Gummy Smile Correction: Understanding Your Options
Crown Lengthening | Gingivectomy
Improve Your Smile with Crown Lengthening in San Diego
We all know the characteristics of a traditionally beautiful smile: straight, white, symmetrical teeth. To achieve that winning grin, though, you need to have a strong foundation underneath your teeth, deep in your gums and bones. If you’ve got hidden decay, overgrown gingival tissue, or damage beneath the gumline, you might need a little extra help to restore the health, function, and beauty of your teeth. Fortunately, San Diego Periodontics & Implant Dentistry can fix the foundation of your smile with a crown lengthening procedure.
What is crown lengthening?
Crown lengthening is a periodontal procedure that involves surgically recontouring your gum tissue and supporting bones to improve both the appearance and the condition of your smile. This can either be done on its own, or in conjunction with additional restorative treatment.
Crown lengthening is a dental procedure that works to reveal more of the crown of the tooth. The crown is the part of the tooth that pokes out of the top of the gums, the pearly whites that make up the smile. The periodontist works to expose more of the crown by moving the gums closer to the root of the tooth. While this procedure can be used for aesthetic purposes to make for a more pleasing smile, there is sometimes a functional need for this procedure as well. .
There are two types of crown lengthening procedures available: Esthetic and Functional.
1. Esthetic Crown Lengthening for Irregular Gum Levels & Gummy Smiles
A “gummy” smile occurs when the gums are located too far down on the teeth, making the teeth look shorter and disproportionate to the size of your face. By moving the gums up to a more natural level, the periodontist reveals your gorgeous natural teeth and smile for all to see.
Often performed on its own, esthetic crown lengthening and/or gingivectomy procedure repositions the gum line, removing excess gum tissue and revealing the natural enamel of the tooth hidden behind it. This is an effective way of improving “gummy smiles” and making “short teeth” appear longer. It also has the added health benefit of preventing pockets from forming in your gums, which can stave off future periodontal disease. This can also give your teeth a more symmetrical appearance.
2. Functional Crowning Lengthening is Used to Access Decay
Functional crown lengthening is necessary when a dentist identifies decay in the tooth they cannot easily access. This decay is usually hidden deep beneath the gums, and no matter what methods they use, they cannot properly access the decay without performing a crown lengthening procedure. This will not be a permanent change, as the periodontist will put the gums back to a lower level when the decay is removed. This procedure will also create more tooth structure for the new crown to “grab” onto, allowing the dentist to make a crown with better retention.
In some cases of tooth fracture, crown lengthening can also be performed to save a partially fractured tooth from extraction, as the gum line is brought down to reveal more tooth structure for a dentist to be able to make a crown.
Functional crown lengthening exposes a greater surface area of your underlying tooth, allowing adequate space for a restoration to be properly placed.
What is involved in a crown lengthening procedure?
Whether you require an esthetic or a functional crown lengthening procedure, you’ll need to prepare with a dental evaluation and X-rays. On the day of your procedure, Dr. Kwok will numb the affected area with a local anesthetic before reflecting the gums back to expose the underlying support structure of your teeth. Dr. Kwok will then trim away any excess gum tissue, and if necessary, smooth and level the bone. When the desired result is achieved, your gums are washed out and stitched back together, and healing can begin.
The entire procedure takes about an hour, although the exact time may vary depending on the number of teeth being treated and the depth of the treatment area.
How long will it take me to heal from a crown lengthening procedure?
Initial healing times can vary from one to four days, depending on the extent of the procedure. Complete healing from functional crown lengthening can differ from person to person, varying from four weeks to eight months, at which point the dental restoration can be completed. For esthetic crown lengthening, it may take up to six months before any permanent crowns or veneers may be permanently cemented.
During your initial recuperation period, it’s important to take proper care of yourself to encourage a fast and thorough recovery. This includes:
- Taking any medication as prescribed
- Applying an ice pack to prevent swelling
- Avoiding alcohol and smoking
- Not brushing at the site
- Eating on the opposite side
Dr. Kwok will have specific guidelines for your recovery. Once healing is complete, you’ll have a healthy, stunning smile.
