Sometimes, periodontal surgery may be needed to treat certain gum diseases and conditions, such as gingivitis or periodontitis. This type of surgery is commonly known as gum surgery.

The procedure aims to treat the gum disease and any damage it may have caused by:

• regrowing damaged bones and tissues
• preventing tooth loss
• reducing gum gaps between teeth, known as black triangles
• reshaping the jaw hone to lower the risk for bacterial growth in bone crevices
• eliminating bacteria and infection

What conditions can gum surgery treat?

Periodontal surgery can treat many conditions, including gingivitis.

Gum diseases such as gingivitis and periodontitis may require surgical treatment.

Gingivitis is a mild form of gum disease that can cause gum redness, swelling, and bleeding. Most often, gingivitis occurs due to poor oral hygiene, plaque, and tartar buildup. Professional treatment can reverse the condition.

Periodontitis is a more severe form of gum disease in which gingivitis has worsened and advanced, leading to an inflammatory response that destroys bone and tissues.

During this inflammatory process, the gums begin to separate from the teeth. This causes spaces called pockets to develop, which in turn trap bacteria and lead to infection.

As a result, tooth loss and bone damage can occur.

Types of surgical procedures

Which kind of surgery we perform depends on the type and severity of the gum disease.

Before surgery, we might give the gums a deep clean. One procedure known as deep scaling can remove tartar and bacteria from teeth and gums.

Another procedure known as root planing can smooth the surfaces of the roots of the teeth, meaning that there are fewer places for tartar and bacteria to build up. This procedure also removes any tartar that is on the root.

Deep scaling and root planing usually occur at the same time.

Flap surgery

Flap surgery is especially helpful for people who have tartar deposits in deep pockets. The procedure involves lifting the gums off of the teeth to remove tartar buildup.

After the surgeon has cleaned the area and removed the tartar, they will stitch the gums into place to fit around the teeth. Sometimes, the bone may require reshaping during this procedure.

Bone grafting

When the bone that surrounds the root of the tooth is damaged or destroyed, a person may need a bone graft. This procedure involves replacing the damaged bone with new bone. This bone may be the person’s bone, a manufactured bone, or donated bone.

The goal of bone grafting is to hold the tooth in place and help it to regrow.

Guided tissue regeneration

During this procedure, we will place a small piece of mesh-like material between a person’s bone and gum tissue.

The material prevents the gum from growing into space where bone should be, allowing the bone and connective tissue to regrow.

Tissue grafting

The type of surgery performed will be based on several factors, such as the condition of the gums.

A lowered gum line, known as gum line recession, is caused by the loss of gum tissue and may require soft tissue grafting to reduce the risk of further damage.

During this procedure, a dental surgeon typically removes tissue from one part of the body and re-attaches it to the area where the gum has receded. The tissue often comes from the roof of the mouth.

Tissue grafting not only reduces the risk for further damage but also covers any exposed roots.

Other treatment options include:

• Laser therapy: Although no current evidence fully supports laser therapy, some dentists use it to reduce the size of pockets and restore damaged connective tissue.
• Tissue-stimulating proteins: This procedure involves using a protein-containing gel to stimulate bone and tissue growth.

Preparing for gum surgery

Before a person has a gum surgery we will perform a pre-operative exam to make sure it is safe to have surgery.

During this exam, our team will likely:

• take a medical history review and do an exam
• examine the teeth, mouth, and jaw to check for stability and health
• check for any infections, abscesses, or other lesions that could make healing from surgery more complicated
• discuss the risks and benefits of the operation, and receive permission or consent to move forward with the surgery

What happens during surgery

Depending on the type of procedure, a range of things may take place.

Most gum surgery procedures take around 2 hours to complete.

In some cases, the surgery will require a person to be asleep or partially asleep during the procedure. Other times, the surgery only involves the use of a local anesthetic to numb the gums. The injection of the numbing medication can be mildly uncomfortable.

