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What Is an Operculectomy?

When you think about wisdom teeth surgery, you probably picture impacted teeth, extraction, and time resting on the couch, enjoying ice cream and mashed potatoes. However, your wisdom teeth can cause other issues that might require surgery. Some people develop an operculum, and if it becomes problematic, your dental professional may recommend an operculectomy to remove it. This might sound daunting, but an operculectomy is a minor surgical procedure. Learn more about it so you can know what to expect.

What is a Gingival Operculum?

Simply put, a gingival operculum refers to a flap of excess tissue covering a partially erupted tooth. You may also hear it called a pericoronal flap. This flap usually occurs on wisdom teeth, but it can happen around the base of any tooth that has not erupted completely. The flap of tissue may be hard to keep clean, and food debris and germs can become trapped in the area.

The ensuing tenderness and condition is clinically referred to as pericoronitis — or sometimes operculitis. When the operculum becomes infected, the tissue becomes swollen and painful. According to the International Journal of Dental and Medical Research (an open-access, online journal published in India) you may also experience pain during biting or swallowing, halitosis, bad taste, or discharge of pus in the area. Without treatment, complications can arise, which may lead to swelling in the face, swollen lymph nodes, and jaw spasms. All these symptoms indicate the spreading of the condition into the throat and sinus cavities, which could be life-threatening. If you notice early signs of pericoronitis, contact your dentist immediately.

Operculectomy or Extraction?

How can you treat a dental operculum? According to the US-based Columbia College of Dental Medicine, a typical treatment plan begins by cleansing the affected area. The dental professional will flush away any trapped food particles or debris. You may be prescribed oral antibiotics or an oral antibacterial rinse. They may also recommend over-the-counter pain relievers to manage the pain.

  • Operculectomy might be right for you if... the wisdom tooth appears to be erupting normally. The dental professional will monitor the area to ensure the condition does not recur. Still, if symptoms return or become severe, they may recommend an operculectomy to remove the flap of gum tissue.
  • Extraction might be right for you if... the wisdom tooth appears to be wholly or partially impacted. The dental professional may choose to remove both the upper and lower wisdom to prevent biting into the gum and causing further problems.

Operculum Removal Procedure

Your dentist may opt to perform the operculectomy or refer you to an oral surgeon. The procedure will help you clean the area more easily, reducing plaque build-up and helping prevent the return of the condition. Before the procedure, the dental professional will administer a local anaesthetic to numb the area. They will then remove the flap on top of the tooth, usually with a scalpel or laser.

Suppose you are concerned about the operculectomy cost. In that case, the International Journal of Current Research (an international peer-viewed online academic research journal) states that removal by scalpel incision is "cheap, conventional, and effective". However, the scalpel may cause more bleeding and postoperative pain. Laser surgery, though more expensive, allows the dental professional to see the area more clearly. Plus, it allows for quicker procedures, less scar tissue, and better postoperative healing.

Operculectomy Aftercare Instructions

After the procedure, your dental professional may prescribe an antiseptic mouth rinse to help keep the area clean. You may also need to follow a soft diet and avoid smoking or eating hot foods while the area heals. 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 about a month, the tissue should be back to normal.

If you notice a flap of the gum tissue over a partially erupted wisdom tooth or experience any of the symptoms listed above, see your dentist before it becomes problematic. A little extra attention to oral hygiene may be all that's needed to stay free of painful pericoronitis. However, if you need an operculectomy, know that it is a simple, short procedure that yields good dental health results.

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