Gum Surgery

Question:

When you have gum surgery do they cut the gums from the front of the teeth or behind the teeth?

Answer:

Well this answer depends upon the type of gum surgery.  There are several types of gum surgeries including clinical crown lengthening, gingivoplasty, gingivectomy, gingival grafts, and more.

It appears as if you could be referring to either crown lengthening, gingivoplasty, or gingivectomy, so let’s explore each one in plain terms.

Clinical Crown Lengthening

A Crown lengthening procedure removes some gum tissue so that the tooth appears longer.  This is used when the tooth is TOO SHORT, or needs to be lengthened so that it can support a tooth filling or a dental crown.

Gingivoplasty

Gingivoplasty is used to reshape and remove excess/extra  gum tissue (gingiva).  This procedure is used for esthetics only.  For example, some individuals have flabby or excess gum tissue, or feel that too much gum is revealed when they smile.  In this case, a gingivoplasty would be performed.

Gingivectomy

This procedure is very similar to a gingivoplasty in that gum tissue is removed, however it’s used for inflamed, hyperplastic (too many cells), or diseased gum tissue.  This procedure was once used to remove periodontally involved tissues, however is no longer employed when dealing with periodontitis or gingivitis.

How is a gingivectomy or crown lengthening performed?

There are two ways in which these procedures can be performed:

• The dentist makes an incision with a scalpel to “cut away” excess gum tissue.  Of course, the tissue is completely numbed up with a local anesthetic.
• The gum tissue is cut away with a laser.  This procedure can be accomplished using electrocautery or a Waterlase technology and is very efficient in that it removes tissues, and seals the blood tissue so that there is minimal bleeding and inflammation after the surgery.

Is tissue removed from the front and back?

If the tissue needs to be removed from the front and the back, then yes.  But, if this is just a cosmetic procedure, or gingivoplasty, then it’s a possibility that it may just be removed from the front.

We hope this information helps you out,

SaveMySmile Team

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Full Mouth Debridement

Question:

My dentist recommended that I get a full mouth debridement.  What does this mean and will it hurt?

Answer:

A full mouth debridement is a very thorough deep cleaning procedure performed by the dentist or hygienist.  In order to fully explain this procedure let’s examine three areas:

• Why a full mouth debridement is needed
• What a full mouth debridement consists of
• Instructions for what to do after a full mouth debridement

Why a full mouth debridement is needed

This procedure is needed if you have an excessive buildup of calculus or have some form of gingivitis or periodontitis  (Please read more about these conditions here).  But to offer a brief recap, gingivitis and periodontitis are caused by bacteria that are left around our teeth and gums when we are not brushing and flossing adequately.  As a result, the gums become red, swollen, and inflamed.  If left untreated, this can progress to periodontitis, which consists of losing the bone around the teeth.  This leads to loose teeth and eventually the teeth falling out.

What a Full Mouth Debridement Consists Of

Before this procedure is performed, the dentist or hygienist records a series of numbers called periodontal probings.  The hygienist will stick this small probe beside your tooth and slightly under the gum in order to obtain the pocket or sulcus depth.   The pocket depth is an indication as to whether the gum tissue is healthy.  A healthy pocket ranges from 1-3mm.  An unhealthy pocket is 3 mm and above.

The next step is to use a Cavitron (electric scaler) or hand instruments to clean the teeth.  The hygienist places the tip of the scaler on the tooth and manually scrapes off the calculus, bacteria, and other debris.  The scaler also reaches under the gum tissue to remove deep down debris and bacteria.  Sometimes anesthesia is used so that you won’t feel the scaler reaching under your gum tissues.

The procedure itself does not hurt.  It you feel some discomfort, ask your hygienist to administer some anesthetic.  This should take away all pain.  The only thing you will feel are some vibrations on your teeth.

Instructions for what to do after a full mouth debridement

After a full mouth debridement, your teeth may be somewhat sensitive.  Here are some possible steps than can be taken to avoid sensitivity:

• Ask your dentist to polish your teeth with a densitizing agent (BEST OPTION)
• Avoid cold drinks or food for a few hours after the procedure.
• Use a toothpaste or mouthwash for sensitive teeth (although this measure sometimes take up to 1-2 weeks to have an effect)

All in all, the health of your gum tissue should be restored and healthy before getting any other work done.

And most importantly, remember to brush and floss daily to maintain your dental work and nicely cleaned tooth surfaces.

Sincerely,

SaveMySmile Team

Pain and bleeding gums

Question:

I am having pain and bleeding from a tooth.  Also, anything that I eat sticks between by teeth.  Do you have any advice or suggestions for medications?

Answer:

Based off of your description, it looks like you are suffering from pain from your gingiva (gums) and not your actual tooth.  However, please read our article on Toothaches to further assess the situation involving the actual tooth itself.

Inflammation of the Gums = Gingivitis

Usually, when food, bacteria, plaque, calculus, or anything else accumulates around our gums it causes an inflammatory response.  This means that the gums are sensitive, red, puffy, swollen, and bleed very easily.  It sounds like your gums are inflamed, thus causing the bleeding and pain.  This condition is called gingivitis.  A more advanced form of this ailment is called periodontitis if bone loss is involved.

How to Treat Gingivitis

So how can you treat this?  Well, your best bet is to visit your dentist for a thorough cleaning.  If severe, he/she may prescribe you antibiotics to help solve the problem.  However, here are some suggestions to help you with the situation now.

• Rinse with warm salt water to deal with the pain and sensitivity
• Use a mouthwash with chlorohexidine gluconate.  This is a mild antiseptic that is used to kill harmful bacteria in the mouth thus helping to eliminate plaque, calculus, and gingivitis.
• FLOSS EVERY DAY.  This is key to maintaining the health of your gums/gingiva.  Flossing eliminates the bacteria or food trapped under the gums.  This step is also very important for you being that food packs between your teeth.  In areas such as that, you must be sure to brush thoroughly and floss to remove all irritants.

Hope these tips help out and good luck,

SaveMySmile Team

Signs of Gingivitis

Gum disease, known as gingivitis (or it’s more severe form, periodontitis), refers to the inflammation of the gums (gingiva).  It results from accumulation of bacteria near the gum line, causing bacterial invasion into the tissues of the body.  If not addressed and treated, gingivitis will lead to recession of the gums, bone loss, tooth loss, and systemic disease.

Signs of Gingivitis

• Swollen gums
• Bleeding gums (especially when brushing or flossing)
• Shiny or red gums
• Associated pain
• Bad breath or foul smelling gums
• Gum recession (teeth appear longer)

Causes of Gingivitis

• Most often caused by plaque accumulation and poor oral hygiene habits
• Hormonal changes (i.e. pregnancy)
• Certain medications that may suppress the immune system

Gingivitis is a mild form of inflammation.  Unlike it’s more serious form, periodontitis, gingivitis can be treated quickly and easily if addressed in a timely fashion.

Treatment for Gingivitis

• Improve oral hygiene habits – Brush after each meal and floss every day.  If this regimen is followed precisely, the bleeding will eventually stop.
• Incorporate a mouth rinse, preferably with chlorohexidine, into your daily routine.  This can assist with the removal of unwanted bacteria.
• Visit the dentist and get a cleaning – The dentist will be able to effectively remove plaque and calculus, the main causes of gingivitis.  However, it’s up to you to maintain the plaque free mouth after this point.
• Antibiotics – If serious, the dentist may prescribe antibiotics to control the bacterial invasion.

All in all, gingivitis can easily be managed if addressed early.  Take the right steps in keeping up with your oral hygiene to maintain a healthy smile.

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