Complex gum surgery at Wayside is carried out by our periodontist, Dr Mitul Shah.
Your dentist may recommend Crown lengthening for two main reasons. The main reason is for aesthetics. Crown lengthening can improve the appearance of your teeth if you have a ‘gummy smile’ or uneven symmetry to your gums.
Another reason for Crown lengthening is if your teeth are heavily worn down or broken, and your dentist is otherwise unable to restore them definitively.
Prior to Crown lengthening, Dr Shah will see you for a complete assessment. Together with the referring dentist and a dental technician, Dr Shah will create a bespoke digital smile design, so that you are fully aware of the intended outcome prior to embarking upon treatment.
The procedure is carried out under local anaesthesia to ensure you are comfortable and relaxed. The excess gum tissue may be removed and carefully shaped with either a laser or conventional instruments. Certain cases will additionally require some bone around your teeth to be gently reshaped. This is to allow us to position the gum exactly where we require and helps to prevent the regrowth of the excess tissue in the future. The tissues are stitched back and left for 7-14 days. Your dentist is usually able to place provisional restorations a week following the removal of the stitches. The final restorations can be cemented 2-3 months following the Crown lengthening procedure.
- The procedure allows your dentist to restore and save teeth that would otherwise not be possible and would therefore require extraction.
- It allows for improved appearance of your teeth by ensuring they have better proportions.
- Improves the appearance of a ‘gummy smile’.
- Post-operative pain which will normally require the use of paracetamol/ibuprofen as instructed for 3-5 days.
- Mild swelling/bruising.
- Short-term bleeding from the gums, typically only for the first 24 hours following surgery.
- Sensitivity to hot/cold food and drink.
- Short term looseness of teeth, recession
Gum recession is the term used to describe the downward movement of the gums away from the neck of the tooth. There are many potential factors which can contribute to gum recession,
- The position of your teeth
- Previous Orthodontic therapy
- Over-zealous toothbrushing
- Gum disease
- The presence of tongue/lip piercings
Dr Shah will assess the potential causes of your gum recession and advise yours accordingly on how to proceed. It is imperative that the cause of recession is addressed and controlled to prevent its progression and to allow any treatment to be successful.
The treatment approach to managing recession depends on the individual circumstances and what our intended aims are.
Wherever possible Dr Shah will aim for:
- Complete coverage of the exposed root surface.
- Minimal formation of scar tissue.
- Optimal colour and blending of the gum tissues.
- A situation where it is easy for you to clean your teeth and gums following surgery.
Surgery is carried out under local anaesthetic. Most techniques require the use of a gum graft, which is harvested from your palate. This is carefully harvested using microsurgical techniques. The palate is carefully sutured, and a dressing is often placed. The harvested gum tissue is then carefully secured with stitches.
To improve outcomes, it is common to utilise biologic agents such as enamel matrix protein derivatives during surgery. There use can reduce complications, improve healing, and increase the probability of achieving complete coverage of the exposed root surfaces.
Benefits of treating recession include:
- An improved ability to clean teeth which have suffered from the recession.
- Reduced sensitivity.
- Reduced probability of decay affecting the root surface.
- Increased thickness of the gum tissues and a reduced risk of further recession which can compromise teeth or lead to tooth loss.
- A possibility of root coverage and an improved appearance when smiling.
- Post-operative pain which can be managed with paracetamol/ibuprofen, typically for 7 days.
- Post-operative bleeding for the first 24-48 hours.
- Swelling and bruising.
- Post-operative infections and failure of the surgery.