Gingivectomy for Gum Disease
Gums play an important role in our oral health. Healthy gums are firm and pink, creating a tight seal around the bones of your teeth to keep bacteria out. Gums also help hold your teeth in place so you can do the important work of nourishing your body and sharing your smile with the world. Gingival enlargement, or abnormal overgrowth of gum tissue, usually indicates gum disease. Proper oral hygiene can help reduce the risk of developing gingival enlargement, but occasionally, a surgical treatment known as a gingivectomy is the best way to restore your gums to a healthy state.
What causes gingival enlargement?
The causes of gingival enlargement can vary. The main culprits include:
- Bacteria-induced inflammation caused by poor oral hygiene
- Certain medications, such as anticonvulsants and immunosuppressants
- Hereditary gingival fibromatosis
- Physiologic and systemic conditions such as hormonal imbalances, vitamin deficiencies, or leukemia
Improved oral hygiene, discontinuation of medication, and management of the underlying systemic condition can usually help to reverse gingival enlargement and restore the gums to a healthy state. But when these methods of treatment prove ineffective, a gingivectomy may be required.
What is a gingivectomy and how is it performed?
A gingivectomy is an in-office procedure involving the removal of excessive, overgrown, or diseased gum tissue from in and around the teeth. Before the procedure begins, you’ll be given a local anesthetic to numb your gums and keep you comfortable while Dr. Kwok uses a surgical scalpel or a low-frequency laser to remove the gum tissue. When the excision is complete, your remaining gums will be gently reshaped and reattached to the tooth line with sutures. Dr. Kwok will send you home with a surgical dressing or temporary putty in and around your teeth and gums to promote healing and protect your stitches.
In many cases, a gingivectomy is one step in a more complex procedure, such as an open flap debridement, where the gingivectomy provides the periodontist with increased access to root and tooth surfaces for the purpose of scaling and root planing.
What happens after a gingivectomy?
Recovery from a gingivectomy is generally quite simple, though soreness and irritation are common. While it may take a few days, or possibly weeks, for your gums to feel and look normal again, you should be able to manage any discomfort through over-the-counter pain relievers such as ibuprofen or acetaminophen. You may have specific post-operative instructions, such as avoiding certain foods or following a special oral hygiene routine. It’s important to follow these instructions to ensure a full recovery.
Once healing is complete, you should have healthy, pink gums that are easier to keep clean with regular brushing and flossing. With proper aftercare, a gingivectomy can often provide a permanent resolution to ongoing periodontal disease, and give you a beautiful, balanced smile. Regular checkups with Dr. Kwok can help to ensure your gingivectomy has the desired effect, and routine dental cleanings can prevent gum disease from returning.
What are the benefits of a gingivectomy?
For patients suffering from gum disease, the gingivectomy procedure not only removes diseased tissue, but it also reduces the likelihood of serious oral infections in the future by reducing gum pocket depth where bacteria can get trapped. The procedure also helps save teeth and bone, and contributes to an overall healthier mouth by improving your ability to maintain good oral hygiene. Reshaped gums also appear pinker, firmer, and healthier, giving your smile an extra boost.
What are some signs indicating you might need a gingivectomy?
Before consulting a specialist, there are some signs that might indicate you need a gingivectomy. Red, tender, swollen, or bleeding gums could mean you’re brushing too hard, or it could be a sign of gum disease that, if left untreated, may require a gingivectomy. When gums pull away from the teeth, it is often a symptom of periodontitis. The pockets created between the gums and teeth can cause an array of oral problems unless the loose gum tissue is removed with a gingivectomy. In cases of hereditary gingival fibromatosis, chronic infections at the gum line or difficulty eating and chewing may indicate the need for a gingivectomy. A periodontist can help determine whether a gingivectomy is the right course of treatment for you.
Protect Your Smile and Promote Healthy Gums with a Gingivectomy or Crown Lengthening Procedure
If you’re concerned about the state of your gums and teeth, call San Diego Periodontics & Implant Dentistry today at (619) 543-0905 to schedule an appointment with Dr. Kwok. He’ll evaluate your gums and create a plan to optimize your oral health and restore your beautiful smile.
