Novoliv

Gingivectomy

Gingivectomy: Procedure, 3 Types, Cost, and Care

Table of Contents

Imagine that your gums are like a garden. If the garden is overgrown with weeds, it’s difficult to reach the plants and care for them properly. Right. Gingivectomy is a surgical procedure to remove inflamed gum tissue. Gum disease, or gingivitis, is a common problem in the United States and affects an estimated 47.2% of adults over the age of 30. Your gums are most likely to get an infection whenever your oral hygiene is not up to par or some injury to the tooth happens.

In such severe cases, gum tissue removal becomes necessary, or else the person might have to lose his teeth and bear the pain that accompanies this problem. The problem has a tendency to develop into tongue cancer and a large number of other issues. This is why doing this gum surgery becomes vital for maintaining overall oral health.

Healthy gums actively strengthen your teeth’s foundation, preventing tooth loss and related health issues.

Let’s dive deep into it

The procedure of gingivectomy

Gingivectomy
Treatment

Following is the step-by-step list of procedures one has to go through when having a gingivectomy.

1. Initial Assessment:

Before the gingivectomy, your dentist will conduct a thorough examination of your oral health. This will include the evaluation of

  • The extent of gum disease
  • The amount of excess gum tissue
  • Overall condition of your teeth and gums.

2. Anesthesia:

To ensure your comfort during the procedure, the dentist will administer a local anesthetic to numb the area where the gingivectomy will be performed. Articaine and Lidocaine are commonly used local anesthetics for gum surgery.

In some cases, sedation may be used to help you relax and reduce anxiety during the procedure. Sedation can be administered by mouth, intravenously, or through a breathing mask.

3. Marking:

The marking of gums for gingivectomy is a process of identifying and outlining the areas of gum tissue that need to be removed during the procedure. This is done by the dentist or periodontist using a periodontal probe and a marking pen.

Firstly, the dentist will use the periodontal probe to measure the depth of the pockets around the teeth. Gum pockets are the spaces between the teeth and the gums. When gum disease is present, the pockets can become deep and inflamed.

Secondly, the dentist will use the marking pen to outline the areas of gum tissue that need to be removed.

Marking helps

  • The dentist to accurately identify the areas of gum tissue that need to be removed. This increases the precision of the process.
  • To reduce the risk of bleeding and other complications. Correct marking can avoid damaging any healthy tissue.
  • To create a more even and symmetrical gum line which improves the appearance of the smile.

4. Gum Tissue Removal

Your dentist will carefully cut away the marked gum tissue using a scalpel, laser, or electric current. The choice of tool depends on the specific case and the dentist’s preference. Lasers are often used because they minimize bleeding and offer a faster recovery. Electrosurgery can be a good option for sensitive gums.

5. Smoothing and Shaping

The dentist will shape and contour the remaining gum tissue after the removal of excess tissue. This ensures an aesthetically pleasing appearance for your teeth. It may involve reshaping your gumline to improve the symmetry of your smile.

6. Bone Reshaping:

It may be necessary sometimes to remove diseased or damaged bone tissue (due to gingivitis). Bone reshaping can create a favorable bone structure for the gums to heal. It is typically performed in conjunction with a gingivectomy, but it can also be done as a standalone procedure

7. Final Inspection:

Once the procedure is complete, the dentist will thoroughly inspect the area to ensure that the gum tissue has been appropriately contoured and that there are no issues, such as excessive bleeding.

8. Post-Operative Care:

After the gingivectomy, you’ll be given instructions for post-operative care. This may include guidelines for oral hygiene, dietary restrictions, and medication if necessary. It’s essential to follow these instructions to ensure proper healing and recovery.

9. Follow-Up:

You will have follow-up appointments with your dentist to monitor the healing process and address any concerns or complications that may arise. Follow-ups are typically scheduled for one or two weeks after surgery. Additional follow-ups may be necessary, depending on the individual patient’s needs.

Who should have a gingivectomy?

