Index / Cosmetic
Gum recontouring
Sometimes the tooth
is fine. The gum
is in the wrong place.
A tooth that looks short is often a tooth of normal length with gum tissue sitting too low on it. Moving the gum is a smaller intervention than rebuilding the tooth, and it is frequently the step that makes the rest of the design work.
Why people come here
- He teaches occlusion and full-mouth rehabilitation to other dentists
- Fellowships in three academies — FAGD, FACE and FICOI
- The complex cases other practices refer out
- A written, itemized plan before anything is scheduled
The diagnosis
Measure before you remove.
Before any tissue is touched, the position of the bone underneath is measured. That measurement decides everything. Where there is enough space between the gum margin and the bone, the gum alone can be reshaped and it will stay where it is put. Where the bone is sitting too high, removing gum alone means it grows back within months, and the bone has to be addressed too.
This is the difference between a procedure that holds and one that disappoints, and it cannot be judged by looking at the gums. It is why a case that looks like a fifteen-minute laser appointment sometimes turns out to need a periodontal referral, and why you will be told which yours is before anything is scheduled.
A diode laser does the soft-tissue work with very little bleeding, which also means the margin is visible immediately and provisionals or impressions can often be taken at the same visit.
What it is used for
Four jobs, in order of frequency.
Leveling an uneven smile line
One tooth whose gum sits a millimeter lower than its neighbor is a small thing that reads as crooked teeth even when the teeth are straight. Evening the margins is often the cheapest cosmetic improvement available.
Reducing a gummy smile
Where a lip reveals several millimeters of gum above the teeth, lengthening the visible teeth can balance it. How much is possible depends entirely on the bone measurement, and in some cases the honest answer involves orthodontics or a surgical referral rather than a laser.
Exposing enough tooth to restore
A tooth broken at or below the gum line cannot be restored without exposing a sound margin first. This is functional rather than cosmetic, and it is a routine part of saving a tooth that would otherwise be extracted.
Shaping tissue around implants and provisionals
The gum around a front implant crown decides whether it looks like a tooth. Provisionals are used to train that tissue, and the laser refines it.
Questions
Gum recontouring, answered.
Does it hurt?
It is done under local anesthetic and is not painful during. Afterward, most patients describe a few days of tenderness similar to a scraped gum, managed with over-the-counter pain relief. There is very little bleeding with a laser, and no stitches in most soft-tissue cases.
Will the gum grow back?
If the bone position was measured and respected, no — the new margin is stable. If gum was removed without regard to the bone underneath, it very often rebounds within three to six months. That measurement is the whole difference, and it is the reason this page leads with it.
How soon can the rest of the work be done?
Minor refinements can often be restored at the same visit or within a couple of weeks. Where more substantial tissue or bone change was involved, final impressions wait six to twelve weeks for the margin to mature, so the porcelain is made to a gum line that has stopped moving.
Keep reading
Next step
Start with an examination and a straight answer.
A consultation includes an examination, the records the case needs and a written, itemized plan. If what you are asking for is not the right treatment, Dr. Nosti will say so and tell you what is.