During the procedure, we use sterile equipment, including instruments and drapes, to lower the risk of infection.

After making small incisions or cuts along the gum line, our dentist will lift the gums away from the teeth. This allows us to see the roots better so that we can remove and clean away any tartar, plaque, or infection.

Following this deep cleaning, we can perform other procedures, such as gum reshaping, bone regeneration procedures, or other planned procedures.

Once the planned dental surgery is complete, the surgeon will stitch the gums back into place, using fine thread stitches. We will remove the stitches 7 to 10 days after surgery.

Recovery

Antiseptic mouthwash may help to prevent infection after surgery.

Following any dental procedure, we will provide detailed instructions on how to achieve the best possible recovery. Recovery times will depend on the extent of the procedure taking place

Typically, patient will require pain relief medications in the days after gum surgery.

We may also recommend:

• using an antiseptic mouthwash to keep the area clean and to avoid infection
• avoiding strenuous exercise
• eating soft foods in the days following surgery
• not smoking

The next appointment will be scheduled after 1–2 weeks time. During this appointment, the surgeon will check how the gums are healing and, if required, remove any stitches.

A person’s gums will look and feel different after surgery. The gums and teeth will heal, tighten, and become firmer and stronger. Some people may have tooth sensitivity to hot or cold temperatures and may find relief by using desensitizing toothpaste.

Dentists will discuss a follow-up schedule to maintain good oral health in the future.

Can gum disease be prevented?

Since gum disease is caused by bacterial overgrowth, plaque, and tartar buildup, proper oral hygiene is usually effective in preventing and reversing the condition.

In most cases, seeking regular dental care accompanied by brushing and flossing two times a day is enough to prevent gum disease from occurring.

Outlook

If left untreated, gum disease may lead to the development of a variety of health problems, such as cardiovascular disease, diabetes, and pre-term, low-birth-weight babies.

Gum disease can also become a serious health condition affecting the teeth, gums, and bones, leading to infection and bone and tissue death. This may require extensive surgery to repair and treat the condition.

Reducing risk factors, maintaining a good oral hygiene, and keeping routine dental appointments can reduce the risk and severity of gum disease.

Gum contouring / grafting/Gum reshaping-Gum reshaping can improve a “gummy” smile in which teeth appear too short, or where the gum line appears uneven. A small amount of gum tissue — and excess bone tissue if necessary — is removed and contoured to expose more of the teeth. This procedure can be done to one tooth to even the gum line, or to several teeth to expose a natural, broadsmile.

Color of gums play a crucial role in aesthetics of a smile. Normal color of a gum should be coral pink, but due to deposition of melanin gums appear to be darker. The most common cause of darker pigments in the gums is  genetics. Excess melanin can build up in the gums, making them look brown or black instead of pink Several lifestyle factors like smoking tobacco, several medications or amalgam tattoo could also be the reason for darker gums. The extra pigment does not indicate any disease or dysfunction.Patients seek treatment because of an aesthetic preference for pink gums that showcase their teeth better.Gum depigmentation with the help of lasers is a minimally invasive procedure where the laser energy is used to peel off the gingival epithelium. Laser causes less bleeding, post opt complications like pain, swelling and infection are also less compared to surgical techniques.

Questions

What Is the Healing Process Like?

Patients who utilize a dental laser can expect minor discomfort and no complications after the treatment. Patients with very sensitive gums may experience some discomfort for a short period of time. Patients can expect to be able to speak and eat normally immediately after the treatment is completed.

Everything heals in about 2 weeks .

How Long Does the Gum De-pigmentation Treatment Last?

One gum depigmentation treatment can last 20 years or up to a lifetime.

How Long Does the Treatment Take?

The procedure takes 20-45  minutes depending on the colour and size of the dark patch. We will give you local anaesthetic to make the procedure as comfortable as possible .

What happens if I still have a few pigments left once the gums have healed.

On your review appointment we can go over the areas that you can still see some pigmentation .

Can I smoke ?

