Gingival Sculpting

Authored By: Nayda Rondon
Reviewed By: W. Peter Nordland, DMD

Gingival sculpting, also known as gingival contouring, is the process of reshaping the gum (gingival) tissue around your teeth. A cosmetic dental treatment that can help reinvent your smile and improve your oral health, gingival sculpting involves a minimally invasive laser procedure to remove and re-sculpt uneven or excessive gingival tissue. Typically, however, soft tissue sculpting also requires bone recontouring that cannot be accomplished with a laser alone. The result is healthy and natural-looking gums for a vital, young-looking and attractive smile that adds to your confidence and appeal.

Gingival sculpting procedures can be performed for cosmetic reasons, as well as for oral health reasons such as poor dental hygiene. The latter can result in the formation of deep gum pockets due to improper tooth brushing and the accumulation of calculus and plaque. Common gingival esthetic problems that can be corrected with gingival sculpting include gummy smile (excessive gingival display), uneven (asymmetrical) gingival contours, the loss of papillae (small amounts of gum tissue between your teeth) and exposed root surfaces.

Gingival sculpting also can help address esthetic concerns of teeth that appear "too small" or are unusually shaped. This may result when the surrounding gum tissue has grown down and over a large portion of the teeth, creating the illusion of small or crooked/oddly angled teeth. The gum contouring process removes and re-shapes the extra gum tissue to lift the gum line and reveal more teeth and/or even out the gum line for enhanced symmetry. This procedure removes extra gum tissue without leaving a deficit and only exposes the part of the tooth that is normally visible.

What Gingival Sculpting Involves

Gingival sculpting is most commonly performed by periodontists and cosmetic dentists.

The minor in-office gum contouring procedure typically requires only one visit of about an hour. After a local anesthetic is applied to the gums, a soft tissue laser is used to trim away, re-contour and seal the excess gum tissue. There is only minor discomfort and no bleeding or stitches are involved.

More commonly, the procedure to reduce tissue and bone requires more time and stitches, yet it creates no pain.

Related Procedures

Gingival sculpting can be performed alone, or before and/or in combination with other cosmetic dental procedures as part of a larger cosmetic treatment plan (e.g., a total smile makeover).

Other techniques, such as reducing the bone at the front of the tooth root to prevent re-growth of the gums, also may be needed. Orthodontics and porcelain veneers or crowns may be indicated as well. In some cases, in order to achieve optimal gingival symmetry, a combination of esthetic crown lengthening and root coverage grafting are necessary. In root coverage grafting — also called connective tissue grafting — soft tissue, usually from the roof of the mouth, is grafted to cover exposed root surfaces. This prevents damage to roots, reduces sensitivity and makes your teeth appear more attractive.

Gingival sculpting or crown lengthening refers to re-contouring both the gum and supporting bone. During the crown lengthening procedure, your periodontist administers conscious intravenous (IV) sedation and a local anesthetic, and then re-contours excess gum and bone tissue to expose more of your natural teeth.

In other instances, patients may lose gum tissue due to poor dental hygiene (aggressive toothbrushing, prominent teeth, orthodontic tooth movement, delicate gingival biotypes and gum disease, such as gingivitis or periodontitis). Papillary regeneration fills the dark spaces that may occur between adjoining teeth resulting from the progression of periodontitis, surgical trauma or of tooth alignment. Additionally, root coverage procedures now can provide predictable results with the application of connective-tissue periodontal grafts and plastic surgery techniques.

Benefits of Gingival Sculpting

Gingival sculpting or crown lengthening is safe, fast and virtually painless. You can continue your normal activities right after treatment, and the results are permanent.

The laser gingival sculpting procedure — which seals and sterilizes the treatment area — significantly reduces your chance of infection, minimizes inflammation and promotes fast healing. Lasers also provide greater precision, protecting the surrounding tissue from damage during the procedure.

Gingival sculpting can have psychological and social benefits, improving your looks and self-confidence, encouraging you to be more socially active and making you more willing to smile. You feel happier and seem friendlier and more approachable.

Gingival Sculpting Risks

Gum sculpting is considered surgery, so it is important for your periodontist or dentist to fully inform you about any possible risks associated with the procedure before you undergo treatment. However, since gingival sculpting is typically performed under only local anesthesia, there’s little to fear of the risks associated with general anesthesia.

While extremely rare, you may experience infection at the treatment site, or some minor swelling and discomfort after undergoing gum sculpting.

Check the credentials of the periodontist or general dentist performing the procedure to ensure that he or she is properly trained and skilled in oral surgery and the use of dental lasers, and has considerable experience and practice in performing gingival sculpting.

Gingival Sculpting Costs

Dental insurance companies typically do not cover gum sculpting, which is considered a cosmetic procedure. Procedure costs vary by dentist and the extent of the procedure (e.g., number of teeth involved, how much excess gum must be removed). For example, a gingivectomy or gingivoplasty involving one to three contiguous teeth costs on average about $235, while the same procedures that involve four or more contiguous teeth costs on average approximately $425. Clinical crown lengthening procedures cost approximately $550.

Therefore, it is important to inquire at your dental office about specific costs and financing options.

Do not dismiss the oral health costs, either. Apart from its purely esthetic aspects, gingival sculpting also has health benefits. For instance, removing excess gum tissue can reduce deep gum pockets, which can harbor harmful bacteria that can contribute to infection and gum disease in the form of gingivitis or periodontitis. These forms of gum disease have been further linked to heart disease, diabetes and respiratory problems.

Gingival sculpting also can positively impact your mental health, boosting your self-image and social confidence by improving your appearance. Additionally, the use of laser surgery to perform gingival sculpting involves less risk of infection, promotes faster healing and offers greater surgical precision to protect surrounding tissue from damage. All of these factors should be considered when determining if gingival sculpting makes sense for you.

[Updated May 18, 2010]

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