Gingivectomy: Reshaping Overgrown or Excess Gum

What gingivectomy and gingivoplasty involves

A gingivectomy removes excess gum tissue; a gingivoplasty reshapes it. The two are usually done together and reported under the same codes. Tissue is excised with a blade, an electrosurgery unit or a laser, and the remaining margin is contoured to a natural shape. The purpose can be functional — removing overgrown tissue that traps plaque and cannot be cleaned, or a pocket wall that prevents access to the root — or it can be restorative, exposing enough tooth for a crown margin. It is also done cosmetically to correct a gummy smile or an uneven gumline.

When this treatment is used

Common indications: drug-induced gingival overgrowth from certain blood pressure, anti-seizure or immunosuppressant medications; hyperplastic tissue around orthodontic appliances; pseudopockets created by swollen tissue rather than bone loss; and access for a restoration whose margin lies under overgrown tissue.

The recurrence problem

Gum tissue removed because of a cause that has not changed grows back. Overgrowth driven by a medication will recur while the medication continues, and overgrowth driven by poor plaque control will recur unless the plaque control changes. This is worth understanding before treatment: the surgery treats the tissue, not the reason for it. Where the cause is a drug, it is worth asking the prescribing physician whether an alternative exists — often it does, and switching produces a better long-term result than repeated surgery. Where the cause is plaque, the surgery makes the mouth cleanable, which is genuinely useful, but only if the cleaning then happens.

Costs and insurance in summary

Typical fee range across the group: $0–$0 where a single band applies. Several codes here are priced individually and carry their own range on their own page. Priced per quadrant for four or more teeth, and lower for one to three teeth. Purely cosmetic reshaping is usually a private fee.

Benefit category: Major periodontal, typically 50–80% on a typical plan. Covered where there is a documented functional need. Cosmetic gum reshaping is excluded.

Common restrictions: Cosmetic reshaping is excluded on essentially all plans; Charting and a narrative are generally required; Not payable on the same date as scaling and root planing in the same quadrant on many plans.