Gingivoplasty is a dental procedure that reshapes healthy gum tissue to improve its appearance or contour. Unlike a gingivectomy, which removes diseased gum tissue caused by periodontal disease, gingivoplasty targets gums that are structurally healthy but overgrown, uneven, or cosmetically disproportionate. The two procedures are often performed together, but they serve different purposes.
Why It’s Done
The most common reason for gingivoplasty is excess gum tissue that covers too much of the teeth. This can create what’s often called a “gummy smile,” where a disproportionate amount of gum shows when you smile and the teeth appear short or uneven. Reshaping the gumline exposes more of the tooth surface and creates a more balanced appearance.
Gum overgrowth isn’t always cosmetic. It can result from a surprisingly wide range of causes: certain medications (particularly anti-seizure drugs), hormonal changes, plaque buildup, orthodontic treatment, vitamin deficiencies, genetic conditions, and chronic low-grade irritation. When braces cause gum tissue to swell and overgrow, for instance, that excess tissue can actually interfere with finishing orthodontic treatment and make it harder to keep teeth clean. In those cases, gingivoplasty is both a functional and aesthetic fix.
Some people are born with gum tissue that naturally sits too low on their teeth. Hereditary gingival fibromatosis, a genetic condition causing progressive gum overgrowth, is one example where gingivoplasty becomes a recurring part of dental management rather than a one-time procedure.
What Happens During the Procedure
Gingivoplasty is typically an outpatient procedure performed with local anesthesia, the same numbing injection used for fillings and other routine dental work. If you have significant dental anxiety, your dentist or periodontist may offer additional options like nitrous oxide or an oral sedative taken about an hour beforehand.
The dentist marks the new gumline, then carefully removes or reshapes the excess tissue to create a natural, even contour. The whole process usually takes 30 to 60 minutes depending on how many teeth are involved. Two main tools are used: a traditional surgical scalpel or a laser. Laser gingivoplasty has gained popularity because it cauterizes tissue as it cuts, which means virtually no bleeding during the procedure, less postoperative pain (the laser creates a natural protein seal over the wound), and a reduced risk of infection thanks to the heat’s sterilizing effect.
A longer-acting anesthetic may be administered at the end of the procedure to extend pain relief into the first few hours of recovery, reducing the need for pain medication right away.
Recovery and What to Expect
Most people experience mild to moderate discomfort for the first few days. A retrospective study of periodontal surgical patients found that about 7% reported excessive pain afterward, while roughly 10% experienced temporary tooth sensitivity as the reshaped gums exposed areas of the tooth that were previously covered. Swelling and redness affected about 10% of patients, and minor gum bleeding occurred in about 2.5%.
Infection rates are low, around 3%, and serious complications like delayed healing or tissue recession are uncommon (each under 5%). Your dentist will likely recommend anti-inflammatory pain relievers and possibly a pre-surgical dose to get ahead of any swelling. You’ll eat soft foods for several days and avoid brushing directly on the surgical site while the tissue heals.
The gums typically heal within one to two weeks, though the final contour may take a bit longer to settle. With laser procedures, recovery tends to be faster because of less tissue trauma and reduced bleeding.
Cosmetic Results
For gummy smile correction, results are often visible almost immediately once swelling goes down. In studies following patients who had gum recontouring for gummy smiles, esthetic improvements were noticeable as early as 13 days after surgery and remained stable through 12 months of follow-up. The procedure can lower the visible gumline, make teeth appear longer and more proportional, and correct asymmetry where one side of the smile shows more gum than the other.
When gingivoplasty is combined with other treatments, like lip repositioning for patients whose gummy smile is partly caused by the upper lip rising too high, the results can be particularly dramatic. In these combined approaches, the smile line moves closer to the teeth so less gum is exposed, and the outcome tends to look natural rather than surgically altered.
How Long Results Last
For most people, gingivoplasty results are permanent. Once healthy gum tissue is reshaped, it stays in its new position as long as you maintain good oral hygiene and the original cause of the overgrowth is addressed.
The exception is when the underlying cause persists. If you continue taking a medication that causes gum overgrowth, or if you have a genetic condition like hereditary gingival fibromatosis, regrowth is likely. Studies on hereditary cases show an overall recurrence rate of about 35% after surgical treatment. Even in a well-documented seven-year follow-up of one such patient, slight regrowth appeared in the back of the mouth within two years after completing orthodontic treatment.
For patients prone to recurrence, regular periodontal checkups every three to six months help catch regrowth early, when it’s easiest to manage. In cases tied to orthodontic treatment, the overgrowth often resolves once the braces come off and oral hygiene improves, making repeat surgery less likely.
Gingivoplasty vs. Gingivectomy
These two terms often appear together, and many procedures involve elements of both, but they’re distinct. Gingivectomy removes gum tissue that has become diseased, typically to reduce the deep pockets between teeth and gums that harbor bacteria in periodontal disease. Gingivoplasty reshapes tissue that isn’t diseased but is excessive or poorly contoured. Think of gingivectomy as therapeutic and gingivoplasty as reconstructive or cosmetic, though in practice a dentist may perform both in a single visit: removing diseased tissue first, then sculpting what remains into a healthy, natural shape.