The most common types of gum surgery are gingivectomy, gingivoplasty, gingival flap surgery, crown lengthening and gum grafts. Gum surgery might be performed for either medical or cosmetic reasons. The majority of gum surgeries, however, are performed to address periodontal disease inside the gum.
Gingivectomy is the removal of excess gum tissue through surgery. It was developed for the treatment of gum disease but is also frequently used for cosmetic purposes. If gaps form between teeth and gums, food particles and infectious bacteria can be trapped there, increasing the likelihood of developing gum disease. During the procedure, the dentist will pull back the gums, clean the diseased area, trim the gums and any diseased tissue and then replace the gum tissue.
A gingivectomy also might be performed if too much gum tissue is present. Overgrowth of gum tissue might be caused by certain medications or for no reason at all. Having an excess of gum tissue makes it difficult to keep the teeth and gums clean and free of disease.
Gingivoplasty is the surgical reshaping and smoothing of healthy gum tissue, usually with lasers. This procedure might be necessary to restore the shape around a specific tooth or to restore the contour of the gums. Gingivoplasty is used to correct diseased gums, malformed gums or trauma, or it can be done for purely cosmetic reasons. This procedure can be done by itself or after a gingivectomy or gum graft.
Gingival flap surgery is a procedure during which the gums are separated from the teeth and temporarily folded back, allowing the dentist to reach the root of the tooth and the bone. This allows the dentist to treat gum disease deep under the gum line by removing bacteria, eliminating diseased tissue and examining the bone for problems. Gingival flap surgery also might be performed along with osseous surgery, in which the bone that holds one or more teeth in place is reshaped. After the disease is treated, the gum tissues are replaced.
Crown lengthening is performed to expose more tooth structure before restoring a tooth or placing a prosthetic, such as dentures or a crown. If a tooth has broken off, for example, a dentist might need to cut away the gum to expose the tooth below the gum line in order to work on it. This procedure is also used when a crown, repaired tooth or filling falls out, exposing decay underneath. The dentist will need to remove gum tissue in order to expose a solid foundation on which to set a new crown or filling.
A gum graft, or a gingival graft, is a type of gum surgery that restores receding gums. Gum tissue, usually removed from the palate, is added to the gum line where not enough gum tissue exists. This procedure is used to strengthen the gums and teeth, to repair gum disease damage, to prevent further tooth root exposure, to eliminate excessive sensitivity and to improve the look of the gums.
Gum surgery might be performed by a dentist, an oral surgeon or a periodontist, which is a dentist that has received advanced training and specializes in treating gums. Some pain and discomfort is normal following gum surgery. There also might be bleeding and swelling. The dentist or periodonist might advise the use of pain medication, antibiotics, ice packs or special cleaning techniques to promote healing.