Why do I Need Gum Surgery?

Treatment for gum disease is often divided into non- surgical and surgical. Everything we have been discussing so far has been non-surgical. In most cases, it is always best to proceed with the simpler non surgical approach to begin with if you have pockets of under 6mm. Usually this type of treatment (done properly) with appropriate home care by YOU is sufficient to reduce your pocketing to normal levels.

Surgery however maybe suggested in certain circumstances:

• You have pockets over 6mm

• You have the furcation of molar roots exposed

• You have excess gum that requires removal

• In order to help reconstruct/regenerate problem areas of your gums.

It can also be needed for cosmetic reasons:

• To increase the height of your teeth to allow them to be restored more effectively

• To improve the appearance if you suffer from unaesthetic gum lines.

The aim is the same as for non-surgical treatment, that is- creating a mouth where the gum’s depth is in the normal range, so you can keep it plaque free at home.

Are You Suitable for Gum Surgery?

It is not wise for everybody to undergo gum surgery, even if you suffer from the conditions in the above list. Your dentist will judge whether this treatment is suitable and likely to be of overall benefit to you.

They will take into account your level of hygiene, commitment, response to other treatment, medical history and ensuring you understand the potential complications, advantages and limitations of such a treatment.

What is the Procedure?

The actual procedure depends, as you would expect, on which treatment is being provided. The most common procedure in general dental practice would be a surgical one providing access for deep cleaning and repositioning the gum to reduce pocket depth and make cleaning easier.

The area of the mouth to undergo surgery will be made numb. This may require a couple of injections depending on the site.

A flap will then be raised to expose the area in question i.e. your gum carefully cut with a scalpel and pushed back. Some cleaning and reshaping of the bony pocket will then be performed with the normal hand instruments or ultrasonic scaler and the flap sutured back into place.

Treating posterior (back) teeth is always more difficult and some level of shrinkage of the gum always occurs. On occasions this causes the loss of a portion of the gum in-between the teeth, we call this the ‘inter-dental papilla’. This maybe an aesthic problem for you to consider. It is however worth remembering that when this shrinkage causes a reduction in pocket depth, it represents a transition to a healthier mouth that you can keep clean more effectively. As your gum shrinks inter- dental brushes will become very important in keeping these gaps clean.

What Should I do After Gum Surgery?

Your dentist will provide you with full instructions that will commonly include the following:

• Avoid brushing and flossing the area of the surgery

• Use a chlorhexidine mouthwash -1 minute rinse twice a day for a week

• Apply a cold compress to the outside of the face to reduce swelling (not normally a lot with this procedure)

• Avoid smoking for 1 week (shouldn’t be doing it anyway!)- as it delays healing

• Expect some level of pain and soreness for a couple of days and take painkillers if necessary as per the packet

• Eat a softish diet

• If bleeding occurs, apply pressure with gauze for 10- 15 minutes.
• Return in 1 week to have the sutures removed and to check on healing
• Call your dentist if you have any concerns following the procedure.