Why
do I need periodontal surgery?
Surgery has been recommended to correct or improve a problem with your gums
that is affecting your periodontal health. The choice of surgical
technique depends on the type and severity of the disease and other conditions
in your mouth.
Some reasons
why surgery may be indicated include:
To clean and reduce periodontal pockets. Some gum pockets
are too deep for you to clean with daily home oral care and for your dentist to
clean during professional care visits. Surgery is thus necessary to
remove plaque and calculus below the gum line. The pockets & position of
the gums are reduced to minimize areas where disease-causing bacteria can
hide. During this procedure, the gum tissue is folded away from the tooth
and disease-causing bacteria removed from the root surface by scaling and root
planning with hand and ultrasonic instruments, before securing the tissue into
place with stitches. This type of surgery is known as open flap debridement/ pocket reduction surgery.
To
reshape damaged bone. In some instances where bone loss has occurred
around teeth, aside from gaining access to clean the root surfaces of affected
teeth, surgery might be done to smoothen the
uneven or irregular surface of the damaged bone. This allows the gum
tissue to be repositioned, promoting healing of the gum pocket. This type
of surgery is known as osseous surgery.
To regenerate or “regrow” tissue. If the disease
is left untreated, damage to gum and bone attachment to the teeth will
continue. Plaque accumulates along the roots of the teeth and this results in infection that can cause more serious damage
to the bone supporting the teeth. Some surgical procedures may be
recommended to regenerate part of the bone and supporting tissues previously
lost to the disease. These techniques (use of membranes and bone grafts)
aim to partially restore and strengthen the support of the teeth so they can
function longer. This type of surgery is known as guided tissue
regeneration/ bone graft surgery.
To expose more of the tooth structure to make dental restoration
possible. When a tooth is decayed, badly broken down below the gum
line or has a short clinical crown height, there is insufficient tooth
structure for a restoration, such as a crown or a bridge. In such
instances, your dentist may advise surgery to adjust the gum and bone level to
expose more of the tooth structure. During this procedure, gum and bone
tissue is reshaped to expose the extent of the decay or fracture or more tooth
structure. This will provide both sufficient tooth structure and
accessibility for subsequent placement of a restoration. This type of surgery
is known as crown lengthening surgery.
 Before crown lengthening surgery
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After crown lengthening surgery
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After crown is fitted
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To improve appearance/ aesthetics of your gum line. Exposed root
surfaces of teeth due to gum recession may affect your smile (‘toothy’ smile)
and/or may be sensitive to hot or cold foods and liquids. The gums may
have receded for a variety of reasons, including aggressive toothbrushing
or periodontal disease. Your periodontist will
help you to identify contributing factors to the problem. Once these
factors are controlled, a soft tissue graft
procedure can repair the defect and help to prevent additional recession.
During this procedure, gum tissue from the roof of your mouth (palate) or from
other areas in your mouth is taken to cover the exposed root. This can
even out your gum line and reduce root sensitivity. This type of surgery
is known as mucogingival surgery.
Correcting
a toothy smile
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Before surgery - Short clinical crowns
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2 months after surgery
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Mucogingival Surgery
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Before surgery
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Three months after surgery
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If you have a ‘gummy’ smile because your teeth appear short (teeth are actually
of the proper length but are covered with too much gum tissue), a crown
lengthening procedure may be done to improve your gum line and to expose a
natural, broad smile.
Will
it hurt?
Your periodontist will use a local anaesthetic to numb the surgical area. During the
procedure, you should feel little or no discomfort. Following surgery, the treated area may be slightly tender, sore or
swollen. You may be prescribed analgesics (painkillers) to relieve
post-surgical discomfort; antibiotics to prevent infection and an antibacterial
rinse to keep the surgical site clean. If you take your medicine as
directed and follow your periodontist’s instructions,
you will most likely experience minimal discomfort following surgery.
Most patients resume their normal routines the day after surgery.
Will
I be able to speak and eat normally after surgery?
You should be able to speak normally after the local anaesthetic
has worn off. It is important to eat a well-balanced
diet after surgery. Avoid chewing hard foods in the surgical area
for several days. Following some types of periodontal surgery, the teeth
may be more sensitive to hot and cold. The sensitivity will lessen during
the first few weeks after surgery.
Will
I need to have surgery again?
In most cases, you will not need surgery in the same area again. However,
in certain cases, retreatment or additional surgery
may be needed. Proper oral hygiene procedures at home and regular
professional care are key factors in achieving a successful long-term
result.
What
can I do to help control the disease?
Periodontal disease can and will recur if you do not follow a strict program of
supportive therapy. You play a major role in preventing further outbreaks
of disease. In addition to keeping to regular professional check-ups and
cleanings with your dentist, your home oral care routine is important. Daily
removal of plaque by proper brushing, flossing and other recommended cleaning
methods will help ensure you keep your teeth for a lifetime.