We encourage all smokers to stop smoking completely after the procedure as smoking is one of the causes of pigmentation.

You need to stop smoking for at least 7 days after the procedure .

The treatment process

Laser Gum Depigmentation vaporizes and removes a thin top layer of the gum tissue, destroying the cells that produce melanin. As new tissue is created during healing, it tends to be pink rather than brown. The treatment may require a local anesthetic injection and has a short recovery time with manageable discomfort. Sometime depending on the colour and depth of the dark patch, it could take several sessions to achieve the desired degree of lightening.

Who Is a Candidate?

The main guideline is simply that the gums must be healthy. We can assess your gum health at the free consultation that you have with our dentist.

This cosmetic treatment is not suitable for:

• Patients with oral disease
• Patients with dark gums caused by periodontal disease (this is not a surface pigment problem)
• Patients taking blood thinners (these can cause excessive bleeding during treatment)
• Patients with thin gum tissue or prominent tooth roots (they may experience ongoing sensitivity if roots are accidentally exposed by the removal of gum tissue)

Our mouth is the gateway to all the things that go into our bodies. It is a window that provides essential functions to keep us alive for example eating, drinking, etc. On the other hand, our mouth is a hub of various species of bacteria that live, grow and multiply every second. Some of these are good for our health, however; most of them affect the mouth and body negatively. That is why it is essential to keep good oral hygiene, including brushing and flossing. Often brushing and flossing alone cannot completely remove the bacteria and food debris from the hard-to-reach area (between the teeth, gum margins, gum lines, or below gum lines) in the mouth.

These bacteria and food remnants if left uncleaned, produces plaque. This plaque is soft in nature and can be visible as whitish-yellow or light brown on the teeth, on the gum lines, and between the teeth. Note that this plaque can be easily cleaned and removed using the correct methods of brushing and flossing. However, this plaque can grow and mature into a hard and tenacious substance known as calculus or tartar if left uncleaned. The tartar is tenacious and cannot be removed using a toothbrush or floss. This can then be removed professionally by a skilled dentist or dental hygienist.

What is scaling and polishing?

Scaling is a professional method of removing tartar using hand and power-driven instruments. It is a non-surgical procedure that meticulously removes the tartar buildup and flushes the bacteria out. In addition to the tartar and bacteria, scaling also effectively removes the superficial stains (present on the enamel surface). On the other hand, polishing is also a non-surgical procedure that is recommended after the scaling. It removes the remaining stains after the scaling, smoothens the teeth surface, and brings out the natural color of the teeth.

Why scaling and polishing?

Plaque and tartar induce inflammation in the gums leading to bleeding at initial stages and destruction of the tooth-supporting structures at later or severe stages. It saves our gums and teeth from developing gingivitis (the initial stage of gum disease) and periodontitis (a severe form of gum disease). Moreover, periodontal disease will lead to tooth mobility and tooth loss if left untreated. Besides, plaque and tartar accumulation will produce bad breath and dental cavities.

 

Procedure

Our dentists or dental hygienist will first make sure to perform a thorough clinical and radio graphical examination. Based on the clinical and radio graphical examinations, a treatment and care plan is devised. If you have not had a dental cleaning in a long time, your gums may be sensitive. If this is the case, an anesthetic gel or local anesthesia is used to make your procedure more comfortable.

Hand and power-driven instruments such as scalers and ultrasonic can also be used to remove the plaque and tartar from the gums and beneath the gums as well. It might take an hour or multiple visits for a dental cleaning; mostly it depends on the amount of tartar build-up.

Sometimes, local anesthesia (a numbing agent) is used to numb the treatment site. This is usually the case when a patient feels pain or the tartar is heave and deep into the gum pockets.

Once the treatment is completed either in a single or more than one visit, it is followed by polishing. Polishing is done at the last visit.

Post-procedure, mild soreness can be sensed, and it will relieve after few days. Over-the-counter medications can be used in case of severe pain, or consult your dentist or dental hygienist.