SCALING AND GINGIVECTOMY
Gingivectomy is surgical removal of gum tissue, or gingiva. Gingivectomy can
be used to treat conditions like gingivitis. It’s also used to remove extra gum
tissue for cosmetic reasons, such as to modify a smile.
A dentist may recommend gingivectomy if you have gum recession from:
aging
gum diseases, like gingivitis
bacterial infections
gum injury
If you have gum disease, a dentist may recommend this procedure to prevent
future gum damage as well as give your dentist easier access to the teeth
for cleaning.
Gum disease often creates openings at the bottom of the teeth. These openings
can lead to a buildup of:
plaque
bacteria
hardened plaque, known as calculus or tartar
Those buildups can then lead to further damage.
Your dentist may also recommend this procedure if they discover gum disease or
infection during a check-up or cleaning, and want to stop its progression.
Elective gingivectomy
Gingivectomy for cosmetic reasons is totally optional. Many dentists don’t
recommend it unless the risks are low or if they specialize in cosmetic
procedures.
A gingivectomy takes 30 to 60 minutes, depending on how much gum tissue
your dentist removes.
Minor procedures involving a single tooth or several teeth will probably only
take a single session. Major gum removal or reshaping may take several visits,
especially if your dentist wants one area to heal before they move onto the next.
Here’s how the procedure works:
1. Your dentist injects local anesthetic into the gums to numb the area.
2. Your dentist uses a scalpel or laser tool to cut away pieces of gum tissue.
This is called soft tissue incision.
3. During the procedure, your dentist will likely keep a suction tool in your
mouth to remove excess saliva.
4. Once the tissue has been cut away, your dentist will likely use a laser tool
to vaporize remaining tissue and shape the gumline.
5. Your dentist puts a soft putty-like substance and bandages on the area to
protect your gums while they heal.
Laser gingivectomies are increasingly common because advances in laser
technology continue to make tools cheaper and easier to use. Lasers are also
more precise and allow faster healing and cauterization due to the heat of the
laser, as well as a lower risk of infections from contaminated metal tools.
Laser procedures are more expensive than scalpel procedures and require more
training, so your dentist may offer a scalpel gingivectomy if they’re not trained
or don’t have the right equipment.
If you have health insurance, your plan may not cover laser procedures, so a
scalpel gingivectomy may be more cost-effective. It’s a good idea to call your
insurance provider before scheduling a gingivectomy so that you understand
your benefits.
Surgeries are often done using surgical scalpels. However, there can be
instances wherein a low-frequency laser is utilized instead during the
procedure. Gingivectomy is done by trimming down and removing the
diseased tissue, leaving the remaining gums to be reattached in and around
the teeth by sutures. Then the area is cleaned with saline and special rinses.
If you need to undergo gingivectomy, you won’t have to worry about feeling
any discomfort since local anesthetic and other sedation options will be
offered to you by our expert team here at Flex Dental to keep you
comfortable during the procedure.
Once the procedure is done, a surgical dressing, or pack, will then be placed
in and around the teeth and gums. This dressing will remain in place for
about a week. Also, rinsing the mouth with an antibacterial mouthwash is
recommended, as it can help in the healing process.
Scaling means ‘scraping away’ in order to remove tartar.
We get tartar when the coating of
germs on our teeth becomes hard.
Gums that press against tartar
become sore and infected.
Clean teeth keep our gums healthy. Scaling a person’s teeth gives infected
gums a chance to become normal again.
However, gums remain healthy only when we keep the teeth beside them
clean. If we are not careful about cleaning our teeth after they are scaled,
tartar will soon return. Instead of being healthy, the gums will become sore
and infected again.
Scale a person’s teeth, but also teach how to keep teeth clean.
Use a mirror to show the person gum infection inside his own mouth. Later he
can see the improvement he has made. He can learn about how to keep gums
healthy as he follows his own progress.
THE INSTRUMENTS YOU NEED FOR SCALING
We scale teeth with special instruments called scalers. There are many
different kinds of scalers for different teeth, to make scaling easier. It can be
a problem to know which ones to buy.
