Periodontal Surgery to Remove Gum & Bone Over Teeth

Poor dental habits can lead to plaque, gingivitis, and, if untreated, periodontal disease. Sabine O. Geerts with the Department of Operative Dentistry in Belgium found oral bacteria and their endotoxins circulating in the bloodstream of patients with periodontal disease. The bacteria attaches to coronary arterial plaque and contributes to arterial clot formation. Thus, patients with periodontal disease face twice the risk of developing coronary artery disease than those without periodontal disease. Cleaning and medication can treat mild cases, but severe periodontal disease may warrant surgery.

Periodontal Surgery to Remove Gum and Bone over Teeth

• Mild periodontal disease is treated with tartar removal (scaling), and root planing to prevent bacterial adhesion. Periodontal surgery is suggested for cases unresponsive to non-invasive therapy and in severe disease, such as gum recession to a depth of over 5 millimeters.

  Surgery involves gum removal to expose the roots of a tooth and allow more thorough cleaning and planing. Where there is extensive damage to the tooth, the periodontist may also remove some of the bone over the teeth to change the contours of the socket and repair existing damage.

Pre-Surgery Preparation

• Preparing for periodontal surgery can involve an x-ray of the region of interest. Close detailing of the area allows the periodontist to determine the extent of disease as well as the overall health of the area around it.

  According to the Columbia University College of Dental Medicine (CUCDM), the periodontist will ensure good oral hygiene is present before removing plaque and tartar from around the teeth prior to the procedure. He or she will also decide if your health or any medication you might be consuming at the time may interfere with the procedure.

Flap Surgery

• One feature of periodontitis is the formation of deep pockets, or sulci (plural), in the gumline. A deep sulcus allows accumulation of bacteria, which builds up into tartar over time. This eventually prevents the gum from adhering to the tooth securely, resulting in the possibility of tooth loss.

  Flap surgery is a common dental procedure that involves lifting back the gums to remove tartar buildup. Following tartar removal, the depth of the pocket is reduced when the periodontist sutures the gums to fit closely around the tooth.

Bone and Tissue Grafts

• Other than the slight removal of gum and bone over teeth in flap surgery, bone or tissue grafts may be needed to aid the healing process. A graft can replace or encourage new bone or gum tissue to grow in areas damaged by periodontitis.

  The periodontal surgery involved sees insertion of a tiny piece of mesh "fabric" between the gum and bone tissue. It prevents gum tissue from displacing bone growth and facilitates the regeneration of bone and connective tissue, thus holding the tooth in its socket.

Post-Surgery Care

• Painkillers are prescribed for three days following the procedure. CUCDM also mentions that antibiotics and prescription mouthwash are also provided. The antibiotics promote healing while the mouthwash kills any oral bacteria present.

  They also advise periodic application of ice in 20-minute intervals to the affected area within 24 hours post-surgery to prevent swelling, which can hinder healing. Similarly, the site shouldn't be brushed until the dressing comes off and the stitches dissolve. Instead, the university recommends a warm salt rinse after eating foods that are cool, bland, soft and easy to chew.