Everything You Need to Know About Periodontal (Gum) Surgery (2024)

Periodontal surgery is an oral surgery procedure used to correct or prevent defects in the bone or gums. It also treats various forms of gum disease and is often called gum surgery. This procedure is an excellent treatment option because it can stop and reverse damage caused by gum disease. It can also restore tooth function, prevent tooth loss, and provide a deep clean of the oral cavity. It can also be done for cosmetic reasons.

This article covers what to expect from periodontal surgery, the conditions it treats, and recovery after the procedure.

What Conditions Can Periodontal Surgery Treat?

There are various conditions and oral health issues that can be treated using periodontal surgery. They include:

• Gingivitis
• Mild periodontitis (infection of the gums)
• Moderate to advanced periodontitis

These types of diseases affect the health of the mouth and oral cavity in different ways and can lead to:

• Gum inflammation and tenderness
• Bleeding gums
• Crevices between teeth and gums, known as periodontal pockets
• Early bone loss around the teeth
• Receding gums
• The need for teeth removal

Along with the effects mentioned above, gum disease can also come with other symptoms, including:

• Loose teeth
• Pain when chewing
• Bad breath

Types of Periodontal Surgery

There are several types of periodontal surgeries, each used for a specific reason. The four main types include:

Flap Surgery

Flap surgery is performed by making small cuts into the gum to lift the tissue so that tartar and bacteria underneath can be safely and effectively removed. Afterward, the gums are stitched back to their original space so that they are snug around the tooth.

The bone is smoothed and reshaped during the surgery to prevent further plaque buildup around the teeth and gums. People with severe gum disease that cannot be treated using root planing, scaling, or antibiotics are candidates for flap surgery.

Bone Grafting

Bone grafting is a procedure that works by taking bone from somewhere else in the body and fusing it onto bones in the jaw to make up for bone loss. Synthetic bones may also be used in this type of surgery if bone from the person’s body cannot be used.

It is used to treat more severe forms of periodontal disease, such as severe or advanced periodontitis, because these diseases come with the highest risk of bone loss. Bone grafting can also be used to provide a strong base for a dental implant and reduce the depth of periodontal pockets.

Guided Tissue Regeneration

Guided tissue regeneration, or GTR, works by opening the gums and cleaning out bacteria and debris to expose damaged bone. Once that is done, a membrane is placed between the bone and the gums, allowing the bone to heal and rebuild.

Essentially, the goal of this procedure is to encourage new bone growth to address bone loss and the other issues caused by gum disease and periodontitis.

Tissue Grafting

Tissue grafting is a procedure that uses tissue removed from the roof of the mouth to restore lost gum tissue around the teeth. It can help reduce gum recession.

Preparation for Periodontal Surgery

Preparing for periodontal surgery is similar to other types of surgery, especially if you will be put under anesthesia. It’s recommended that you follow specific guidelines to prepare for surgery.

Preoperative Instructions

The following are guidelines to follow before periodontal surgery:

• Talk to your healthcare provider about any medications you’re taking.
• Avoid the consumption of alcohol for at least 24 hours before surgery.
• To prepare for recovery after surgery, buy nutritious foods such as cottage cheese, yogurt, pasta, rice, applesauce, soup, jello, pudding, oatmeal, and eggs.
• Take any antibiotics or other drugs as prescribed to avoid infection after surgery.
• Arrange for a ride home, as you will not be able to drive if you are sedated during the procedure.

Consultation and Evaluation

It’s vital to consult with a qualified periodontist before getting periodontal surgery. They will examine your current oral health and health history to determine if the surgery is right for you. A periodontist must understand your oral health fully so that they can properly tailor the surgery to your needs and avoid unnecessary complications. The dental healthcare provider will also check to see if any other oral health issues need to be addressed before the surgery.

What Happens During a Periodontal Surgery Procedure?

During the procedure, you may have to be sedated, and varying surgical techniques will be used depending on the issues, such as the ones mentioned above.

Anesthesia and Sedation

There are three types of sedation used during dental surgeries. They include:

• Local anesthesia: A numbing medication is injected directly into the mouth so the person doesn’t feel the work being done in that area. They are awake during the procedure but numbed in the proper location for a pain-free procedure. It is generally safe and has only a few side effects, including numb lips, cheeks, or gums, for a few hours after surgery.
• IV sedation: This method uses an intravenous catheter to deliver medication into the bloodstream to sedate someone for a specific amount of time. It is generally safe but can have after-effects, including headaches, nausea, and drowsiness.
• General anesthesia: General anesthesia essentially puts you to sleep. It is administered via inhaling a gas. This type of surgery is used for more intensive periodontal procedures and is often the primary type used for periodontal surgery. It’s also frequently used in surgeries that will take a longer time. It's rarely used in periodontal surgery.

Recovery and Postoperative Care

Following the procedure, there will be a period of recovery and some postoperative care guidelines to follow to limit the risk of complications.

Postoperative Instructions

In the first 24 to 48 hours following surgery, there are things you can do to reduce discomfort from the procedure, such as:

• Drinking or eating foods that are at room temperature
• Using a tea bag, clean cloth, or gauze to apply pressure to the gums to stop bleeding
• Using ice applied to the outside of the face to decrease discomfort or swelling in the 20-10 method in the first 24 hours
• After 24 hours but before 48 hours, you can switch to a warm, moist heat source on the face for swelling
• Avoid flossing or brushing the area

In the days that follow, you should also:

• Take any prescribed antibiotics as directed
• Take over-the-counter pain relievers if given the go-ahead from your healthcare provider
• Start eating non-abrasive foods, such as mashed potatoes, cottage cheese, and pasta

Recovery Timeline

Recovering from periodontal surgery depends on several factors, including:

• The type of procedure
• How severe the issue was
• Your overall state of health

Typically, a follow-up appointment will occur around one to two weeks to check on healing and remove stitches. Aside from that, the healing process is highly personalized and can take anywhere from a few weeks to a few months.

During that time, your dental healthcare provider will instruct you on what to eat, oral hygiene practices to follow, and how to keep your risk of infection or complications to a minimum. The healing stages are as follows: