There are many reasons why the gums and jawbone may require corrective treatment, including periodontal disease, trauma and birth defects. Periodontal disease particularly, can greatly disfigure the natural appearance of the gums and teeth and give the smile an unaesthetic appearance.

New “cosmetic surgery” procedures are now available in periodontics, which effectively correct cosmetic problems and restore natural beauty to the smile.

Here are some of the most common gum and jawbone corrective treatments:

Common Gum Treatments

• Crown lengthening (gum lift) – Crown lengthening is usually performed to correct a “gummy” smile, or to expose more of the tooth prior to a restorative surgery.  In some cases, the teeth look short and stubby and partly covered by gum tissue due to genetics or gingivitis.  Excess gum tissue can easily be removed to reshape the outline of the gums, expose the natural tooth length, and provide a fuller, more attractive smile.  The same procedure is also an excellent way to create a more aesthetic gumline for dental crowns and other restorative procedures.
  
  
• Gum grafts – Gum grafts are generally performed to correct a crooked smile, or to restore symmetry to the gumline after periodontal disease has been treated.  Periodontal disease causes the gums to recede; making the smile look overly “toothy.”  During a gum graft, a thin strip of tissue is removed from the palate and stitched in place over the recession site.  Gum grafts are often used to re-contour the gum line and give the teeth a more pleasing appearance.
  
  
• Pocket reduction surgery – Periodontal disease can cause the smile to be marred with unattractive teeth, brown gums and ridge indentations.  The aim of pocket reduction surgery is to clean the root surfaces of the teeth e subgingivally (beneath the gum line).  During this procedure, tartar, plaque and bacteria that are affecting the teeth and gums will be removed.  The gum is first gently separated away from the tooth, and then the calculus (tartar) and plaque are removed using special ultrasonic and hand instruments.  An antimicrobial liquid may be administered to the area to destroy bacteria colonies and ensure the pockets are given the chance to naturally heal.  Pocket reduction surgery is an effective way to restore health to the gums and bone.

Example:  Combination of crown lengthening and gum grafting

The person in this photograph presented with a concern to improve her smile. A consultation was performed and we worked with the patient's dentist to develop a treatment plan.  The gum line was altered through crown lengthening (gum lift) and gum grafts to create a symmetrical and harmonius smile line. 

The patients general dentist put the final package together with new crowns and the final result is a beautiful smile. 

Example:  Another combination procedure and braces (orthodontics) was used to transform this smile. 

This patient also presented with concerns to improve his smile.  In working with his general dentist and orthodontist, a plan to use crown lengthening and gum grafts to improve symmetry and oral health was put into action. 

The general dentist placed new crowns to help transform the smile.  These crowns were placed about 3 months following the periodontal combination procedures.  The gum grafting covered the exposed roots and strengthened the gum line for decades to come.  The general dentist was able to place normal length crowns versus having long and unsightly crowns. 

Common Jawbone Treatments

• Sinus augmentation – This procedure is usually performed prior to the placement of dental implants, to ensure that the prosthetic teeth are both functional and firmly affixed to the bone.  The success of an implant hinges on the quantity and quality of the jawbone to which it will be attached.  If the jawbone has receded or been injured, a sinus augmentation can slightly elevate the sinus floor to allow new bone to form.  Generally, a small incision is made in the bone and the underlying space is packed with grafting material.  The incision is sutured closed, and the implant will be placed when healing has occurred.
  
  
• Ridge modification – Ridge modification procedures are used to treat deformities in the jawbone which have occurred due to periodontal disease, trauma or birth defects.  Birth defects particularly, can leave an unattractive indentation in the jaw, which makes placing dental implants difficult.  During the ridge modification procedure, the gum is gently pulled away from the bone to fully expose the defect.  The defect is filled with bone graft material or a similar synthetic product and then sutured closed.  When healing occurs, the cosmetic appearance of the jaw is much improved and implants can be successfully placed where necessary.
  
  
• Bone grafts – There are a wide variety of reasons why a bone graft may be necessary.  Bone grafting thickens the jawbone to allow for the successful placement of implant anchors.  Bone grafts can also help elevate the sinus floor, fill craters or deformities in the jawbone itself, or allow for successful nerve repositioning.  The grafting material may be harvested from the lower jaw, the iliac section of the pelvis, or synthetically created.  In most cases, a small opening is made in the jawbone and packed with the bone graft material.  Sutures are placed and restorative treatments are performed when healing is complete.

If you have questions or concerns regarding Gum or Jawbone corrective treatments please ask your dentist.