When you see your smile in the mirror, you may focus on the pearly whites. There's more to your smile, however, than just your teeth. Your gums are important to your appearance and to your health. Sometimes maximizing your appearance or your oral health requires attention and even surgery on the gums.
Types of gum surgery
There are different types of gum surgery. A gingivectomy removes gum tissue, which is also called gingiva or gingival tissue. Gingivoplasty attaches tissue from somewhere else in the mouth to the gums. This is also known as a gum graft.
One reason for gum surgery is basically cosmetic. Some people have more gum tissue than they want, perhaps as the result of medication or other conditions. A "gummy smile" from excessive gum tissue makes the teeth look smaller or shorter than they really are. A practical problem is that excessive gum tissue can make it difficult to keep teeth and gums clean.
Another kind of gingivectomy is for crown lengthening. When a tooth has broken off or if a crown or filling falls out, there may not be enough tooth sticking above the gum line for it to be repaired properly. In this case, the dentist will need to expose more of the tooth by cutting back some of the gum tissue.
Conversely, some people have cosmetic gum surgery to add gum tissue. Teeth can look odd--and a person can look older--if the gums have receded. A gum graft or gingivoplasty is the answer.
Gum surgery may be the remedy for gums that have receded. People with extra-thin gums may experience gum recession. Brushing too hard, gum disease (periodontitis), and injuries can also lead to gum recession. Eventually, gums can recede so much that the tooth's root is exposed. Exposed roots can be unsightly, but they are also susceptible to pain from heat, cold or touch. They are also more susceptible to root decay and tooth loss.
Doing the surgery
Dentists often refer patients needing gum surgery to periodontists or oral surgeons who specialize in working with the tissue in and around the teeth. The surgery is normally conducted in the periodontist's office.
Gum surgery is typically done using local anesthetic to numb the mouth. Some dentists may also use other medication for relaxation or even sedation.
For gingivectomies, lasers or surgical tools are used to remove the extra gum tissue. There are three main ways of performing gum grafts to attach extra gum tissue. The surgeon may take tissue from the roof of the mouth (the palate) and attach it to the gum area. Sometimes, the surgeon cuts a small flap in the palate, and transplants some of the connective tissue that is beneath the top layer. And if there is enough tissue surrounding the tooth that needs repair, the surgeon may just cut a flap, called a "pedicle," the fold it over the exposed root and stitch it into place. On occasion, dentists may recommend using graft material from a tissue bank instead of the patient's own tissue.
There are risks involved with gum surgery. Bacteria are the biggest concern. Harmful bacteria can cause infection of the gum tissue, and sometimes the surgery can introduce bacteria into the bloodstream.
People with impaired immune systems, or with certain heart conditions need to be especially cautious with gum surgery. Commonly dentists will prescribe antibiotics following--and sometimes even before--surgery.
After the surgery
At the conclusion of the surgery, the surgeon may place a temporary "putty" or barrier around the surgical site. Patients will be given instructions for cleaning as they heal, as well as for antibiotics. People who use tobacco products are strongly urged to quit because the tobacco reduces the ability for the tissues to fight infection and heal properly. Once the healing is complete, patients are encouraged to practice careful dental hygiene of brushing, flossing, dental checkups, and so on.
To maximize healing, dentists often prescribe a rinse or topical dental gel. Dental gels with antioxidants that complement the natural antioxidants in saliva are an emerging technology gaining approval with dentists, periodontists, and oral surgeons.
Attractive gum tissue is an important part of a beautiful smile and of complete oral health.
Renee Schmidt is a blogger in the dental care industry who writes about topics like the oral-systemic link (link between oral health and overall health), periodontal diseases and new oral care products like antioxidant oral gel, mouthwash and oral care products for smokers.
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