- The amount of gum tissue display
- The size and shape of the teeth
- The length and the degree of movement of the upper lip
- The vertical position of the upper jaw and teeth in relationship to the skull
- Connective-tissue grafts. This is the most common method used to treat root exposure. During the procedure, a flap of skin is cut at the roof of your mouth (palate) and tissue from under the flap, called subepithelial connective tissue, is removed and then stitched to the gum tissue surrounding the exposed root. After the connective tissue — the graft — has been removed from under the palatal flap, the flap is stitched back down.
- Free gingival grafts. Similar to a connective-tissue graft, free gingival grafts involve the use of tissue from the roof of the mouth. But instead of making a flap and removing tissue under the top layer of flesh, a small amount of tissue is removed directly from the roof of the mouth and then attached to the gum area being treated. This method is used most often in people who have thin gums to begin with and need additional tissue to enlarge the gums.
- Pedicle grafts. In this procedure, instead of taking tissue from the palate, it is grafted from gum around or near the tooth needing repair. The flap, called a pedicle, is only partially cut away so that one edge remains attached. The gum is then pulled over or down to cover the exposed root and sewn into place. This procedure can only be done in people who have plenty of gum tissue near the tooth.
Some dentists and patients prefer to use graft material from a tissue bank instead of from the roof of the mouth. Sometimes tissue-stimulating proteins are used to encourage your body’s natural ability to grow bone and tissue. Your dentist can tell you which method will work best for you.
Gum contouring is a procedure which is most commonly done through the use of a scalpel. However, technological advances have seen special laser devices emerging in the treatment of ‘gummy smile’. The scalpel or laser will be used to trim away at any excessive gum overlying the teeth. This is a quick and often painless treatment. The scalpel will make the process slightly longer, and the laser also has the added bonus of being able to seal blood vessels during the procedure. This will help to limit the amount of blood released due to the incision. Along with the use of crownsand veneersafter the treatment is complete, gum contouring is a simple procedure that can easily remedy ‘gummy smile’.
To begin with a local anaesthetic is used to take away feeling from the area where the procedure is to commence. The scalpel or laser device will then be used to trim away at the excessive gum that is covering the front teeth. As well as cutting away at the gum, the dental practitioner will also work to reshape the gum that is to remain in place. The healing process is relatively quick, but will be made faster if the laser device is used, as it works to seal blood vessels, in order to prevent excessive bleeding once the procedure is complete.
There are certain instances in which the removable and reshaping of the gum is not enough. If this is the case then the dental practitioner may need to remove some of the bone in which the teeth are rooted. This will be down to the judgement of the dental practitioner, should they think the gum will reform too far down on the teeth. This may seem more daunting to some than the mere removable of excessive gum, but it is just as simple a procedure. Once treatment is complete you may be prescribed with veneers or crowns to help improve the look of your smile.
Before the procedure, you will be given a local anesthetic to numb the area where the doctor will work on your gums.
The doctor will pull back a section of your gums to clean the roots of your teeth and repair damaged bone, if needed. The gum flap will be sewn back into place and covered with gauze to stop the bleeding.