Gum Pain
Gingivectomy
  • Individuals with Severe Gum Disease (Periodontitis)
  • Those Seeking Cosmetic Enhancement for a “Gummy Smile”
  • People with Functional Concerns (like speech and hygiene issues)
  • Cases Requiring Medical Necessity (e.g., tumor or cyst removal)
  • Individuals with Gingival Overgrowth Conditions (e.g., hereditary gingival fibromatosis)
  • Patients with Localized Gum Problems
  • Those with Overlapping Gums (gingival clefts)
  • Individuals with drug-induced gum overgrowth, e.g., antiseizure drugs and immunosuppressants

Types of Gingivectomy Procedures

Following are the gum tissue removal procedures that are commonly used.

1. Traditional gingivectomy:

This is the most common type of gingivectomy procedure. The procedure involves using a scalpel to remove excess gum tissue. In some cases, the dentist may also need to remove a small amount of underlying bone. After the procedure, suturing is done to close the incisions.

Benefits

  • Is the most widely available and least expensive type of gingivectomy procedure.
  • It does not require any specialized equipment, as in laser or electrosurgery treatment.

Complications

  • Can cause bleeding, especially during the first few days after the procedure.
  • Can increase the risk of infection.
  • The scalpel used in traditional gingivectomy can damage the nerves in the gums
  • Can cause scarring of the gum tissue.
  • Patients may experience sensitivity to hot and cold foods and drinks.
  • Sometimes this can lead to gum recession (gums pulling away from the teeth).

2. Laser gingivectomy:

This type of gingivectomy procedure uses a laser to remove excess gum tissue. Laser gingivectomy is a relatively quick and easy procedure. It takes 30–50 minutes to complete, but treating multiple teeth can take longer.

The dentist will use a dental laser (commonly a diode laser or an erbium laser) to precisely remove or reshape the gum tissue. The laser energy is highly focused and controlled, allowing for minimal damage to surrounding tissues.

Benefits

  • Most patients experience little or no discomfort during the procedure.
  • With a shorter healing time, most patients can expect to fully recover within a few weeks.
  • Less bleeding
  • Reduced risk of infection
  • Improved precision and accuracy
  • Reduced need for sutures

Complications

There are very few to no complications with this procedure. It might have some mild symptoms (like the ones that are experienced in every type of gingivectomy), but overall, it is the safest procedure. However

  • Soreness and swelling of the gums for a few days after the procedure
  • Minor burns which heal quickly

3. Electrosurgery gingivectomy:

This type of gingivectomy procedure uses an electric current to remove excess gum tissue. An electrosurgery gingivectomy is performed using a device called an electrosurgery unit. The electrosurgery unit generates an electric current that is passed through a small electrode that is placed on the gum tissue. The electric current causes the gum tissue to heat up and coagulate, which is then removed easily.

Benefits

Electrosurgery gingivectomy is less common but has the following benefits:

  • It is less painful and has a shorter healing time than a traditional gingivectomy.
  • This is a good option for patients with sensitive gums or who have bleeding problems.
  • It is a relatively quick and easy procedure.
  • It can be performed in a single appointment.

Complications

The surgery can also lead to the following complications if not done properly:

  • The electric current used can cause burns to the gums or surrounding tissues.
  • Electrosurgery can increase the risk of infection.
  • The electric current can damage the nerves in the gums, leading to numbness or tingling.
  • This procedure can also cause scarring of the gum tissue.

Post-Operative Care for Gingivectomy

Gingivectomy

Post-operative care after a gingivectomy is crucial for ensuring a smooth and successful recovery. Here’s what’s typically included in post-operative care for this dental procedure

  • Oral Hygiene: Follow gentle brushing and flossing guidelines if you have any concerns or experience unexpected complications.
  • Rinsing: Use the prescribed mouthwash or saltwater rinse.
  • Pain Management: Take pain medication as directed.
  • Dietary Restrictions: Avoid hot, spicy, and crunchy foods; opt for soft, cool, and bland options.
  • Ice packs: Apply as recommended to reduce swelling.
  • Rest: Allow for adequate rest; avoid strenuous activities.
  • No Smoking: Refrain from smoking during recovery.
  • Follow-up visits: Attend scheduled post-operative appointments.
  • Sensitivity Care: Use desensitizing products as needed.
  • Protection: Be cautious while eating to protect the surgical area.
  • Oral Hygiene Continuation: Maintain oral hygiene gently.
  • Hydration: Stay well-hydrated to support healing.

