Have you ever looked at the excessive line of gum between your upper lip and teeth when you smile and wondered if that was quite normal? Does an excessively “gummy smile” bother you and make you less inclined to smile in general? You are not alone, and there is help. A gingivectomy can help restore your self-confidence and beautiful smile.

What is a gingivectomy?

A gingivectomy is a gummy smile treatment that removes excess gingiva (gum tissue) around the teeth.

Gummy smile is also sometimes referred to as “gingival excess” or “exacerbated gingival display.” While a gummy smile is not a life-or-death issue, some studies suggest that people make decisions about us based on our smile. In one study, researchers registered negative perceptions of people with more than three millimeters of gingiva. These negative perceptions can affect our interactions with people and our confidence in ourselves.

Gummy smile can stem from a variety of factors, including:

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

This procedure helps with a gummy smile but also works as a treatment for people who have advanced periodontal disease. Periodontal disease causes pockets to form in the gums between the gum and the tooth. These pockets allow the advancement of the disease by trapping food particles and bacteria. A gingivectomy trims away the pockets after other treatments are not successful.

What is the procedure for a gingivectomy?

Procedure steps may vary slightly depending on the type of gingivectomy you receive (see below). In general, there are five steps for this periodontal disease or gummy smile treatment.

#1: Thorough examination with X-rays

This step is an important first step to determine whether or not a gingivectomy is warranted and will be successful. If there is an underlying condition, your dentist will also factor this into your treatment plan. Your dentist may opt for a dental scaling and root planing to thoroughly clean and prepare the teeth below the gumline.

#2: Local anesthetic

Your dentist will prepare the area by first offering a local anesthetic such as Novocain.

Most patients do not require any further anesthesia, but for those who are nervous or feeling anxiety, your dentist may offer a mild sedative before surgery.

#3: Marking the area

It is important to remove the correct amount of gingiva. Your dentist will make marks on your gums to guide them.

#4: Gum removal and suturing

Excessive gum tissue is removed surgically, and the remaining gum tissue is reattached with sutures.

These can be placed between the teeth or underneath the lip (as determined by your dentist).

#5: Packing the surgical area

To minimize bleeding and help speed healing, your dentist will pack the surgical area with a surgical dressing. The initial surgical dressing stays in place until the bleeding stops.

Patients will follow directions to place more surgical dressing as needed in the days following their gingivectomy.

Types of gingivectomy procedures

There are a few different types of gingivectomy procedures:

• Surgical gingivectomy: A surgical gingivectomy uses a traditional surgical instrument (scalpel) to remove excess gum tissue, followed by stitches to close the wound.
• Laser gingivectomy: This type of gingivectomy uses a laser as a scalpel. Laser technology in dentistry is revolutionizing dental surgery. In many cases, lasers act as not only the instrument of incision but also for suturing, cauterizing, and sterilizing the wound during the procedure. Patients (and dentists) often report less blood loss, less pain, and faster healing times with laser gingivectomy when compared with traditional surgical gingivectomy.
• Gingivoplasty: Unlike gingivectomy which removes gum tissue altogether, gingivoplasty reshapes and recontours the gums. This may not completely eliminate a gummy smile and is usually not utilized as a standalone gummy smile treatment.

You and your dentist can decide which type of gingivectomy is best for your situation. Complications such as underlying periodontal disease may also influence your decision.

What is gingivectomy recovery like?

As with most surgical dental procedures, it is important to rest for the remainder of the day on the day of your procedure. Limiting strenuous or aerobic activity for at least three days after your procedure is also highly recommended.

You may experience gingivectomy pain and swelling after your surgery. Follow your dentist’s instructions regarding prescription pain medication following surgery. You can also take over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen for both pain and inflammation.

Most patients experience swelling that can be eased with an ice pack applied to the face. Apply ice wrapped in a dry cloth on a 20 minutes on, 20 minutes off schedule for two to three hours following surgery to help minimize swelling and provide relief.

Some bleeding is normal. If bleeding does not stop within a few hours, press a cold, wet tea bag to the surgical site for 15 minutes on, 15 minutes off. If bleeding continues, you may want to contact your dentist.

Can I brush my teeth after a gingivectomy?

Oral hygiene remains important during the recovery period. In all untreated areas, brush and floss as normal, but take special care around the area of gingivectomy.

Use a soft bristled toothbrush to gently brush teeth, and avoid flossing for at least a week after your procedure. Do not use undiluted mouthwash, salt water, or other rinses without your dentist’s approval.

Your dentist may also provide you with Peridex to swab onto the area before bed, in the morning, and after eating and drinking.

What can I eat after a gingivectomy?

Eating soft, high-protein foods like eggs, tofu, yogurt, and custard are all great options following your gingivectomy. Do not eat until the anesthesia from the surgery has worn off. Once you do begin to eat, avoid salty, spicy, or very hot foods, as they can irritate the surgical area.

If you are experiencing excessive bleeding, fever, or excessive pain, call your dentist immediately. Although complications from gingivectomy are rare, these may be signs of infection. Your dentist will want to follow up and make sure healing is progressing.

Ready to fix a gummy smile? AZ Dentist is your Phoenix area cosmetic dentist, and we can help. Get in touch today!