Why Do I Need a Gingivectomy
Many people spend many years thinking that they have small teeth, and with that, they are often even ashamed to smile wide open. It is very often that people get emotional and cry as soon as they look in the mirror at the result. Many intend to make Dental Contact Lenses, or veneers, to make their teeth bigger, and end up giving up after discovering that their teeth are beautiful, they were just hidden. The procedure that can show you these beautiful teeth is called a gingivectomy.
Gingivectomy is a much sought after treatment for people who have a gummy smile. That smile that shows too much gum. It is also sought after by people who have one or more teeth that are disproportionately sized in relation to the others. It consists of removing excess gum, which partially covers the tooth. That way the teeth get bigger, and the smile becomes symmetrical and harmonic.
Is Gingivectomy indicated for all cases of Gummy Smile?
No. Like everything else in life, each case must be evaluated individually, in order to make an adequate treatment plan. The first thing that must be evaluated by the Dental Surgeon specialized in Periodontics is the size of the teeth in question. If the teeth of the person with the gummy smile are already showing and are really small, or if there is part of the tooth that is hidden by the gum. This can be evaluated clinically in the office.
If part of the teeth are hidden by the gum, treatment is indicated. Now, if in the evaluation the Periodontist verifies that in fact the person's teeth are really small, he can even do it, but in this case he will have an exposure of the root of the teeth, and later the Dental Contact Lenses must be installed.
All this must be planned and agreed with the patient before treatment.
Another very important question that must be evaluated is whether the excess is only gingival, or if the bone part, which is below the gum, is also enlarged. Most of the time there is also this change. In this case, the indicated treatment is not simply to perform a Gingivectomy, which is to remove the excess gum, but to perform the Clinical Crown Augmentation, which consists of removing both the gingival excess and the bone excess. In most cases, in addition to removing vertical excesses, the Periodontist Dental Surgeon also removes excessive bone and gingival volume.
Due to the large number of terms, to avoid confusion people usually call all these gum surgeries generically Gingivectomy.
Understand, in a healthy patient, without gum disease (gingivitis / periodontitis), the gum is usually positioned 4 mm above the bone. In this way, if the gum is out of position, it is because it is following the bone, which is also out of position. Performing gingivectomy exclusively is indicated only in cases where the person has had gingival inflammation (gingivitis or periodontitis), and with that the gum has increased in size.
In these cases, it is initially necessary to treat the disease, with cleaning and scraping, hygiene orientation, so that the person can keep their mouth healthy with the daily use of dental floss, and have adequate brushing. When the gum becomes healthy, the remaining gingival excess must be cut, both vertically and horizontally, that is, performing a Gingivectomy and Gingivoplasty. This is very common in people who use fixed braces.
As they have difficulty cleaning with the device, the gum becomes inflamed and increases in volume. Even after Periodontal Treatment, the gum may remain with this excessive volume, in these cases a Gingivectomy must be performed.
If the person has healthy gums, and has always had this excess gum, this was probably due to a change in the timing of tooth eruption, and in these cases, the appropriate treatment is Clinical Crown Lengthening.