- Gingivectomy removes tissue; gingivoplasty shapes the margin
- Done with a laser or a scalpel; the choice depends on the case
- If there is too little room to the bone, the bone edge is reshaped too
A gingivectomy is the removal of gum tissue that covers more of the tooth than it should. A gingivoplasty is the reshaping of the gum margin: thinning a thick, rounded edge and giving the triangles of gum between the teeth a natural form. The two are usually done together, in the same session.
Sometimes the aim is aesthetic: teeth that look short, an uneven gum line. Sometimes it is about health, because overgrown gum forms pockets that cannot be cleaned and become inflamed. The overall assessment of the smile, and whether the problem really lies in the gum, is on the gum aesthetics page; here we describe the procedure itself.
When is it done?
- Altered passive eruption. After a tooth comes through, the gum normally moves back towards the root. In some people this does not happen fully; the gum continues to cover part of the tooth and the teeth look short and square.
- Medication-related gum overgrowth. Some epilepsy medicines, some blood pressure medicines in the calcium channel blocker group and some medicines taken after an organ transplant can make the gums overgrow. Do not stop the medication yourself; whether a change is possible is assessed together with the doctor who prescribed it.
- Excess left during or after orthodontic treatment. Gum that swells around brackets often shrinks back by itself in the months after the appliances come off. The part that does not is reshaped.
- False pockets. Pockets that have deepened only because the gum has overgrown, with no bone loss. If they do not shrink after cleaning, the excess tissue is removed.
- Before a restoration. If decay or a fracture extends below the gum, the gum, often together with the bone, is reshaped to reach sound tooth surface.
We do not carry out this procedure unless we are sure the gum really does cover too much of the tooth. If the teeth are worn, or the upper lip rises too far when you smile, removing gum will not correct the smile; it only increases the risk of exposing the root surface.
Is only the gum removed, or the bone reshaped as well?
This is the most important decision in the procedure. Between the gum margin and the bone beneath it there is a band of tissue, roughly 2–3 millimetres, that the body tries to maintain. If so much gum is removed that this distance is disturbed, the body rebuilds it: the gum grows back or the margin becomes persistently inflamed.
So before the procedure, under anaesthetic, we measure where the bone begins with a fine probe and confirm it with an X-ray if needed. If the distance is sufficient, only gum is removed. If the bone is too close to the gum margin, the gum is lifted and the bone edge is reshaped as well; this is called crown lengthening.
| Gingivectomy / gingivoplasty | Crown lengthening | |
|---|---|---|
| What is removed | Gum only | Gum and the edge of the bone |
| Stitches | Often not needed | Needed |
| Surface healing | 1–2 weeks | About 2 weeks |
| Margin reaching its final position | A few weeks | A few months |
Laser or scalpel?
Both cut the gum; the difference lies less in the tool than in how it is used. Because a laser seals small blood vessels as it cuts, bleeding is generally less and small procedures may not need stitches. A scalpel gives very fine control when creating a thin, crisp margin, and it is used in any case when the gum has to be lifted. Some studies report slightly less discomfort in the first days after laser treatment; no clear difference between the two methods has been shown in the long-term result. What decides the outcome is the planning, not the tool.
The procedure step by step
- Planning. The new gum line is set on photographs, with digital smile design if needed; how much will be removed on each tooth is known in advance.
- Preparation. If the gums are inflamed, a scale and polish comes first; measurements taken in swollen tissue are misleading.
- Anaesthetic and measurement. The procedure is done under local anaesthetic; you usually feel no pain during it. The bone level is measured. If you take blood thinners, tell us beforehand; do not stop the medication yourself.
- Shaping. The new margin is marked, the excess tissue is removed, and the margin and the tissue between the teeth are shaped.
- Protection. If needed, stitches are placed or a protective dressing is applied over the surface.
On the six front teeth, reshaping the gum alone often takes less than an hour; if bone reshaping is added, it takes longer.
What is recovery like?
For the first day or two there may be tenderness and light oozing; for most people an over-the-counter painkiller is enough. In the first days a whitish-yellow layer is visible on the surface; this is the normal appearance of healing tissue, not infection. Avoid hot, spicy, acidic and hard foods for a few days, and clean the area gently with a soft brush. Because the gum margin has moved, there may be brief sensitivity to cold in the first weeks. If you develop a fever, increasing swelling or bleeding that will not stop, contact us without delay, and if you are no longer in İzmir, see a local dentist straight away as well.
If veneers or crowns are to follow, we wait for the tissue to settle before taking impressions; on front teeth where the bone has been reshaped, this is usually a few months.
Is the result permanent?
In altered passive eruption, a correction made while preserving the right distance is generally permanent. In medication-related overgrowth, the tissue can grow back for as long as the medication continues and plaque control remains poor. There is one more limit you should know about: gum that has been over-removed cannot easily be restored, and if necessary an additional operation such as a connective tissue graft is required. That is why we are cautious in planning.
The cost depends on the number of teeth and whether bone reshaping is needed. You receive a written, itemised quote after the examination at our clinic in İzmir.
Common questions
Will I feel pain during a gingivectomy?
The procedure is done under local anaesthetic and you usually feel no pain during it; you may feel pressure. Once the anaesthetic wears off there is tenderness for a day or two, which usually settles with an over-the-counter painkiller.
Does the removed gum grow back?
Generally not, if the natural distance between the gum and the bone has been preserved. If that distance has been disturbed, or the overgrowth is caused by medication, the gum can partly come back. That is why we measure the distance before the procedure.
Will I need stitches?
When only gum is removed, stitches are often not needed. If the gum is lifted to reshape the bone, stitches are placed; they are usually removed after 7–10 days, or dissolving stitches are used.
Can I go to work or to an event the next day?
Most people return to work the next day; speech is not affected. In the first days, however, the gums look red and the surface whitish. If you have an event where your smile will be photographed, schedule the procedure at least two to three weeks beforehand.
When can impressions be taken for veneers or crowns?
If only the gum was reshaped, usually after a few weeks. If the bone was reshaped too, especially on front teeth, we usually wait a few months for the gum margin to reach its final position. Impressions taken too early mean a restoration margin that later becomes exposed.
My gum overgrowth is caused by medication; should I stop taking it?
No, do not stop it on your own. You need to talk to the doctor who prescribed it about whether there is an alternative. Often, good plaque control and cleaning reduce the overgrowth first; the remaining excess can be removed, but you should know that it may recur as long as the medication continues.
Not sure if this is right for you?
Send us a photo. We will tell you honestly what you need — and what you do not.