Gum that sits too low on the teeth can make healthy teeth look short, and gum that has swollen over the teeth can be impossible to keep clean. A gingivectomy treats both by trimming the excess gum back to a healthier, more even line. Which of those two problems you have shapes everything else, from how much gum is removed to whether something else is needed first.
Two quite different reasons for the same procedure
A cosmetic gingivectomy is done on healthy gums. The aim is to show more of each tooth or to even out a gum line that is higher on some teeth than others, so the smile looks more balanced. It is one of several ways to approach a gummy smile; others work on the tooth shape itself, as our comparison of bonding and veneers describes.
A therapeutic gingivectomy treats gum that is overgrown or diseased. Here the goal is to remove tissue that traps plaque and to leave a gum shape you can clean properly.
Why gums grow over the teeth
Several things can cause the gums to enlarge. Plaque left along the gum line for a long time inflames the tissue and makes it puffy. Braces can make cleaning harder and the gums sometimes swell during orthodontic treatment. Some medicines are well known for causing gum overgrowth. A review in the Journal of Dental Research (Trackman and Kantarci, 2015) notes that it develops in roughly half of people taking phenytoin (an anti-seizure medicine), nifedipine (a calcium channel blocker used for blood pressure) or the immunosuppressant ciclosporin, although reported rates vary between studies. If you take one of these, do not stop it because of your gums; talk to your dentist, who can work with your doctor.
Where gum disease has formed deep pockets, removing the overgrown tissue may form part of treatment, usually after a deep clean such as scaling and root planing has settled the inflammation. Our guide to gum disease treatment shows where this fits.
Gum or bone: why the cause of a gummy smile matters
Not every gummy smile is caused by extra gum. Sometimes the bone sits close to the edge of the gum, and simply trimming gum would lead it to grow back toward its old position. In that case the procedure needed is crown lengthening, which adjusts both gum and bone. In other people the upper lip lifts unusually high when they smile, and the teeth and gums themselves are normal; lip repositioning is one of the options discussed in that situation.
| Cause of the extra gum showing | Usual approach |
|---|---|
| Excess gum over healthy teeth, bone at a normal level | Gingivectomy |
| Bone sitting close to the gum edge | Crown lengthening |
| Upper lip lifting high on smiling | Lip-focused options |
| Gums swollen from plaque or medicines | Treat the cause, then reshape if still needed |
Working out which applies takes an examination, measurements of the gum and often an X-ray. Photographs of the smile help with planning the new gum line.
On the day
The area is numbed with local anaesthetic. The gum is then trimmed to the planned line with a scalpel or a dental laser. A systematic review in Photobiomodulation, Photomedicine, and Laser Surgery (Maboudi and colleagues, 2023), looking at gum enlargement during orthodontic treatment, found less bleeding and pain with a diode laser than with a scalpel, though it included only seven studies of limited quality. Either way, the goal is the same new gum shape.
Healing
The gum is usually tender for a few days. Soft, cool foods are easier at first, and the area should be kept clean with gentle brushing as instructed. The surface usually heals within a few weeks, and the gum line keeps settling for some time after. Results on healthy gums are usually stable. Overgrowth caused by a medicine can come back if the medicine continues, and swelling caused by plaque can return if cleaning slips, which is why daily care and regular visits with your dentist or OHT matter afterwards. Our article on bleeding gums covers what to watch for.
Common questions
Does it hurt?
Not during the procedure, as the area is numb. Some soreness for a few days is normal and is usually managed with ordinary pain relief.
Is it the same as a gum graft?
No, they do opposite jobs. A gingivectomy removes extra gum, while a gum graft adds tissue where the gum has receded.
Can it cure gum disease?
Not on its own. It can remove tissue that traps bacteria, but control of gum disease depends on professional cleaning and daily care at home.
If you are unhappy with how much gum shows when you smile, or your gums have become swollen, our team can examine them and explain which approach fits the cause. You can contact the team at Lumi Dental in Melrose Park or see our current offers.