It’s essential to follow these post-operative care instructions carefully to minimize the risk of complications, such as infection or delayed healing. If you have any concerns or experience unexpected side effects during your recovery, don’t hesitate to contact your dental provider for guidance and evaluation.

Cost of Gingivectomy procedures

The cost of each procedure significantly varies from dentist to dentist. It can also vary according to your insurance plans. However, a rough estimation is provided below.

Types of gingivectomy Average cost without insurance Average cost with insurance
Traditional gingivectomy$200-$400 per tooth$0-$200 per tooth
Laser gingivectomy$300-$500 per tooth$50-$250 per tooth
Electrosurgery gingivectomy$250-$450 per tooth$0-$225 per tooth

If you are unable to afford to pay for a gingivectomy procedure out of pocket, there are a number of financial assistance options available. You can talk to your dentist about financial assistance programs or you can apply for a loan from a dental financing company.

Cautions for Gingivectomy Procedures

  • Consultation: Discuss the procedure and expectations with your clinic.
  • Qualified Practitioner: Choose an experienced dentist or periodontist for the procedure.
  • Health Assessment: Ensure your overall health is stable and inform your provider of any medical conditions or medications.
  • Local Anesthesia: Discuss anesthesia options with your dentist to manage discomfort.
  • Infection Control: Verify strict sterilization practices to prevent infection.
  • Post-Operative Care: Follow the provided instructions for oral hygiene, diet, and medication.
  • Avoid Smoking: Refrain from smoking before and after the procedure to support healing.
  • Maintain Good Oral Hygiene: Prioritize oral hygiene for infection prevention and healing.
  • Dietary Restrictions: Adhere to dietary recommendations, avoiding certain foods after the procedure.
  • Regular Follow-Up Appointments: Attend scheduled check-ups to monitor healing and address concerns.
  • Understanding Risks: Be aware of potential complications and side effects and discuss them with your provider.
  • Consent: Fully understand the procedure and provide informed consent.
  • Medical Conditions: Communicate underlying health conditions and medications to ensure safety.
  • Sensitivity: Expect post-operative sensitivity, especially if tooth roots are exposed.
  • Patience: Recognize that healing takes time, and results may not be immediate.

Recovering from a gingivectomy procedure

Gingivectomy

The recovery phase of a gingivectomy can vary from person to person depending on the extent of the procedure, the individual’s overall health, and their adherence to post-operative care instructions. Here’s a general overview of what to expect during the recovery phase:

Immediate Post-Operative Period (24–48 Hours)

  • The first 24-48 hours are typically the most uncomfortable. You might experience some pain, swelling, and mild bleeding. You should rest and avoid strenuous activities during this time. Follow dietary restrictions, consuming soft, cool, and bland foods to prevent irritation to the surgical site. Apply ice packs as recommended to reduce swelling. Take prescribed or over-the-counter pain medication as directed by your dentist to manage discomfort.
  • Avoid smoking during this period; it can significantly slow down healing.

Days 2-7:

  • Swelling and discomfort typically begin to subside during this time.Continue to follow the prescribed oral hygiene instructions for cleaning the surgical area gently.Attend follow-up appointments with your dentist for monitoring and the removal of any sutures, if any.
  • You may still have some sensitivity and should continue to avoid hard or crunchy foods.

Days 7-14

  • By the end of the second week, most individuals experience significant improvement in pain, swelling, and bleeding.
  • You can gradually reintroduce a more normal diet, but continue to avoid very hard or crunchy foods. Continue following good oral hygiene practices and maintain regular follow-up appointments.

Weeks 2-4

  • By this time, most of the healing is complete, and you should be able to resume your normal diet and oral hygiene routine.
  • You may experience some residual sensitivity, but this should continue to improve.

Long-Term Recovery:

  • The full recovery period can extend beyond a month, depending on individual factors. Your dentist will monitor your progress and address any concerns or complications that may arise.
  • Follow up with your dentist for regular dental check-ups to maintain good oral health.

