A gingivectomy removes excess gum tissue from around a tooth or teeth and reshapes the gum line that remains. It is done for two quite different reasons: to treat gum disease that has not responded to cleaning, and to correct the appearance of a gum line that covers too much of the teeth.
Both are common. The procedure is the same. What differs is what we are trying to achieve, and that changes how much tissue comes away and where.
What A Gingivectomy Is
The word breaks down simply. Gingiva means gum tissue, and the suffix means removal.
In practice, a gingivectomy removes a portion of the gum surrounding the teeth and leaves a contour that is easier to clean and better proportioned to the teeth. It is a surgical procedure, a form of periodontal surgery called gum resection, done under local anesthetic, and it is usually finished in a single visit. Depending on the case it either improves gum health or improves appearance, and sometimes both.
You may also see it called gum contouring, gum reshaping, gum reduction surgery, or a gum lift. Those are marketing names for the same procedure. What they all describe is removing and reshaping gum tissue.
Gingivectomy Vs Gingivoplasty Vs Crown Lengthening
These three get confused constantly, including in a lot of published material, so it is worth being precise.
- Gingivectomy removes gum tissue. That is the whole procedure.
- Gingivoplasty reshapes gum tissue without necessarily removing much of it, smoothing an uneven or irregular gum line. The two are frequently done together in the same visit.
- Crown lengthening removes gum tissue and bone. If the bone sits too close to where the new gum line needs to be, removing gum alone will not hold, and the tissue will creep back.
That last distinction is the one that matters most, and it is the difference between a result that lasts and one that does not.
What A Gingivectomy Treats
Gum disease that has not resolved. Where deep pockets persist after cleaning and the pocket wall is thickened, we remove excess gum tissue and diseased gum tissue to eliminate the gum pockets. Tissue is cut away from around the teeth so the area becomes cleanable, and that is what actually stops the disease coming back and protects your oral health longer term. It is not the right procedure for every pocket, and we explain below when it is not.
Gingival overgrowth from medication. Some drugs cause the gums to enlarge, most commonly phenytoin, ciclosporin, and calcium channel blockers such as nifedipine. The tissue can overgrow enough to cover a significant part of the teeth.
Overgrowth during orthodontic treatment. Braces make thorough cleaning harder and some patients develop puffy, overgrown gum tissue while in treatment. It is often better to wait until the braces come off and see how much settles on its own.
A gum line that covers too much of the teeth. Where teeth look short because gum tissue sits low over them, reshaping the gum line exposes more of the tooth. If that is your reason for reading this, our gummy smile page covers the causes in more detail, because not every gummy smile is a gum tissue problem.
An uneven gum line. Gums that sit at noticeably different heights across the front teeth, often more visible than patients realize until it is pointed out.
Laser Or Scalpel?
Both are legitimate, and we use both.
A scalpel gingivectomy is precise and long established. The tissue edge it leaves is clean, and for larger areas it can be quicker. The tradeoff is bleeding during the procedure and, sometimes, sutures and a periodontal dressing afterwards.
Laser gingivectomy seals small blood vessels as it works, so there is very little bleeding, usually no stitches, and often less discomfort during healing. We use the same Nd:YAG platform we use for LANAP. It is particularly useful in the aesthetic zone where the tissue contour matters and in patients who bleed more readily.
The choice is clinical rather than promotional. Anyone telling you the laser is always better is selling the instrument rather than assessing the case.
When A Gingivectomy Is Not The Right Answer
This is the section most pages leave out, and it is the one that protects you.
A gingivectomy only works where there is enough attached gum tissue to spare. If the base of the pocket sits below the point where the firm gum meets the looser lining tissue, removing gum would leave too little behind, and a flap procedure is needed instead.
It also cannot address a problem in the bone. If the bone level is the reason the gum sits where it does, gum removal alone will not hold, and crown lengthening is the correct procedure. Getting this wrong is the single most common reason a cosmetic gum reshaping fails.
And where medication is causing the overgrowth, surgery alone treats the symptom. We would speak to your physician about whether the drug can be changed, because otherwise it will come back.
What Happens During The Procedure
The gingivectomy procedure follows the same sequence whether it is being done for a gum condition or for cosmetic reasons.
- Numbing. A local anesthetic is given, so you should not feel pain during the procedure. This is local anesthesia only, not sedation, unless you would prefer otherwise.
