My dentist recommended that I have a gingivectomy prior to having a crown placed. What exactly does that entail?
Gingivectomy—sometimes called “dental crown lengthening”—is a periodontal surgical procedure that removes excess gum (gingiva) tissue. It may be recommended for several reasons, among them to realign an uneven smile line (in which gum tissue extends farther over some teeth than others) or, if your smile is “gummy” (and this bothers you), to make it less so by exposing a larger portion of your teeth.
In some cases, a gingivectomy may be done as part of the preparation work for dental crowns or a bridge (either for cosmetic or restorative purposes). If you have very small teeth, for example, there might not be enough natural tooth surface on which to securely attach the crown. Cutting the gums back a bit “lengthens” the tooth, giving the dentist more surface area to work with. Or, if a tooth is decayed or broken below the gum line, a gingivectomy may be necessary for the dentist to gain access to the decay or fracture before restorative work can be done.
A gingivectomy may also be performed to treat severe gum disease (periodontitis), if less-invasive treatments such as antibiotics or root planing and scaling (deep cleaning above and below the gum line) haven’t helped enough. The procedure removes loose, diseased gum tissue to get rid of pockets between the teeth and gums that trap plaque.
In addition, gingivectomy is sometimes recommended for hyperplastic (overgrown) gums, which can occur from use of certain medications (including calcium channel blockers and some anti-seizure drugs) or from orthodontic treatment (braces) or poor home dental care. In this case, gum tissue is cut back and sculpted so the contour is more natural and less bulky looking.
The procedure is performed with local anesthesia, usually by a periodontist, using a scalpel or laser. Your gums will probably be sore afterward but should heal within a few days. If you have dental insurance, your plan might not cover gingivectomy, depending on the reason for the procedure. If it’s purely aesthetic, you’ll have to pay out of pocket. Check with your provider.
