a slightly more serious condition than Gingivitis. The gums pull away from the teeth, creating deep pockets (periodontal pockets) where bacteria can accumulate. To reduce these pockets, extra tissue may need to be removed.
- "Gummy Smile": As we talked about earlier, if you have a lot of gum showing when you smile, this is a good solution to fix it.
- Due to braces: Some people experience swollen gums after getting braces. This can be controlled by maintaining good oral hygiene, but some people may need to have additional surgery to remove the overgrown gums.
- Due to a tooth positioning problem: A tooth that is crooked or in the wrong position can cause abnormal gum growth around it.
- Certain medications: Some medications for high blood pressure (e.g. Amlodipine) or immunosuppressants (e.g. Cyclosporine) can also cause swollen and enlarged gums. If you notice any changes after starting any medication, be sure to tell your doctor . The medication may need to be changed or the dosage adjusted.
How do you prepare before surgery?
This is not a surgery that usually requires a lot of preparation. Your dental surgeon will talk to you before the procedure, explain everything, ask you questions, and learn about your medical history.
Most importantly, if you are undergoing sedation dentistry, you should definitely bring a trusted friend or family member to drive you home.
How the surgery is performed step by step
A gingivectomy usually takes between 30 and 60 minutes to complete. It may take a little longer if multiple teeth are involved. The procedure is performed in a simple manner:
1. Anesthesia: First, the surgeon will inject an injection into your gum to numb the area (local anesthesia). So you won't feel any pain. If you've chosen sedation, you'll be given medication to put you into a light sleep.
2. Removal of excess gum tissue: Next, as mentioned earlier, the excess gum tissue is carefully removed using a scalpel or laser.
3. Gum shaping: After removing the extra parts, the remaining gum edge is shaped to fit the teeth beautifully.
4. Shaping the underlying bone: This is not something that is done all the time. Only if necessary, the shape of the bone under the gum is also slightly changed.
5. Stitches: In the traditional method, one or two dissolvable stitches are placed to close the incision and stop the bleeding. This may not be necessary with the laser method.
6. Dressing: Finally, a special paste (putty) similar to a plaster is applied to the wound to protect it. This usually falls off on its own within a few days. If it doesn't, the doctor will remove it after a few days.
How to take care of yourself after surgery?
This is not a surgery that requires a hospital stay. You can go home the same day. Your doctor will give you a series of instructions to help you reduce pain and discomfort after the surgery and recover quickly. It is very important to follow those instructions exactly.
| Things to follow after surgery | |
|---|---|
| Cleanliness | Don't brush the area where you had surgery. But you should keep the area clean. Brush the area very gently. Soak the area with an antibacterial mouthwash that your doctor gives you. Brush your other teeth normally. |
| Medicines | If your doctor prescribes painkillers or antibiotics to prevent infection, take them exactly as prescribed. If necessary, you can ask your doctor to take a painkiller like Paracetamol. |
| Using an Ice Pack | To reduce swelling and pain, place an ice pack on the outside of your cheek. Leave it on for 10-15 minutes, then remove it and reapply. |
| Food | Avoid spicy, hard-to-digest, and crunchy foods (e.g., biscuits, chips) for at least a week. Eat bland foods like yogurt, mashed potatoes, well-cooked vegetables, rice, porridge, and soup. Do not eat until the numbness caused by the anesthesia has completely gone. |
| Rest | You can return to work within a day or two. But avoid strenuous exercise or heavy lifting for at least 48 hours . Any increased heart rate can increase pain, bleeding, and swelling. |
When should I call the doctor?
Usually, the pain and swelling will subside within 3-4 days. It will take about a week for the wound to heal completely. However, if you experience any of the following symptoms, you should contact your surgeon immediately.
- If you have a fever over 38.3 degrees Celsius (101 Fahrenheit) .
- If you have severe pain that cannot be controlled even with painkillers.
- If there is unstoppable bleeding from the surgical site.
- If a pus-like fluid is coming out of the wound.
After gingivectomy, the gums will not grow back to their original size. If performed by a skilled, experienced surgeon, the results are permanent.
Take-Home Message
- Gingivectomy is a simple surgery that removes excess tissue from the gums. It is used to treat gum disease and to improve a "gummy smile."
- This can be done using the traditional method or the modern laser method. The laser method is less painful and less bleeding.
- It usually takes about a week to recover from surgery. During this time, following your doctor's instructions exactly is essential for a speedy recovery.
- It is very important to eat soft foods, keep your mouth clean, and avoid strenuous exercise.
- If you have swollen, bleeding gums, or are just a little concerned about your smile, don't be afraid to talk to your dentist about it. He or she will give you the best solution.
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