Cleaning – Surgical Periodontal
The procedure aims to treat the gum disease and any damage it may have caused by:
Regrowing damaged bones and tissues
Preventing tooth loss
Reducing gum gaps between teeth, known as black triangles
Reshaping the jaw hone to lower the risk for bacterial growth in bone crevices
Eliminating bacteria and infection
Periodontitis is a more severe form of gum disease in which gingivitis has worsened and advanced, leading to an inflammatory response that destroys bone and tissues.
During this inflammatory process, the gums begin to separate from the teeth. This causes spaces called pockets to develop, which in turn trap bacteria and lead to infection.
As a result, tooth loss and bone damage can occur.
01. Before surgery
Another procedure known as root planing can smooth the surfaces of the roots of the teeth, meaning that there are fewer places for tartar and bacteria to build up. This procedure also removes any tartar that is on the root.
Deep scaling and root planing usually occur at the same time.
02. Flap surgery
After the surgeon has cleaned the area and removed the tartar, they will stitch the gums into place to fit around the teeth. Sometimes, the bone may require reshaping during this procedure.
03. Bone grafting
The goal of bone grafting is to hold the tooth in place and help it to regrow.
04. Guided tissue regeneration
05. Tissue grafting
During this procedure, a dental surgeon typically removes tissue from one part of the body and re-attaches it to the area where the gum has receded. The tissue often comes from the roof of the mouth.
Tissue grafting not only reduces the risk for further damage but also covers any exposed roots.
06. Preparing for gum surgery
During this exam, the dentist will likely:
• Take a medical history review and do an exam
• Examine the teeth, mouth, and jaw to check for stability and health
• Check for any infections, abscesses, or other lesions that could make healing from surgery more complicated
• Discuss the risks and benefits of the operation, and receive permission or consent to move forward with the surgery
07. What happens during surgery
Most gum surgery procedures take around 2 hours to complete.
In some cases, the surgery will require a person to be asleep or partially asleep during the procedure. Other times, the surgery only involves the use of a local anesthetic to numb the gums. The injection of the numbing medication can be mildly uncomfortable.
During the procedure, the dental surgeon uses sterile equipment, including instruments and drapes, to lower the risk of infection. After making small incisions or cuts along the gum line, the dentist will lift the gums away from the teeth. This allows the dentist to see the roots better so that they can remove and clean away any tartar, plaque, or infection.
Following this deep cleaning, the dental surgeon can perform other procedures, such as gum reshaping, bone regeneration procedures, or other planned procedures.
Once the planned dental surgery is complete, the surgeon will stitch the gums back into place, using fine thread stitches. The dentist will remove the stitches 7 to 10 days after surgery.
Typically, people will require pain relief medications in the days after gum surgery. Again, the dentist will talk to the person about any recommended drugs before they leave the office or surgical center.
Dentists may also recommend:
• Using an antiseptic mouthwash to keep the area clean and to avoid infection
• Avoiding strenuous exercise
• Eating soft foods in the days following surgery
• Not smoking
The dentist will schedule an appointment to return to the office for 1–2 weeks time. During this appointment, the surgeon will check how the gums are healing and, if required, remove any stitches.
A person’s gums will look and feel different after surgery. The gums and teeth will heal, tighten, and become firmer and stronger. Some people may have tooth sensitivity to hot or cold temperatures and may find relief by using desensitizing toothpaste. The dentist will discuss a follow-up schedule to maintain good oral health in the future.