This is a gum correction treatment in which the periodontist will remove excess gums because it is aesthetically disruptive. This is the case with a “gummy smile”. This means that the patient has too much gum in relation to the length of the teeth. This may be because the teeth have not completely settled, or the gums have not crept up further. In other words, there is still tooth enamel hidden under the gum. This is a straightforward procedure under limited local anaesthesia with minimal aftercare for the patient.
This can also be the case after orthodontic treatment, where the gums have been adversely displaced or become swollen.
However, good oral hygiene is crucial for proper healing and perfect results. This will be checked in advance by your dentist or periodontist.
Clinical crown extension
Sometimes there is not only too much gum but also too much jaw bone. In that case, the periodontist will remove the gums and some of the underlying jawbone so that the gums do not grow back. The dental crown is, as it were, made longer clinically. This may be necessary to obtain a better aesthetic result with veneers or crown and bridge procedures or at the back of the mouth with deep fillings that are otherwise not accessible by the dentist. These treatments are performed under local anaesthesia and with minimal additional charge. The patient can go to work the same day and usually returns one to two weeks later to remove the delicate stitches and evaluate the result. After the procedure, the patient is given a special toothbrush and instructions to continue to take good care of their teeth.
Once a tooth root is removed, the bone will shrink and, consequently, the gums too. This can be aesthetically disruptive as there is a dent in the gum exactly where that can create a grey shade. To overcome this problem, the periodontist can perform a gum reconstruction. During this treatment, a piece of own connective tissue is removed at the back of the mouth (donor) and fixed under the gums of the problem area (receptor). It is a type of gum transplant. This piece of connective tissue is attached with very delicate stitches so that it remains firmly fixed, and new blood vessels can grow in it so that the gums grow and remain thicker at that spot. This is very technique-sensitive work and therefore requires the necessary expertise and cooperation from the patient. Smoking is a huge risk factor, as it has a strong negative effect on blood flow. The patient will especially experience discomfort at the donor site (at the back of the mouth) depending on the amount of the removed, and for this reason, it is best to avoid hard foods in this area for 1 to 2 weeks.
Gum recession can be both aesthetically disruptive (the yellow root is visible) and painful due to the root’s fine openings that connect to the dental nerve. We call an exposed root due to receding gums a recession. Although some dentists cover this with filling material, the most biological and ideal solution is to cover this root with new gums. This is possible thanks to a recession cover. In this type of treatment, the periodontist will loosen the gums around the root using extremely fine instruments. A piece of connective tissue from another area in the mouth is then placed over the exposed root. Afterwards, the periodontist pulls the existing gums over the root and connective tissue to fix it in the new place with delicate stitches. This new situation should then attach within one to two weeks, after which the exposed root is again covered with gums as if nothing was ever wrong.
Before starting this treatment, the periodontist will first investigate the cause of the receding gums and possibly advise to adjust the brushing technique to avoid these problems in the future. Good cooperation and proper adherence to the instructions by the patient are essential for a good end result.
When a tooth was lost a long time ago or has to be extracted due to an extensive infection affecting the jaw bone, a bone defect might develop after healing. This is characterised by a deep dent in the gums after healing. This can be aesthetically disruptive or even so extensive that there is not enough bone available for an implant if the patient desires a dental replacement. To solve this, the periodontist or dental surgeon can perform a bone reconstruction. With this type of treatment, the defect will be filled with artificial bone or own bone and membranes, after which six months is required to integrate the artificial bone into fully-fledged, mature bone where an implant can be fitted.
Sometimes the specialist may propose to insert artificial bone immediately after removing the tooth to prevent the development of a bone defect.