Open Wide and Say.'Contour!?' by Deborah Southard Here's how your dentist can get rid of that lopsided smile print article      send to a friend

Tour Before You Contour

Gum contouring is used to remove excessive tissue from the gum line and is usually done in conjunction with veneers or another whitening procedure. "One of the elements of an attractive smile is a harmonious gum line," comments Sarah's dentist, Mike Maroon, DDS, an aesthetic dentist from Berlin, Connecticut. If your gums overpower your smile and it looks like you never lost your baby teeth, or if your gum line is asymmetrical - making your smile lopsided - this could be the procedure for you. "The patient comes in with a specific problem. The gum might be overgrown or unevenly contoured next to another tooth, or there might be an infection that caused the gum to overgrow," notes Neil Gottehrer, DDS, a Havertown, Pennsylvania periodontist. The procedure has many different names, including gum surgery, laser gum reshaping, gum contouring, and crown lengthening (the crown is the part of the tooth visible when you smile).

Generally, contouring is done with a laser. "There are a number of different lasers out there. Depending on the wavelength, the laser will cut under dry or wet conditions, and there is also a new laser that can be used on both hard and soft tissue," notes Dr. Maroon. It generally takes only ten to fifteen minutes to cut away the unnecessary tissue, but if you are getting veneers done at the same time, the entire procedure could take much longer.

To contour the gums, the dentist or surgeon burns away excess tissue from the gum line. As the laser burns it also cauterizes the area, keeping the gums from bleeding. As a result, the gums become dark and swollen, and a little callous or crust forms over the area. It will take seven to ten days for the dentist to determine if the treatment was successful. If the gum line is still uneven, the procedure will have to be repeated to make refining touches.

As with any surgery, there are risks involved. If the dentist overcorrects the gum line, your teeth could look too long or gaps may be revealed between your teeth. In addition, there is a risk of infection and bleeding.

A New Technique

A new procedure called Bi-Polar Electrosurgery, which uses a radio surgery unit, is emerging as the next wave in gum contouring. The technology is very popular with neurosurgeons and cardiologists, and has recently moved into the dental marketplace. With electrosurgery, the cutting is done with a very low current so that there is no bleeding, no pain, and no protective dressing required to cover the area. And it takes no time at all - Dr. Gottehrer compares it to the time required to perform the popular eye surgery known as LASIK. When the dentist is finished contouring the gum line, the result is final. "What you see is what you get," says Dr. Gottehrer. "I don't have to worry about how the gums will heal, I don't have to go back and make final touches."

According to Dr. Gottehrer, the procedure is safe enough for the dentist to touch bone without any adverse effects. In addition, it can be used safely around dental implants.

A Package Deal

Generally, a patient will have veneers placed over their teeth as part of a cosmetic package of sorts. But even if you pass on the veneers, you won't have to worry about discoloration where new tooth has been exposed - as long as your teeth are relatively healthy. Dr. Gottehrer also recommends that you ask your dentist if your expectations regarding the procedure are realistic.

Dr. Maroon says that most dentists will include the cost of the contouring in with the price for the veneers. There are instances where dental insurance will cover part or all of the cost of the surgery; your dentist will be able to help you make that determination.

As for Sarah, she can't emphasize enough how much it has changed her life. "I almost cried tears of gratitude after my last appointment!"