1. Scaler with two pointed tips—to remove tartar from the part of the
tooth near the gum.
Its proper name is
lvory C -1 scaler
1. Scaler with two blunt, rounded ends—to remove tartar from the part of
the tooth under the gum.
Its proper name is
G-11 and 12 curette.
The ends of the scaler are the important parts. One end is bent to the left
and the other end is bent to the right, so you can reach more easily around
all sides of the tooth.
The blade at each end of the scaler is sharp. You must keep the blade sharp.
A sharp blade can break more of the tartar away than a blunt blade.
You also need these:
Mirror
Sharpening stone (Arkansas stone)
Probe (explorer)
Tweezers (cotton pliers)
HOW TO SCALE TEETH
Tartar starts to form inside the gum pocket. There it builds up, because the
gums protect it. So you often must feel rather than see the tartar when you
scale a tooth.
You must remove all of the tartar so the gums can heal. New tartar grows faster
when there is old tartar Ieft behind for it to build upon.
Lay out what you need ahead of time:
your instruments: scalers, mirror, probe, tweezers
sharpening stone
cotton gauze
1. Explain what you are going to do. Tell the person what to expect. There
will be some bleeding and possibly some pain. However, you can stop
and rest, or inject local anesthetic, if it is painful. Remember: first wash
your hands and your instruments!
2. Feel under the gum for tartar. Tartar feels like a rough spot on the root of
the tooth. Since tartar can form anywhere inside the gum pocket, feel for it
on all sides of the tooth.
You can check for tartar two ways:
a. Use your probe. Slide the point up and
down along the root surface under the
gum. Feel for places that are rough.
Teeth without tartar are smooth.
b. Use cotton gauze. Twist a corner and
press it between the teeth. The gauze
lowers the gum and soaks up the spit.
You can then see more tartar.
3. Place the scaler under the tartar. You must learn two important things:
how to hold the scaler and how to slide the scaler into the gum pocket.
Hold the scaler almost as you
would hold a pen. You can then
pull it against the tartar with
both power and control.
Control is very important. The ends of
the scalers are sharp. If you are not
careful, the blades can cut the gums.
Be gentle and do not hurry. Always hold
the tip of the scaler on the tooth to avoid
poking the gums.
Rest your 3rd finger against a tooth. This
will steady your hand and let you slide the
sharp scaler under the gum with care.
FOR AN UPPER TOOTH
The edge of the gum, near the tooth, folds under to form a pocket. This gum
pocket goes completely around each tooth. The gum pocket can be shallow or
deep. A deep pocket means there has been an infection for a while.
Tartar starts forming deep inside the gum pocket. If you remove tartar that you can
see above the gum, it is helpful, but not good enough. You must remove the rest of
the tartar, or the infection will continue. If part of the tartar stays on the tooth, the
infection will continue. First, use the pointed-tip scaler to remove the tartar that you
can see. Then, go back with your rounded-tip scaler and scrape away the remaining
tartar.
Be careful when you place the rounded end of the scaler inside the gum pocket.
Put the sharp face of the blade against the tooth. Slide it along the tooth down into the gum
pocket
You can feel the edge as it goes over the rough tartar. Stop when you feel the bottom of the gum
pocket.
Hold the end tight against the side of the tooth and pull the scaler. Try to break
free as much tartar as possible at once. It is a bad idea to remove the tartar a bit
at a time, because the remaining tartar becomes smooth and harder to scrape
away.
1. Check to be sure the tooth is smooth.
With your probe, feel under the gum
for any place that is still rough.
When all the sides of the tooth feel
smooth, move to the next tooth.
Do not hurry. It is more important to take your time and carefully
remove all the tartar. If the person has a lot of tartar, scale only half
the mouth now. Do the other half on another day, as soon as the
person can return.
Finally, make the tooth look clean. Use the sharp edge of either scaler.
Scrape away the dark material on the front and back sides of the tooth.
The tooth itself has not turned dark. It is just a
stain. People most often get these stains when
they eat meat, drink tea or smoke tobacco.
You can scrape away this old food and uncover
the white tooth. But remember: the teeth will
turn dark again if not cleaned carefully every day
