You’ve worked hard to keep your teeth healthy and bright but find a distressingly wide expanse of gum flashing when you smile. Or maybe your teeth and gums are not quite so healthy, falling into the realm of periodontal disease. If either of these are the case, you may be a great candidate for laser gingivectomy. Here’s what you should know.

Do I need a gingivectomy?

A laser gingivectomy is a procedure that removes excess gum tissue (gingiva). It treats two main conditions:

  • Gummy smile
  • Periodontal disease

Gummy smile

A gummy smile can be caused by a variety of factors, including:

  • Abnormal structures in the mouth
  • Excess gum tissue
  • Shortened upper lip or hyperactive facial muscles

While a gummy smile does not affect the mouth and jaw’s function, it can affect your self-confidence in the way that other people see you.

Researchers have actually recorded negative perceptions of people with more than three millimeters of gingiva (as opposed to those with less). While not a health condition that you need to worry about, many people wish to change the look of their gummy smile and do so with a laser gingivectomy procedure.

Periodontal disease

A much more serious condition treated by laser gingivectomy is periodontal disease. Periodontal disease is a condition that is often painless and therefore sometimes challenging to diagnose.

The main symptoms of periodontal disease include:

  • The appearance of “longer” teeth as you age
  • More of a tooth’s root showing when you smile
  • Less coverage of tooth structure by the gums as you age
  • A slightly loose tooth, or teeth, in your mouth
  • Gums that appear puffy
  • An increased sensitivity to cold, air, or sweetness

People with periodontal disease will often have pockets in their gums. These pockets form when built up plaque pushes the gum away from the tooth, allowing food and bacteria to become trapped. Eventually, this can damage the bone irreparably.

Laser gingivectomy removes the pockets and seals the gums to the teeth. When other treatments for periodontal disease are not successful, laser gingivectomy sees good results.

Surgical gingivectomy vs laser gingivectomy

There are two main types of gingivectomy: surgical gingivectomy (the more traditional route) and laser gingivectomy.

These procedures have significant differences in cost, healing time, and pain levels. Here’s what you should know.

Healing time

Although all patients are different, in general, most patients see faster healing times with laser gingivectomy.

In a traditional gingivectomy using a scalpel, cutting into the delicate tissues of the gums can be difficult to gauge precisely. After surgery, the wound is closed with sutures, causing more puncture wounds in the mouth.

On the other hand, laser gingivectomy uses a laser as both surgical instrument and needle and thread. The laser cauterizes the wound, closing it to bacteria as it removes targeted gum tissue. This results in measurably shorter healing times. Laser gingivectomy also causes less tissue damage, which also speeds healing times.

Pain

A major concern of patients who are trying to decide between surgical gingivectomy and laser gingivectomy is the amount of pain they will experience during surgery. Ideally, patients should experience zero pain during either procedure. Both use local anesthesia to numb the area being worked on, so the only experience during the procedure is pressure.

The difference, however, seems to be the amount of anesthesia need.

Strictly in terms of pain management (not anxiety over the procedure itself), patients opting for laser gingivectomy may require fewer operative analgesics than those who opt for surgical gingivectomy. This may be due to the fact that the laser can be more precise so anesthesia does not have to be as widespread as a precautionary measure.

Cost

Most insurance companies will not cover either surgical gingivectomy or laser gingivectomy for elective, cosmetic treatment of a gummy smile, so cost is usually a factor for patients.

Cost of either type of gingivectomy can vary depending on the location of the dentist as well as any amenities or extra services they provide. Only your dentist can provide an accurate estimate of costs for either procedure, but in general, expect to pay a few hundred dollars per tooth. This does not include any additional treatments, such as scaling and root planing or X-rays.

Insurance companies may pay some or all of this procedure as a treatment of periodontal disease, but they have restrictions on the type of gingivectomy they prefer.

Gingivectomy aftercare and recovery

Post-operative care recommendations are similar for both laser and surgical gingivectomy.

  • Follow your dentist’s instructions regarding prescription pain medications (and over-the-counter analgesics as well)
  • Reduce swelling by using an icepack on the jaw for 20 minutes on, 20 minutes off for the first day after your gingivectomy
  • Only eat soft or liquid foods for three days after the procedure (e.g., eggs, tofu, yogurt, soups)
  • Avoid spicy, acidic, or hot (temperature) foods (they might irritate the gingivectomy site) as well as hard, crunchy, or chewy foods
  • Limit strenuous activity on the day of the procedure, only gradually increasing it over the week
  • Do not rinse with undiluted mouthwash or saline solution
  • Brush the area near the gingivectomy very gently, and avoid flossing for a week
  • Call your dentist if you experience fever, excessive pain, or bleeding that will not stop as this could be a sign of infection

Laser gingivectomy patients report faster healing times than those who received surgical gingivectomy. This could be due to the cauterizing action of the laser and the fact that laser gingivectomy patients do not have additional stitches to manage.

What should I get?

Deciding between laser gingivectomy and surgical gingivectomy can be challenging. If you have friends who have had a gingivectomy, talk to them about their experiences. Community forums are also a great source of before and after photos for both laser gingivectomy and surgical gingivectomy.

Gathering the most information you can before you decide can help. Ultimately, the decision is between you and your dentist, balancing the aesthetic look you are going for with practical considerations like healing time and financial commitments.

When you are ready to start the conversation, AZ Dentist is your Phoenix area cosmetic dentist. We can help you make the decision that is best for you. Get in touch today!

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