While you may think that some loss of teeth is inevitable with aging, it is actually possible for all of your teeth to last a lifetime. One of the ways you can achieve this goal is to avoid periodontal (gum) disease (“peri” – around; “odont” – tooth), which is caused by bacteria that attack the tissues around the teeth. Unfortunately, you may not even realize you have gum disease as the signs and symptoms are not always as apparent to you as they are to a dental professional.
When periodontal pockets develop, the first step in treating them is usually a procedure called scaling and root planing. This procedure is a deep cleaning above and below the gum line using ultrasonic and manual instrumentation. If this isn't effective, then periodontal surgery is considered. Gum disease surgery isn't a cure for periodontal disease — but it helps create an environment that makes it easier to maintain your periodontal health. And even if you're prone to gum disease, proper professional treatment and regular care at home can help keep your gums healthy for as long as possible.
If periodontal disease is left untreated, it will eventually destroy supporting tissue and bone around the teeth, forming deeper pockets for bacteria to potentially live in. As bacteria develops around the teeth, they can accumulate and advance under the gum tissue. Once under the gum tissue, these bacteria can cause further bone and tissue loss. If too much bone is lost, teeth may need to be extracted.
The Goals of Flap Surgery
Used to treat moderate to severe periodontal disease, gum disease surgery or osseous surgery is an effective procedure to reduce pockets and control infection. During osseous surgery, the gum tissue is folded back and the disease-causing bacteria is removed before the gum tissue is put back into place. In addition to bacteria removal, damaged bone may be smoothed to limit areas where bacteria can hide – allowing gum tissue to better reattach to healthy bone.
Another goal is the regeneration of bone and periodontal ligament which may have been lost to the disease. A variety of techniques may be used to accomplish this, including high-tech methods of bone grafting and the use of biological aids. These approaches help restore the gums to their normal form and function, and promote the healthy and secure anchoring of teeth.
Before the procedure, a local anesthetic is used to numb the surgical area. Typically, no discomfort is felt as your periodontist removes bacteria and smoothes your damaged bone around your teeth. Following the surgery, the treated area may be a little tender, sore, or swollen; pain medications and antibiotics may be prescribed to help relieve discomfort and prevent infection from occurring.
In most cases, recovery time after osseous surgery is minimal, and patients can resume their normal routines the day after surgery.
Post-surgical care Instructions for Gum Disease Surgery
Rest with your head elevated when you arrive at home after the procedure. We ask that you please limit your physical activity and keep moving to a minimum for the first 24-hours.
For the first 4-5 hours after the surgery, we recommend placing an ice bag to your face in 20-minute intervals. This will help reduce facial swelling. If needed, you can use an ice bag for 24-hours.
Please take anti-inflammatory medications (NSAIDs) to prevent inflammation, swelling, and pain. For the next 4-5 days, we suggest taking 400mg-800mg of Ibuprofen every six hours to reduce swelling and pain and quicken healing. DO NOT take more than 2400mg in a 24-hour period. If you experience excessive pain or discomfort, take the narcotic that has been prescribed to you. If you do not have one, please call our office and the doctor will call in a prescription to your pharmacy. Please take as directed along with the NSAID. If you’ve been prescribed an antibiotic, please take as directed. We ask that you finish the entire dosage. If any of the medications are causing you extreme nausea, itching, or a rash; discontinue its use and call our office immediately.
IF YOU EXPERIENCE BLEEDING
For the next few days following your surgery, some minor oozing may occur and is no cause for alarm. Gently rinse your mouth out with iced water or iced tea (tea contains tannic acid which can help stop the bleeding). We ask that you refrain from smoking and drinking alcohol as these activities will interfere with blood clotting and healing of the surgical site. If your bleeding continues, apply pressure to the surgical site by pinching the area with a moistened piece of gauze for 20 minutes. If your bleeding is moderate to heavy and has continued for a few hours without stopping, please call our office immediately.
When you arrive home after surgery, you may have something very soft to eat or cold to drink. In the evening on the day of your surgery, we recommend eating a soft, bland meal as this is usually the best way to help you feel better. For the first week, please do not eat anything hard or crunchy.
CARING FOR YOUR MOUTH
When possible, we will place a bandage over the surgical area to help with your comfort. Please DO NOT brush the bandaged areas. If the bandage should become loose or fall out and you are comfortable, then continue to avoid brushing the surgical areas. If the surgical area is uncomfortable without the bandage, then please call our office so that we can place a new bandage over the area. Please continue your regular oral hygiene habits on all other areas in your mouth. Please use an antiseptic mouthwash at least once in the morning and once at night before bed until your next appointment with our office. You can also swab the bandaged area with a cotton swab dipped in an antiseptic mouthwash every morning, every night before bed, and after eating and drinking.
If you have any questions or concerns, please call our office at 847-658-3355.