Cosmetic Periodontal Surgery

The recent popularity of television shows such as “Extreme Makeover” or “The Swan” has raised the awareness about the value of a stunning smile. For some patients, the “tooth” portion of the smile is only half of the dental story. Beautiful, healthy gums are often the icing on the cake, or the missing puzzle piece that takes a nice smile and makes it truly spectacular. Consider the following reasons for undergoing periodontal plastic surgery:

Gummy Smile/Uneven Gum Line: Think of someone you know whose teeth appear very “short” or “small” in relation to their gumline when they speak, laugh or smile. This is what we refer to as a “gummy smile.” An uneven gumline can occur naturally or after dental work, particularly placement of crowns or bridgework. When comparing one side of the smile profile to the other, the gumline in certain areas is uneven. Often times after orthodontic treatment, the gums are swollen and puffy when the braces are removed. Usually this swelling subsides within a short period of time when patients are able thoroughly brush and floss. For some patients, however, the puffiness remains.

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All of these cases are ideal for “crown lengthening.” This is probably the simplest of all periodontal plastic surgeries. The gums are gently numbed and carefully contoured in a way that allows the teeth to appear longer. This procedure can also even out the gumline, reducing puffiness and swelling if necessary. Because gum tissue is one of the fastest healing tissues in the body, the recovery is rapid and the results are excellent.

Receding Gums/Exposed Tooth Roots: The expression “long in the tooth” is no laughing matter when referring to gum recession! Exposed roots can not only add years to one’s appearance, but can also be extremely sensitive to cold and touch, as well as highly susceptible to tooth decay (cavities) not to mention an embarrassing food trap. Cosmetic periodontal surgery can “borrow” donor gum tissue from areas such as the palate and graft the borrowed tissue to the areas of recession, resulting in root coverage, protection and improved appearance.

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Missing Teeth and Indentations in the Gumline: While missing teeth can be replaced with implants or fixed bridgework, there can sometimes be “indentations” in the gumline or jawbone. This is particularly true if the tooth or teeth have been missing for some time or if the tooth loss was caused by significant trauma, such as a blow to the mouth or severe abscess. In these cases, bone grafting is the cosmetic periodontal procedure of choice. The area is carefully numbed, opened, and deminineralized freeze-dried bone is added to the indentation to help the body regrow bone and naturally fill in the sunken area, resulting in a beautiful, natural looking smile.

Occasionally, teeth are congenitally missing, meaning the permanent tooth or teeth never formed, and there is no tooth available to fill in the missing space. These cases, which are often diagnosed in childhood, are beautifully addressed with implant placement for long-term, natural looking, low maintenance tooth replacement. You and Dr. Tohme can work together to determine a time at which implant placement is ideal.

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