Why do I need periodontal surgery?

Surgery has been recommended to correct or improve a periodontal problem that is affecting your oral health. The choice of surgical technique depends on the type and severity of the disease and other conditions in your mouth.

Following are some of the reasons why surgery may be necessary:

*To clean and reduce periodontal pockets

As you probably  have learned by now, the main cause of periodontal diseases is plaque, a sticky, colorless film that constantly forms on your teeth. If the plaque is not removed thoroughly, toxins or poisons produced by bacteria in the plaque irritate the gums and destroy supporting tissues around the teeth, forming pockets. Eventually the plaque hardens into a rough deposit called calculus or tartar. Over time, as more plaque and calculus build up, the gums continue to pull away from the teeth. Gum and bone attachment is lost and pockets deepen.

You cannot predictably keep deep pockets clean and free of plaque just by brushing and flossing. The pockets may have become too deep even for your dentist or hygienist to clean them adequately. Therefore, your periodontist may decide that surgery is necessary to remove plaque and calculus below the gumline. Your periodontist will reduce the pockets and position the gums to eliminate areas where disease-causing bacteria can hide.

*To regenerate or "regrow" tissue

If the disease goes untreated, gum and bone attachment to the teeth continues to be destroyed. Plaque moves down the roots of the teeth, resulting in infection which may cause more serious damage to the bone that supports the teeth. Affected teeth can become loose and eventually may be lost.

Your periodontist may recommend surgery to attempt to regenerate or "regrow" gum and bone tissue so you can keep your natural teeth.

*To expose more of the tooth structure to make dental repair possible

Many times a tooth is decayed or broken below the gumline. Often periodontal surgery is needed to adjust the gum level and expose more of the tooth so the dentist can repair the damage.

*To improve appearance

In certain instances, aesthetics can be improved with periodontal surgery. For example, a "toothy" smile, caused by gum recession, or shrinkage, often can be corrected by gum grafting techniques. Gum grafting also helps prevent further gum recession. Likewise, teeth can be made to look longer for a patient with a "gummy" smile. These are just two examples of how periodontal surgery can improve your appearance.

Will it hurt?

You should feel little or no discomfort during the procedure. Your periodontist will use an anesthetic to numb the surgical area. There are many techniques available for relieving anxiety during surgery. You can speak to your periodontist about these options.

Following surgery, the affected area will be tender or sore. Swelling of the surgical area may occur. Your periodontist will probably prescribe a medication to relieve post-surgical discomfort. Antibiotics or antibacterial rinses also may be prescribed. If you take your medications as directed and follow your periodontist's instruction, you probably will experience only minor discomfort. 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 anesthetic has worn off. It is important to eat a well-balanced, nutritious diet after surgery. You may need to avoid chewing some foods in the surgical area for a few days.

Following some types of periodontal surgery, the teeth may be more sensitive to hot and cold. This will diminish considerably during the first few weeks after surgery.

When will I need to return to my periodontist?

Usually patients return for post-surgical treatment in five to 10 days. At this time, it may be necessary to remove any stitches and cleanse the surgical area. Additional follow-up appointments may be required to evaluate your healing response and review proper or oral hygiene procedures.

Will I ever need surgery again?

In most instances, you will not need surgery in the same area again. However, in certain cases, retreatment or additional surgery may be needed. As you have learned, you may be prone to periodontal diseases that require constant and careful attention. Like other chronic diseases, such as diabetes, hypertension and asthma, there is no cure. Periodontal surgery helps control disease an prevent further destruction to the gums and bone, thereby minimizing tooth loss.

What can I do to help control the disease?

Periodontal diseases can and will recur if you do not follow a strict program of supportive periodontal therapy. You play the major role in preventing further outbreaks of disease. Nothing will help you maintain the results of professional treatment better than daily removal of plaque by proper brushing, flossing and other cleaning methods recommended for you.

There are many benefits to safeguarding your periodontal health. By retaining your natural teeth, you can chew more comfortably and enjoy better digestion. You also keep a healthy smile which is a natural asset to your appearance. For feeling good and looking good, nothing works better than your natural teeth. When your efforts are combined with regular visits to your dentist and periodontist, you have an excellent chance of keeping your teeth for a lifetime.