A healthy and attractive smile isn’t all about teeth – it’s the result of a harmonious relationship between your teeth, gums and lips. Gum contouring is a surgical procedure sometimes used to improve the health of your teeth and gums (also called gingiva) and the appearance of your smile. How and when it might be performed depends on several factors.
People may present with a “gummy” smile for many reasons. Someone may have a naturally occurring high lip line, with a smile that shows all of their teeth and gums. Gums can also swell from a bacterial infection or poor oral care, or even grow abnormally large as a side effect of certain medications. Additionally, a condition known as altered passive eruption can prevent permanent teeth from fully protruding, leaving teeth tiny-looking and partially hidden by excess gum tissue.
Too little gum (or gum recession) can often be more of a problem than too much. Besides causing teeth to look elongated or discolored, receding gums expose the roots of teeth to harmful bacteria and plaque. The gum itself is a thin layer of soft tissue overlying the bony sockets that support the teeth, so gum loss can also sometimes point to bone loss. Gum recession can be localized to just a few teeth or generalized to the whole mouth. There are three main causes of receding gums:
An overgrowth of gum tissue can often be corrected through gum contouring, sometimes called esthetic gingival recontouring. Your dentist, oral surgeon or periodontist will use local anesthetic and a laser or scalpel to shape a new, more uniform gumline. Reshaped gums are also often healthier, since the pocket depths of spaces between the gums and teeth are made shallower and easier to brush clean. Post operative healing is usually uneventful and can take a few weeks.
If simple contouring is not enough, your periodontist may go deeper with crown lengthening. In this procedure, part of the gum and some of the underlying bone is removed to change the anatomy of the teeth themselves. Since this surgery involves altering bone and generally requires stitches, recovery is typically longer.
Treatment of gum recession can usually be accomplished by grafting the patient’s own gum tissue from a nearby tooth or part of the palate. Some surgeons also use highly processed, sterile donor tissue. Besides the improvement to your smile, increasing gum coverage also protects your roots from tooth decay, according to the American Academy of Periodontology. The surgical site from a gum graft typically takes about six weeks to heal.
A more troubling situation is one where there has been accompanying bone loss from periodontal disease. Remember to clean your gums just as well and often as you clean your teeth to prevent severe problems before they happen.
Some gum surgeries will require you to wear a dressing over the surgical site for a week or longer. You may experience some minor swelling, pain or tooth sensitivity, but these symptoms will start to go away as your new gumline heals. You may also be asked to avoid smoking, drinking alcohol and using a straw. Always follow your oral surgeon or dentist’s instructions for brushing, using medication, or eating certain foods as you recover. Before you know it, you’ll be debuting a beautiful new smile!