Gingivectomy Guide: All You Need To Know

What Is A Gingivectomy?

A gingivectomy is a cut on your gums. The doctor takes off some of the gum that may be sick. This helps make your teeth look better. It can fix a smile that shows too much gum.

The gum is also called gingiva. When you have big pockets in your gums, bad stuff can grow there. This makes your gums sick. A gingivectomy can help fix this by taking away the sick gums.

Gum contouring is another name for this. It can make your smile look nice and even.

Some things that may mean you need this:

• Bad gum disease (called periodontitis)
• A smile that shows too much gum
• Gums grew too big from some pills

Why Is Gingivectomy Done?

There are medical and pretty reasons to get a gingivectomy.

Medical Reasons:

• To fix periodontitis by making bacterial pockets smaller
• To take out sick gum tissue
• To get teeth ready for new crowns

Pretty Reasons:

• To fix a “gummy smile”
• To make gum lines even
• To make your smile look the same on both sides

What It Fixes:

• Gingival hyperplasia (too big gums)
• Drug-induced gingival overgrowth (when pills like phenytoin make gums too big)
• Chronic gingivitis (long-time gum pain)

Ceramic veneers can help make your smile look even better after your gums heal.

Types of Gingivectomy

There are three main ways to do a gingivectomy:

1. Scalpel Gingivectomy: Uses a small knife called a Kirkland knife
2. Laser Gingivectomy: Uses light beams like Nd:YAG or diode lasers
3. Electrosurgery: Uses electricity to cut with great care

Let’s look at how they are different:

Laser gingivectomy heals in 7-10 days. Scalpel takes 14-21 days to heal. This makes laser a good pick for most people.

How To Get Ready For Surgery

Before Surgery Steps:

• You may need pills to kill germs if you have an infection
• Stop blood-thinning pills 7 days before
• Don’t smoke or drink alcohol

What Will Happen:

• Your gums will be made numb with local anesthesia
• It takes about 30-60 minutes
• You will be awake but won’t feel pain

The Gingivectomy Step-By-Step

Here is what happens in a gingivectomy:

1. The doctor puts numbing medicine on your gums
2. They cut away the sick tissue (with a scalpel, laser, or electrosurgery)
3. They make the rest of the gums smooth (this is called gingivoplasty)
4. They put on anti-germ wash and a special bandage

The doctor uses tools like:

• Periodontal probe (to check gum pocket size)
• Scalers (to clean teeth)
• Laser handpieces (for laser work)

If you’re worried about pain, know that 92% of people say pain is 4 or less out of 10 with laser methods.

Recovery & Aftercare

First 24 Hours:

• Bite on gauze to stop bleeding
• Don’t eat hot foods
• Use ice on your face if it swells

1-2 Weeks:

• Eat soft food (like mashed potatoes, yogurt)
• Rinse with special mouthwash called chlorhexidine
• Don’t brush where the surgery was

Healing Timeline:

• First healing: 7-10 days
• Full healing: 4-6 weeks

Bad Signs To Watch For:

• Very bad pain or swelling
• Pus or bad smell
• Fever

Smokers have 3 times more risk of slow healing. It’s very important to not smoke.

Custom dental guard can help protect your gums and teeth while they heal.

Risks vs. Benefits

Good Things:

• Stops gum disease from getting worse
• Makes your smile look better
• Works well (85%-90% success rate in making pockets smaller)

Risks:

• Gum going back too far
• Teeth feeling sensitive
• Infection (happens in 1%-3% of cases)

For drug-induced cases, there is 80% fix rate in phenytoin-induced cases.

Other Options Besides Gingivectomy

• Scaling & Root Planing: Deep cleaning without surgery
• Gum Grafting: For when gums have gone back too far
• Laser Pocket Cleaning: Less invasive than surgery

When To Pick Other Options:

• If you have just a little gum growth
• If you are at high risk for problems (like if you have diabetes)

Cost & Insurance

• Average Cost: $300-$1,200 (depends on method and how hard it is)
• Insurance: Pays for medically needed cases (codes D4249-D4264)
• Payment Plans: Most doctors offer these

Scalpel methods cost less but may need more care after. Laser methods cost more but heal faster.

Temporary restoration might be needed while your gums heal.

Common Questions

Finding a Good Doctor

• Look for AAP-certified periodontists (special gum doctors)
• Ask if they use laser or electrosurgery
• Look at before/after photos
• Ask how many gingivectomies they have done

It’s best to find someone who has done many of these. The American Academy of Periodontology can help you find a good doctor.

Long-Term Care After Gingivectomy

After you heal, good care keeps your gums healthy:

• Brush twice a day
• Floss every day
• See your dentist every 6 months
• Don’t smoke

75% of people keep stable gum levels at 5-year check-up. This shows how important good care is after surgery.

Flexible denture might be a good choice if you need to replace teeth after your gums heal.

Success Stories

Sara had a gummy smile. After laser gingivectomy, her smile looked much better. She said: “I can smile big now!”

Mark had gum disease. His gums hurt and bled. After gingivectomy, his gums got healthy. His periodontist used a scalpel method.

Linda had big gums from medication. Electrosurgery fixed this. She was happy with how fast she healed.

When To Call The Doctor

Call your doctor right away if:

• You have lots of bleeding that won’t stop
• You have very bad pain that pills don’t help
• You see pus
• You get a fever
• Your face or gums swell a lot

Kids and Gingivectomy

Gingivectomy is not common for kids. It works less well (60% success) in kids. Other ways to treat gum problems are better for young patients.

Summary

A gingivectomy is a good way to fix gum disease and make your smile look better. It can be done with a scalpel, laser, or electricity. Laser methods heal fastest. Most people do very well after this surgery.

The best things to do are:

• Pick a good doctor
• Follow all care steps after surgery
• Keep good oral hygiene for life
• See your dentist often

Good gum health means a better smile and better health overall!

Hard night guard can help protect your teeth if you grind them at night, which can hurt your gums.