Gum surgery involves any of a number of procedures designed to treat the gingiva, the soft tissues that surround the teeth as well as their supporting bone. These procedures are often employed for conditions affecting the gums that fail to respond to less invasive types of treatments (e.g., scaling, root planing).

Gum surgeries typically are performed by a periodontist, a dentist who specializes in treating gum-related disorders. There are many different types of gum surgery, including:

• Crown lengthening. Removal of gum tissue and/or bone to expose more of the tooth. It is performed when there is not enough of the tooth exposed above the gum line to restore the tooth with a filling, crown, bridge or other restorative technique. Crown lengthening may be necessary when a tooth breaks at the gum line or when a filling dislodges from a tooth that has significant decay below it. In some cases, crown lengthening is used to treat gummy smile, a condition in which large amounts of gum tissue are evident around the upper teeth.
  
  
• Gingival flap surgery. A procedure to separate the gums from the teeth temporarily so that the dentist can access the roots of the teeth and the bone for removal of inflamed tissue, plaque and tartar. It is used primarily to treat moderate to severe cases of periodontal (gum) disease by removing tartar in deep pockets or reducing the size of periodontal pockets. Sometimes, gingival flap surgery (also called pocket reduction surgery) is performed in conjunction with osseous surgery which involves removing or reshaping inflamed bone.
  
  
• Gingivectomy. Surgical removal of gum tissue. It is a technique that is used to eliminate pockets between teeth and gums or to reduce excessive gum tissue around teeth. Pockets are crevices between the tooth and gums that trap food particles, plaque and tartar. Excessive gum tissue (gingival hyperplasia) and the presence of pockets are conditions that can be cosmetically unappealing and may trap bacteria around the teeth, which can make it difficult to perform good oral hygiene.
  
  
• Gingivoplasty. A procedure which surgically reshapes gum tissue around the teeth when the tissue is malformed due to genetic factors, disease or trauma. It may also be performed for cosmetic reasons. This procedure can give the gums a more natural look and is often performed during or after a gingivectomy or a soft-tissue graft.
  
  
• Soft-tissue graft. Procedure in which tissue is taken from the palate or other tissue source and added to an area where the gums have receded. When gums recede, the tooth root is exposed and the tooth becomes sensitive to hot and cold, is more vulnerable to tooth decay and may look unappealing. The procedure is also sometimes performed on patients whose gums are very thin or of poor quality, which puts them at higher risk of future recession of the gums. Different types of soft-tissue grafts are performed to prevent gum recession or bone loss and for cosmetic reasons, such as making the gum line appear more even.

Bone surgery, or osseous surgery, replaces or reshapes hard tissue (bone) that supports the teeth. It may be performed in conjunction with certain gum surgeries, such as crown lengthening or gingival flap surgery. For example, a patient undergoing gingival flap surgery may have experienced some amount of bone loss as a result of periodontal disease. The bone supporting the teeth may need to be reshaped before the gums are stitched together toward the end of gingival flap surgery. If too much bone loss has occurred, a tooth extraction may be necessary.

Bone grafts may be performed to help rebuild an area of bone. A technique called guided tissue regeneration involves inserting material which acts as a barrier between the bone and gums to encourage bone regrowth in the proper area (e.g., keeping gum tissue out of the area where bone regrowth is expected to occur). Sometimes bone harvested from another part of the patient's jaw, bovine (beef) bone or freeze dried human bone is added.