Periodontal surgery is a necessary treatment for many patients with periodontitis, the chronic phase of periodontal (gum) disease.
Periodontal disease is caused by the buildup of dental plaque. If plaque is not removed properly with brushing, it mineralizes into tartar (calculus). This early stage is gingivitis, characterized by gum inflammation and bleeding.
When tartar has been present for a long time, the gum separates from the tooth, forming a periodontal pocket, and the bone that supports the tooth begins to be lost gradually. At this stage it is no longer called gingivitis; it has progressed to periodontitis.
In advanced cases, periodontal pockets are very deep (greater than 6 mm) and cannot be eliminated with scaling and root planing alone; a surgical procedure is required to remove them.
What are the consequences of periodontal disease?
Gingivitis presents with redness, inflammation, and bleeding of the gums. It is usually easy to treat a professional dental cleaning (prophylaxis) is often enough to reverse it.
Periodontitis results from gingivitis that was not treated in time and is the most severe phase of periodontal disease. It directly damages the tooth root, causes gum recession, and can lead to tooth loss.
How is periodontal disease diagnosed?
When a patient shows signs of periodontal disease, the periodontist performs an oral examination to confirm the diagnosis and determine the stage.
This includes dental radiographs and periodontal probing, which measures the depth of tartar and pocketing beneath the gums.
With these findings, the specialist can assess the degree of gum involvement and bone loss for each tooth.
How is periodontal surgery performed?
During surgery, the periodontist creates a small gum flap with a scalpel to gain access and eliminate the periodontal pockets that have formed along the tooth.
Using ultrasonic tips and curettes, the periodontist thoroughly cleans and scales the root surfaces, removing tartar, plaque, and biofilm from within the pockets. In patients with severe periodontitis, this procedure is commonly required around multiple teeth.
If there is significant damage to the bony tissues, the specialist may place small bone grafts and membranes to help regain lost bone and improve the quality of the tissues that support the teeth.
After completing the cleaning and any necessary regenerative procedures, the periodontist repositions the gum flap and secures it with sutures.
What is the post-operative course like?
After surgery, slight bleeding may occur. This is not a cause for concern and should gradually subside.
Swelling at the surgical site is also common and varies according to each patient’s inflammatory response, the type of surgery, and its extent.
Inflammation typically lasts about four days. The periodontist will prescribe anti-inflammatory medication and recommend using ice on the treated area.
The day after surgery, avoid hot, acidic, or irritating foods, as well as alcohol. Opt for soft, low-fat foods, chewing on the side opposite the surgical area.
By the second day, you can usually return to a normal diet, but avoid crumbly foods (e.g., chips, popcorn).
For the first four days, brush while avoiding the surgical area. After that and for two weeks brush normally using a post-surgical (soft) toothbrush and rinse with chlorhexidine as directed.
The importance of follow-up visits
Periodontitis is a chronic condition. Surgery is sometimes indispensable to control it, but it does not cure it.
Effective control requires regular maintenance visits with the periodontist and meticulous oral higiene daily brushing and the use of prescribed rinses and interdental aids.
This article describes the periodontal surgery procedure in general terms. Whether surgery is indicated depends on a thorough professional evaluation; not all gum disease cases require surgery. To determine if this treatment is appropriate for you, a clinical assessment by Dr. Daniel Fernández is necessary.
If you’ve been told you may need periodontal surgery or have advanced gum disease symptoms, the next step is a professional evaluation. Schedule an appointment via WhatsApp, phone call, or our online form; our assistant will coordinate your visit.
