An elder woman during the consultation with a dentist showing panoramic x-ray in the dental office

Gum Surgery — What Do I Need To Know?

If your dental professional has recommended that you see a periodontist for gum surgery, you're probably wondering what exactly that means and what to expect from your procedure. We'll break down what a periodontist is, what conditions require gum surgery, and what you can expect when you go into your appointment so you can walk away smiling.

What is Periodontics?

According to the American Dental Association, there are currently twelve dental specialties recognized by the National Commission on Recognition of Dental Specialties and Certifying Boards. Periodontics is the specialty that focuses on the prevention, diagnosis, and treatment of conditions and diseases that affect your gums. The American Academy of Periodontology states that periodontists receive up to three years of additional training after dental school to perform non-surgical and surgical procedures that include gum surgery, dental implant placement, and cosmetic procedures.

What Conditions Require Gum Surgery?

There are different types of gum surgery depending on what you're experiencing and what exactly your periodontist is treating. Some of the most common conditions that require gum surgery include:

  • Gum recession
    If your gums are receding or pulling away from your teeth and exposing your roots, you have gum recession. The roots of your teeth don't have the same hard, protective enamel as the crowns of your teeth, so an exposed root can cause tooth sensitivity and is susceptible to tooth decay.

Some main causes of gum recession range from periodontal disease, brushing too hard, trauma from an injury or accident, ill-fitting dentures, genetics, and use of tobacco products. For brushing issues, your dental professional can show you how to brush without further damage. Periodontal disease is often treated with a non-surgical procedure called scaling and root planing. If you have ill-fitting dentures, they can be refitted for you.

More severe cases of gum recession may require a surgical procedure called a gum graft. Your periodontist will take tissue from another part of your mouth and attach it where your gums are receding. This surgery prevents further recession, reduces tooth sensitivity, and can improve the aesthetic of your smile.

  • Gummy smile or uneven gums
    If you have more gum tissue covering your teeth than you consider normal, you have what's called a gummy smile (also known as excessive gingival display if you want to sound like a professional). There are two surgery options available to you to remove tissue and show off more of your pearly white teeth. One is called a gingivectomy, where they surgically cut away a portion of your gumline. The other is called crown lengthening, in which they do the same thing but also remove some of the bone so that more of the tooth surface is above your gumline.
  • A decayed or broken tooth below the gumline
    If your tooth is damaged beneath your gumline, or if you don't have enough tooth above the gumline for a restoration, your periodontist may need to utilize a crown lengthening procedure to expose more of your tooth.
  • Periodontal disease
    Periodontal disease is caused by bacteria built up around your gumline and has turned into plaque (a soft, sticky, colorless film). According to statistics published in the Journal of Dental Research, nearly half of adults over 30 in the US have some form of gum disease. Left untreated, your tissue and bone will be destroyed by the plaque, and pockets can form around the roots of your teeth. The pockets may begin to collect more bacteria, your teeth may loosen, and your teeth could even fall out.

If you have deep pockets around your teeth from gum disease, your dental professional may refer you to a periodontist for a periodontal pocket reduction surgery. In this procedure, your gums will be folded back so they can deep clean the bacteria out of the pockets, then they will be sutured back into place, providing you with more of a chance that you can hold onto your natural teeth for the long run.

How Can You Prepare for Gum Surgery?

After your dental professional refers you to a periodontist for gum surgery, your first visit will be an initial consultation. At this appointment, they may:

  • Take additional X-rays of your mouth and head.
  • Review your medical history,
  • Ask what medications you take, including over-the-counter products, vitamins, and supplements.

Depending on the procedure you have planned and your medical history, there are some medical conditions for which your dentist may recommend antibiotics as a preventative measure to fend off infection (antibiotic prophylaxis). According to the American Dental Association, there are very few circumstances in which antibiotics should be used for preventive measures before dental procedures. 

If you're undergoing general anesthesia, your periodontist will probably recommend that you avoid food and drink for eight hours before your procedure. Be sure to follow their recommendations for your specific needs. If you have a chronic condition, like diabetes or hypertension, they will monitor you during the procedure for any complications relating to the anesthetic. Most periodontal procedures can be comfortably performed using local anesthesia only.

Recovering From the Procedure

After gum surgery, you'll be informed how to clean your teeth and gum tissue without disturbing your healing gums. The types of food you can eat may be limited for a period of time, and you may be prescribed pain medication.

While you're recovering, contact your dental professional if you have any questions or concerns. Don't wait until an oral infection develops or complications occur. Call your dentist as soon as you notice anything out of the ordinary.

You can rest assured that your dental team will be behind you every step of the way, from preparation to recovery. Surgery never sounds like fun, but it can be vital in helping you to get your oral health back into a condition you can smile about. Hopefully, with this information, you feel confident and comfortable about what to expect with your procedure. You can do this!

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This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to be a substitute for professional advice, diagnosis or treatment. Always seek the advice of your dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.

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