Gingivectomy

A gingivectomy is a periodontal surgery performed to treat severe cases of gum disease, also known as periodontitis, that do not respond to antibiotics or root planing alone. This procedure is necessary when the gums have pulled away from the teeth, creating deep pockets. Plaque and tartar often form in these pockets, causing gum disease. If the disease is left untreated, it progresses to the point that it damages the roots of the teeth and potentially leads to tooth loss. The gingivectomy procedure is designed to remove loose or diseased gum tissue in order to prevent tooth loss and is performed by either a periodontist or an oral surgeon.

The Gingivectomy Procedure

In preparation for a gingivectomy, a local anesthetic is applied to the gums. Usually a laser is then used to remove loose or diseased gum tissue, although a scalpel may also be used for this purpose. This process may take up to an hour. Once the gum tissue has been removed, a periodontal dressing, something like a protective putty, is placed over the gums to protect them as they heal.

Risks of a Gingivectomy

The greatest risk of a gingivectomy is getting an infection either in the gums themselves or systemically. This is because the surgical procedure may allow harmful bacteria to gain access through the gums into the bloodstream. For patients who have conditions that put them at increased risk of infection, the doctor may prescribe antibiotics to be taken both before and after surgery. This group includes patients who have:

  • Heart conditions.
  • Damaged immune systems
  • Certain heart problems
  • Undergone recent surgeries

Patients with heart problems may be at increased risk of developing a heart infection known as endocarditis and individuals who have had recent surgeries involving joint replacement may be more vulnerable to other infections.

Recovery from a Gingivectomy

For a few days after treatment, patients may experience temporary discomfort, which can be alleviated with over-the-counter analgesics at a dosage prescribed by the dentist, and by the use of ice packs. Following a gingivectomy, it is important that patients follow postsurgical guidelines, including:

  • Eating bland soft foods
  • Chewing on the other side of the mouth
  • Avoiding hot or iced beverages
  • Not using straws
  • Avoiding smoking and alcohol
  • Avoiding looking at or handling the affected area

Although complete recovery from the gingivectomy procedure may take as much as a few weeks to a few months, patients are not usually troubled by discomfort for long and can generally resume their activities soon after the anesthetic wears off. The contour of the gums may change somewhat as a result of the surgery, so patients should be prepared for small changes in appearance.

As always, oral hygiene is important in maintaining dental and gum health. Fortunately, keeping the teeth and gums clean after the procedure should be easier than it was before. In most cases, a gingivectomy stops gum disease before any teeth are affected and, after treatment, the gums return to their normal healthy state.

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