By Parsa T. Zadeh, DDS, FAGD
Article in PDF format: Gum Lift – What to Expect
What is the “Gummy Smile Surgery” or Gum Lift?
The term “Gum Lift” was coined by Dr. Zadeh in 1989 to describe the surgical procedure which is often performed to reduce the “gummy smile’ that some individuals have.
It is performed as an out patient procedure at the Beverly Hills Center for Reconstructive and Cosmetic Dentistry.
The technical description for “Gum Lift” is “Crown Lengthening thru an apically positioned muco-periosteal flap and osseous recontouring”. In simple language, The existing gum is separated from the underlying bone, the excess bone is trimmed and the same gum tissue is placed back and stitched at a higher level but we just like to call it the gummy smile surgery. The result is a biologically stable and acceptable proportion of bone and gum which are now less visible.
Is Gummy Smile Surgery Just Cutting Off of the Excess Gum Tissue?
No. This procedure is different from the simple “cutting off” (gingivectomy) of the excess gum that can be achieved by a: Laser, b: Radio-surgery or c: Surgical knife. The “cutting off” of the gum edge, while having some useful indications, is very limited in what it can achieve. When the very limited biological restrictions are violated, the gum will either re-grow or a permanent state of gingivitis will develop. For a stable and permanent improvement the underlying bone must be also reduced proportionately.
Is the Gummy Smile Procedure Painful?
The actual procedure that takes about 2 to 3 hours to complete is done under local anesthesia, the same way most other dental procedures are done. While local anesthesia is sufficient to perform the Gum Lift completely painlessly, Dr. Zadeh has found that most patients do better and are more comfortable when some degree of sedation is used. You can discuss the suitable technique of sedation for your case with Dr. Zadeh.
Gum Lift is a minor surgery and there will be a wound that carries the same discomforts, limitations and delicacies of any other wound in the body. Post-operatively, you will be given two types of pain medications that you can use as you see fit.
However, interestingly, most patients report a degree of “numbness” on the gum at the operated site rather than “pain”. Apparently, the nerve fibers that are supposed to carry the pain signals from the gums are cut-off and there is “no sensation” from the gum! Most of the discomfort of the procedure comes from the swelling of the area rather than the wound itself.
Here is another example of Michael and his gummy smile surgery before and after photos:
How Long is the Recovery After Your Gummy Smile Surgery?
For fastest and most comfortable recovery, Dr. Zadeh’s recommendations are as follows:
For the day of the procedure: Bed rest. Do not plan on ANY activity after you leave the office. If you have had any type of sedation, you must arrange for a ride home/to your hotel. You must arrange for the medications and few days of suitable food in advance of the procedure.
For days 2 and 3: You must minimize your physical activity. This is a great time to catch up with books, internet and TV. If you have traveled from out of town, it is better if you do not travel back until the 4th day. Physical activity during this period increases the post operative swelling which is the primary cause of post-operative discomfort.
Days 4 thru 9: You can resume all normal activity from the 4th day on except work outs.
10th day on: No special consideration for the procedure needed.
How Many Visits Does It Take?
The procedure is done in one visit. Dr. Zadeh would like to see the patient one more time in the days following the procedure to make sure the tissues are holding up well. For out of town patients, the pre-operative work up can be done through photographs and telephone conversations.
Will there be Stitches?
Yes. If you are local, the remaining stitches are removed after 6 days. If you are traveling, resorbable stitches are used that do not require professional removal.
What are the Possible Complications from the Gummy Smile Surgery?
Basically NONE. If patients follow the instructions in taking the prescribed antibiotics, resting and proper dieting following the procedure, there is nothing that can go “wrong”.
Dr. Zadeh has performed close to a thousand of these procedures and has had no complication so far. However, there can be some consequences to this procedure that the patient must be aware of:
-Some teeth sensitivity will occur that usually disappears few months later.
-The gum numbness that was earlier mentioned can take up to a year to completely go away.
-“Spaces” between the teeth take 10 to 14 months to fill up by gum if gums are kept healthy during this period.
Will I later need Veneers or Crowns on my Teeth?
It depends. This is a very important question that must be discussed BEFORE the procedure is done with Dr. Zadeh.
Whether you would need further restorative work on your teeth after the gum lift or not, depends on the preexisting condition of your teeth and gums and how much gum lift you want done.
-Dr. Zadeh can walk you through the published pictures of his cases at the web site so that you can see how much gum lift you need and can expect from gum lift without any further work on the teeth. Many of the more drastic improvements have been accomplished by a combination of gum lift and restorative procedures.
– In many cases a gum lift is all that is needed to give you a perfect smile:
– In some other cases a gum lift can improve your smile but a more desirable result can be achieved if it is followed by some restorative procedures:
You must discuss this including all the expenses of it with Dr. Zadeh before the procedure because the gum lift procedure VARIES in technique depending on whether a restorative procedure is going to follow or not.
Are there Any Guarantees?
Yes. Dr. Zadeh guarantees that the final results will be similar to the preoperative computer imaging of your case. Of course natural tissues heal and move differently from computer images and exact replication is not possible. Slight asymmetries can happen due to differences in root prominences of the teeth. After complete healing, if necessary, Dr. Zadeh will trim the gum edges (as part of the main procedure) to correct these irregularities.
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