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I’ve heard a lot about cosmetic dentistry, and how porcelain veneers and crowns can make smiles more beautiful, but when I went in for a smile makeover, my cosmetic dentist said I would need cosmetic gum surgery for my makeover to be really great. Can you tell me more about what it is and why I might need it?

Carol, Florida

Hi Carol,

This is a great question because it doesn’t get asked that often. Cosmetic gum surgery is often needed to restore the beauty and balance of the gums after treatment for advanced periodontal disease. And sometimes it is undertaken as part of the smile makeover process even when there is no gum disease present.

Sometimes periodontal disease will respond to non-invasive treatments, but when it is very far advanced, it may require gum surgery. As you can see in the illustration to the left, when plaque and tartar build up under the gums, they break down the tooth’s supporting structures, affecting both the soft tissues and the bone. This in itself can cause recessed gums, exposed tooth roots, and characteristic black triangles between the teeth. Gum surgery may be required, first of all, to completely remove plaque, bacteria, and damaged tissues. And even though this leaves healthy teeth and gums, sometimes the results are not very aesthetic. In these cases, cosmetic gum surgery can cover exposed roots, fill in gaps, and bring a more uniform and natural look to your smile.

And if you are working with a well-qualified cosmetic dentist, he or she will pay close attention to the contour of the gums and how it is contributing to or distracting from the beauty of your smile. If the gums don’t show enough of your teeth or if they are very uneven, they can make some teeth look longer and some shorter. When dentists talk about “gummy smiles” they are referring to teeth that are out of proportion with predominant gums, making the teeth look smaller or shorter.

So it sounds as though you are probably on the right track with your cosmetic dentist. It is a good sign that the appearance of the gums is playing a role in your smile makeover. And there’s more good news. Cosmetic gum surgery is often accomplished with a high-tech device like a laser or electrosugery instrument. This means the gum tissue can be trimmed and contoured with minimal discomfort. In addition, this type of procedure heals quite rapidly.

If you would like to learn more about this topic, click here to read Pumphrey Periodontics’ Periodontal Plastic Surgery page.

This Blog is brought to you by David Pumphrey of Pumphrey Periodontics in Atlanta.

My parents both had gum disease, so I know what it looks like. I’ve been afraid to go to the dentist for many years, but I know if I do, they’re going to operate because I have the family problem. My mom had gum surgery when I was young, and I remember how painful it was. She was in pain for days. Now I’m facing the same thing. Aren’t there better painkillers now?

Theresa V.
Atlanta

Hi Theresa,
It sounds like your mom had a very bad experience with both gum disease and gum surgery, and that may have contributed to your being afraid and avoiding the dentist. That’s unfortunate, but there’s a very bright side here. Your fear may have kept you away, but during your absence, there have been a lot of advances in the way gum disease is diagnosed and treated. None of them include the kind of pain your mom experienced.

It can be hard to overcome long-lasting fear, but you may be pleasantly surprised. Instead of assuming you need gum surgery, if you allow a qualified periodontist to examine your teeth, you may find out that your dental condition is easily treatable without surgery.

Healthy Gums vs. Periodontal Disease

Let’s break things down a little here. Sometimes straightforward information can be the best prescription for fear and avoidance. To begin with, periodontal disease is caused by plaque and tartar that attach to the tooth root below the gumline where brushing and flossing can’t reach. These pockets of plaque and tartar cause inflammation, which damages the bone structure that keeps our teeth stable. The drawing above shows this process.

Even diagnosing the extent of the inflammation and damage used to be fairly difficult. But a new, high-tech camera, called a perioscope, now allows the periodontist to see how far the damage extends. In addition, the laser technology that uses both heat and water to eliminate pain now enables non-surgical gum treatment to smooth the tooth root and remove bacterial toxins. This procedure is called scaling and root planing, and it does not require incisions, sutures, or a long healing process. In essence, it is a deep cleaning that can be accomplished in one or more appointments, leaving healthy tissue intact.

Here’s hoping you find a solution to your fear and your dental condition soon!

This Blog is brought to you by Dr. David Pumphrey of Pumphrey Periodontics in Atlanta.

What is cosmetic gum surgery?

I’m facing gum surgery, and I’m terrified.