Diet after a gingivectomy

After a gingivectomy, it’s important to follow dietary guidelines that are gentle on the surgical site to promote healing and minimize irritation. Here are some of the best foods to have in the days immediately following a gingivectomy:

1. Soft Foods: Opt for soft and easy-to-chew foods to minimize discomfort and irritation to the surgical site. Examples include

  • Applesauce
  • Mashed potatoes
  • Yogurt
  • Cottage cheese
  • Smoothies (without seeds or chunks)

2. Cool and Bland Options: Foods that are cool and bland can be soothing and less likely to irritate the surgical area. Some choices include:

  • Plain oatmeal
  • Pudding
  • Jell-O
  • Rice or pasta (cooked until very soft)
  • Scrambled eggs

3. Soups: Soups, especially clear or pureed varieties, can be a good option as long as they are not too hot. Avoid chunky or spicy soups that may cause irritation.

4. Blended or Pureed Foods: Foods that are blended or pureed to a smooth consistency can be easier to consume without chewing. Examples include smooth vegetable soups and fruit purees.

5. Protein Shakes: Nutrient-rich protein shakes or meal replacement shakes can provide essential nutrients without the need for chewing.

6. Hydrating Foods: Consuming foods with high water content can help with hydration and can be less likely to cause irritation. Examples include watermelon, cucumber, and gelatin.

7. Nutrient-Dense Snacks: Nutrient-dense snacks that are soft and gentle on the gums include banana slices, avocados, passion fruit, and ripe melons.

8. Dairy Products: Dairy foods such as milk, yogurt, and soft cheese are good options as they are nutritious and can be soothing.

9. Avoid Crunchy, Spicy, and Hot Foods: During the initial recovery phase, it’s best to steer clear of foods that are hard, crunchy, hot, or spicy, as they may irritate the surgical area.

FAQS

Q: What are the alternatives to a gingivectomy?

The alternatives to a gingivectomy include:

  • Scaling and root planing: This is a non-surgical procedure that removes plaque and tartar from the teeth and below the gumline.
  • Gingivoplasty: is a surgical procedure that reshapes the gums. Read the full article on the differences and similarities between the two procedures here.
  • Osseous surgery: This is a surgical procedure that removes bone to reduce the depth of periodontal pockets.

Q: How can I prevent the need for a gingivectomy?

The best way to prevent the need for a gingivectomy is to practice good oral hygiene. This includes brushing your teeth twice a day for two minutes each time, flossing once a day, and seeing your dentist for regular checkups and cleanings.

Q: What are the long-term effects of a gingivectomy?

The long-term effects of a gingivectomy are generally positive. A gingivectomy can help to improve your oral health and create a more esthetic smile. However, it is important to continue to practice good oral hygiene to prevent the recurrence of gum disease.

References

  • Newman MG, Takei HH, Carranza FA, Klokkevold PR. Carranza’s Clinical Periodontology. 12th ed. Philadelphia, PA: Elsevier Saunders; 2019.
  • Eke PI, Dye BA, Wei L, Thornton-Evans GO, Genco RJ, et al. CDC Periodontal Disease Surveillance workgroup: James Beck (University of North Carolina Chapel Hill, USA). Prevalence of periodontitis in adults in the United States 2009 and 2010. J Dent Res. 2012;91:914–20.
  • Albandar JM, Streckfus CF, Adesanya MR, Winn DM. Cigar, pipe, and cigarette smoking as risk factors for periodontal disease and tooth loss. J Periodontol. 2000;71:1874–81. 
  • Tezal M, Sullivan MA, Reid ME, Marshall JR, Hyland A, Loree T, et al. Chronic periodontitis and the risk of tongue cancer. Arch Otolaryngol Head Neck Surg. 2007;133:450–4.
  • American Dental Association (ADA), “How Much Does Gingivectomy Cost?”, https://ebusiness.ada.org/Assets/docs/85994.pdf
  • Grossi SG, Zambon JJ, Ho AW, Koch G, Dunford RG, Machtei EE, et al. Assessment of risk for periodontal disease. I. Risk indicators for attachment loss. J Periodontol. 1994;65:260–7.
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5426403/
  • https://my.clevelandclinic.org/health/treatments/24749-gingivectomy
  • https://my.clevelandclinic.org/health/diseases/21482-gum-periodontal-disease
Share with people you care about
Facebook
LinkedIn
X
WhatsApp
Telegram
Email
Print