Gingivectomy refers to the surgical removal of gum tissue (gingiva). Gingivoplasty is the surgical reshaping of gum tissue around teeth with healthy gums. Both procedures typically are performed by periodontists, dentists who specialize in treating gums and the other supporting structures of your teeth.

Gingivectomy originally was developed to treat periodontal disease. Today, gingivectomy is more commonly used as a cosmetic technique. Gum tissue may need to be removed for two reasons:

• Gaps (pockets) have formed between the teeth and gums, trapping food particles, harboring colonies of bacteria, and making it difficult to keep the area clean. If the pockets involve only soft tissue, they can be removed by performing a gingivectomy (trimming the gums).
• There is too much gum tissue around your teeth. In addition to being a cosmetic concern, this can make it difficult to keep your teeth and gums clean. In severe situations, this condition can interfere with chewing and speech. An overgrowth of gum tissue can be caused by certain drugs, such as anti-seizure medications, or there may be no apparent cause.

Reshaping the gums through gingivoplasty can help gums look more natural. This procedure can be used to correct malformed or asymmetrical gums caused by genetics, disease or trauma, and might be done solely for cosmetic purposes. Gingivoplasty often is done alone, but can be done during or after a gingivectomy or a gum graft (which adds tissue to the gum line).

Treatment Gingivectomies and gingivoplasties usually are done with scalpels, but also are done with electrosurgery units, lasers and/or diamond dental burs. Your periodontist also might use specialized instruments that were designed for gingivectomies, with angled blades to help them get around teeth.

Before either procedure, you will receive a local anesthetic by injection to numb your gums. A gingivectomy can take from a few minutes to more than an hour, depending on how much tissue is being removed. Gingivoplasties typically are done in a couple of minutes.

• You have bleeding that doesn't stop.
• You have excessive pain that cannot be controlled by medication prescribed by your dentist. People have different thresholds of pain, but gingivectomy is not considered to cause a lot of pain.
• You think the area might be infected.
• You have excessive swelling or discharge from the surgical area.
• The periodontal dressing becomes loose or is displaced.
• Lymph nodes beneath your lower jaw or in your neck become swollen.

Gingivectomies and gingivoplasties usually are done with scalpels, but also are done with electrosurgery units, lasers and/or diamond dental burs. Your periodontist also might use specialized instruments that were designed for gingivectomies, with angled blades to help them get around teeth.

Before either procedure, you will receive a local anesthetic by injection to numb your gums. A gingivectomy can take from a few minutes to more than an hour, depending on how much tissue is being removed. Gingivoplasties typically are done in a couple of minutes.

After a gingivectomy or gingivoplasty, a type of bandage called a periodontal dressing will be placed on your gums. This usually is left in place for a week to 10 days, during which you will need to follow a somewhat soft diet and avoid spicy and crunchy foods. Your dentist might give you prescriptions for pain medication and a chlorhexidine mouthwash.

It is very important to keep your mouth clean during the healing period. You will be advised not to brush your teeth in the surgical area while the pack is in place. You will be able to brush and floss the rest of your mouth normally. When the pack comes off, you can brush and floss your teeth normally, but gently. It is not uncommon for the healing tissues to bleed when you floss or brush immediately after the dressing is removed.

After 7 to 10 days, you will return to your periodontist to have the pack removed. Your gums will begin to look normal in three to four weeks, but it can take two to three months for the tissue to heal completely.

There are no major risks to either procedure. Infection is very rare. Bleeding is a possibility, but also is rare. The affected area might ooze blood for the first 24 to 48 hours, but after that, it should not bleed much, if at all.