- Marking the new gum line. The intended contour is marked before anything is removed, so the result is planned rather than judged in the moment.
- Removing the tissue. The excess gum tissue is trimmed and removed with a scalpel or laser.
- Shaping. The remaining gums are contoured so the result looks natural rather than obviously cut.
- Protecting the site. A periodontal dressing is sometimes placed over the gums to shield the surgical site while it heals. With laser treatment this is often unnecessary.
A gingivectomy usually takes between 30 and 60 minutes, and you are able to go home straight afterwards. Between the teeth and gums the contour is checked carefully, since that is where food traps if the shape is wrong.
Recovery And Aftercare
Healing takes a week or two on the surface, with the tissue fully settling over several weeks.
- Discomfort is usually mild and controlled with over-the-counter pain relievers
- Stick to soft foods and cool liquids for the first few days
- Keep up your oral hygiene, brushing gently and avoiding the treated area directly at first
- A prescribed mouthwash may be recommended for a short period
- Some swelling and minor bleeding in the first day or two is normal
- We will see you for a follow-up appointment to check the healing process
Most patients return to work the next day.
Do Gums Grow Back After A Gingivectomy?
This deserves a straight answer, because the usual one is misleading.
Gum tissue removed in a healthy mouth does not regrow to where it was. Once the tissue has healed, that is the gum line you have.
But the tissue can return in three situations, and they are all predictable:
- The bone was the real problem. If the gum sits low because of where the bone is, tissue will migrate back toward its original position within months. This is the case that needed crown lengthening.
- The medication is still being taken. Drug-induced overgrowth recurs while the drug continues.
- Gum disease is still active. Inflammation causes tissue to swell and enlarge again. If the underlying disease is not controlled, the pocket comes back.
So when a gingivectomy fails, it is usually because the wrong procedure was chosen, not because gums simply regrow. Correctly indicated, the result lasts indefinitely.
What Affects The Cost
Cost varies according to how much work is involved. What drives it:
- How many teeth are being treated, one area or across the arch
- Whether it is a single procedure or part of wider periodontal treatment
- Whether crown lengthening is needed instead of, or as well as, gum removal
- Scalpel or laser
- Whether follow-up periodontal treatment is required
Insurance is worth checking carefully here. Gingivectomy performed to treat periodontal disease is often a covered benefit. The same procedure done purely for appearance usually is not, even though the work is identical. We will check your plan and tell you which category your case falls into before you commit.
We’ll give you an exact cost as part of your treatment plan at your consultation.
Frequently Asked Questions
How painful is a gingivectomy? You should not feel pain during it, since the area is fully numbed. Afterwards, most patients describe soreness rather than pain for a few days, managed with over-the-counter pain relief. Laser treatment tends to be more comfortable during healing than scalpel.
How long does a gingivectomy last? Indefinitely, when the right procedure was chosen for the right problem. Recurrence usually points to bone that needed addressing, ongoing medication, or uncontrolled gum disease.
Does a gingivectomy require stitches? Often not. Laser treatment usually needs none. A scalpel gingivectomy sometimes needs sutures or a dressing depending on the area treated.
How much does a gingivectomy cost? It depends on how many teeth are involved and whether it is being done for health or appearance, which also affects insurance coverage. We will give you a firm figure at your consultation.
Do I need a gingivectomy with braces? Sometimes, but it is usually better to wait. Gum tissue that has become puffy during orthodontic treatment often improves once the braces are removed and cleaning gets easier. We would reassess a few months after they come off.
Is a gum lift the same as a gingivectomy? Yes. Gum lift, gum contouring and gum reshaping are all names for the same procedure.
What are the risks? Bleeding, infection and sensitivity at the treated area are the main ones, and all are uncommon. The more meaningful risk is a poor result from removing tissue where crown lengthening was needed, which is a planning error rather than a surgical one.
Who should perform a gingivectomy? It can be performed by a general dentist, and any dental professional trained in it may offer it, but it is done by a periodontist as a matter of routine. The judgment about whether gum removal alone is enough is the part that benefits most from specialist training.
Schedule A Consultation
If you have been told you need a gingivectomy, or your gums cover more of your teeth than you would like, come in and we will look at what is actually going on. We will tell you whether gum removal alone will hold, whether bone is involved, and what result is realistic.
Call our office at (347) 493-2439 or schedule your consultation online.
