Surgical excision of gingival enlargement

Gingival enlargement (often seen in gingival overgrowth, gingival hyperplasia, gingival hypertrophy, or epulis - tumor of the gingival mucosa) is a condition marked by an increased size of gum tissue.

The enlargement of the gum tissue can be caused by multiple factors, such as:

• Inflammatory enlargement -  a prolonged exposure to bacterial plaque that causes chronic inflammatory gingival overgrowth
• Enlargement due to systemic diseases - a series of systemic diseases may develop oral manifestations that could lead to gingival overgrowth
• Drug-induced enlargement - certain medications (anticonvulsants, calcium channel blockers, immuno-suppressants), or a combination of two or more of them, may lead to gingival overgrowth
• Neoplastic enlargement (epulis) - a localized mass of inflamed gum tissue
• False enlargement

In mild cases the management of gingival enlargement usually requires good oral hygiene, and only in severe overgrowth, the surgical procedure (gingivectomy) is performed.
The drug-induced enlargement is usually treated by ceasing or replacing the drug that causes the problem, but if the overgrowth is considerable the surgical procedure is recommended. 

How does it work?

The doctor injects the gum with a local anesthetic, numbing it, and then removes the excess of the gum tissue with a laser blade (the most common technique), or with the classical scalpel blade. The procedure is finished by suturing the flaps. 

What are the risks?

• Infection of the gum tissue
• Unsuccessful procedure
• Allergic reaction to the anesthetic
• Recurrence of the problem 

How to prepare for the procedure?

Oral hygiene is recommended prior to the procedure. 

How long does the procedure take?

The duration of the procedure depends on the severity of the problem. If a large part of the mouth is involved, then you may need more than one visit to the dentist. 

How to recover after the procedure?

A couple of days after the procedure avoid solid food that may cause pain when chewing or even mild bleeding. If you have pain after the surgery, ask your doctor to prescribe some painkillers for a day or two.
To avoid the recurrence of the problem you should always maintain proper oral hygiene. If the overgrowth is caused by certain drugs that you need to take for a long period of time, then you should see your doctor so that he/she could replace the medication due to your health condition. 

Considering Surgical excision of gingival enlargement? Reading about Frenectomy and Gum Contouring might also be useful.
Read more about related procedures in our Gingivectomy article.
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