• Gum surgery is primarily performed to prevent complications that occur due to advanced gum disease (periodontitis), such as tooth loss and bone damage. Surgery can be performed to treat severe gum recession that is not directly caused by periodontitis for example, trauma/injury or forceful tooth brushing.
• Removing excess gum tissue in order to improve the appearance of your smile is another potential reason for surgery.
• If you are anadvised for gum surgery, learning about the different types of surgeries available, as well as the overall preparatory/recovery processes involved, will hopefully help you feel more comfortable and at ease going into it.
What is Gum Surgery?
• Gum surgery is performed under local anaesthesia by a periodontist, a dentist who specialises in treating gum disease.
• In addition to local anaesthesia, patients may be given a sedative (orally or intravenously) to make them deeply relaxed, if not asleep, during the procedure.
• There are different types of gum surgeries, and the one chosen depends on your condition, its severity, and any aesthetic goals.
Types of gum surgery include:
Gingival flap surgery (pocket reduction): The gums are folded back from your teeth and the doctor performs a deep cleaning to remove bacteria (called scaling and root planing). The gum tissue is then stitched back, and secured firmly around your teeth. Sometimes, bone reshaping is also performed (called osseous surgery).
Gum regeneration: Gums are folded back, bacteria is removed, and then a bone graft is used to stimulate regrowth of the gum tissue around your teeth. The bone graft may be made from synthetic material or come from your own jawbone, hip, or lower leg, a cadaver, or an animal. A synthetic or donor membrane is then placed over the bone to prevent any nearby tissues from growing into the bone. Sometimes, tissue-stimulating proteins are also applied to promote healthy bone growth.
Crown lengthening: Excess gum tissue is removed to make the teeth look longer.
Soft tissue grafting: Donor tissue or tissue taken from somewhere else in your mouth is attached to the receding gums.
Contraindications
Various medical circumstances/conditions may prevent you from being able to undergo gum surgery. These include:
• Certain uncontrolled medical conditions (eg. angina, diabetes, high blood pressure)
• Bleeding disorder
• Heart attack or stroke within the last six months
• Unrealistic expectations for the functional or aesthetic outcome of the surgery
• Elective periodontal surgery should also be avoided in pregnant patients, if possible, especially during the first trimester and the second half of the third trimester.
Purpose of Gum Surgery
• The main purpose of gum surgery is to treat periodontitis, which is a serious infection of the tissue that surrounds and supports the teeth.
• With periodontitis, the gum pulls away from the teeth and creates pockets where bacteria become trapped and form a sticky film called plaque. Once the plaque get beneath the gum line, tissues and bones in the mouth may become damaged. This can ultimately lead to tooth loss if not treated.
• Symptoms and signs of periodontitis include receding gums, persistent bad breath, loose or sensitive teeth, and poor tooth alignment.
• Surgical treatment of periodontitis is warranted when the gum infection advances despite conservative therapies (eg. cleanings to remove plaque and antibiotic mouthwashes/gels/pills).