It's no secret that the third molars, or wisdom teeth, are a nuisance for many young adults. Not only do many people not have enough room for these teeth in the very back of the mouth, but some people also develop a flap of gum tissue over a partially erupted tooth, according to a review in the International Journal of Dental and Medical Research (IJDMR). If the flap of tissue, known as an operculum, becomes infected, your dental professional may recommend a procedure called an operculectomy to remove it.
As daunting as it sounds, this is a minor surgical procedure, and learning more about it will help you understand what to expect should your dentist recommend it to you or another family member.
What's an Operculum?
To understand why an individual might need an operculectomy, you should first know what an operculum is. Simply put, an operculum is a flap of excess tissue covering a partially erupted tooth, and it's usually seen on the lower third molars, according to the IJDMR review. This flap of tissue may be hard to keep clean, which can lead to food debris and bacteria becoming trapped in the area and causing inflammation, as explained by a study in the National Journal of Maxillofacial Surgery.
Pericoronitis is the clinical term commonly used when referring to the inflammation of this flap, but it can also be called operculitis. When the operculum becomes infected, the tissue becomes swollen and painful. The inflamed area may interfere with biting and closing the mouth, notes the IJDMR review. Without treatment, complications can arise, and in rare cases a patient may develop a life-threatening condition called Ludwig's angina, according to a report in the Journal of Interdisciplinary Medicine and Dental Science.
Operculectomy or Extraction?
If a patient develops pericoronitis, there are several treatment options. The most common treatments are surgically removing the flap through an operculectomy or extracting the tooth, reports the IJDMR review. Before considering whether or not removing the flap is the best remedy for the inflamed operculum, your dentist will want to treat the infection. The first step is to clean and flush the area under the flap with an antiseptic solution. In some cases, they may prescribe antibiotics.
Once the infection is cured, your dental professional will determine the best next step. Compared to a tooth extraction, removing only the flap is a less invasive option that helps preserve the tooth, according to a case report in the Journal of Health Sciences and Research. However, if the infection comes back or the wisdom tooth is causing other problems, extraction may be the best option.
Operculum Removal Procedure
Your dentist may opt to perform the operculectomy themselves or refer you to an oral surgeon. The procedure is designed to help you clean the area more easily, prevent plaque buildup and reduce the chance of inflammation coming back, explains the Journal of Health Sciences and Research report. Before the procedure, the dentist will administer an anesthetic to numb the area, and then they will remove the flap on the top of the tooth, usually using either a scalpel or laser.
The most traditional and cost-effective way a dentist can remove the tissue during an appointment is by incising with a scalpel, according to an article in the International Journal of Current Research (IJCR). However, this method may result in more bleeding and postoperative pain. Laser surgery is a cleaner procedure, as there is less bleeding and the dental professional is able to see the area more clearly. Moreover, scarring is minimal, healing is better and the overall procedure is faster.
After the procedure, your dental professional may prescribe an antiseptic mouthrinse to help you keep the area clean, as noted in the IJCR article. They may also recommend a soft diet and that you avoid smoking or eating hot foods for a day or so while the area heals. You should maintain a good oral hygiene routine to prevent plaque from accumulating in the area again and follow any special instructions your dental professional provides. After approximately a month, the tissue should be back to normal.
If you have a flap of gum tissue over a partially erupted wisdom tooth, see your dentist before it becomes inflamed or infected. It may be that some extra attention to oral hygiene in this area is all you need to stay free of painful pericoronitis — but if you do need an operculectomy, know that it is a simple, short procedure that yields good dental health results.