Overview

Gum disease is caused by the germs (bacteria) which live in your mouth. The bacteria sticks to your teeth, irritates the gums and makes them bleed. Gum disease can eventually destroy the gum and bone which support your teeth if it is not treated.

You will have already had some treatment for your gum disease (periodontal treatment). This would have included cleaning (scaling) your teeth, and teaching you how to clean your teeth to remove the plaque above the gum.

If you still have some gum disease, and need treatment for your gums and surrounding teeth and bone, you might have periodontal surgery.

Surgery is used for any gum disease that needs more treatment after your dentist has carried out deep cleaning of your teeth.

Benefits of periodontal surgery

• By lifting the gum away from the teeth during surgery, we can do a deeper clean and remove more plaque. This allows us to control the gum disease better.
• By re-shaping the gum we can make it easier for you to clean the teeth and maintain better gum health.

The result of the surgery will depend on how well you brush your teeth in the future, and how severe your gum disease was at the start of treatment.

Giving your permission (consent)

We want to involve you in decisions about your care and treatment. If you decide to go ahead, you will be asked to sign a consent form. This states that you agree to have the treatment and you understand what it involves.

You can read more about giving your consent.

Preparing for periodontal surgery

Smoking

If you smoke we recommend that you stop. If you cannot stop completely, we recommend that you stop smoking for at least 2 weeks after the surgery because this will help your gums to heal better.

Find out more about our Stop smoking service. Call 020 7188 0995 or email [email protected]

Medical conditions

Please make sure that you have told us about any problems with your health and about any medicines you are taking. Some medical conditions change the advice and information we need to give you.

During periodontal surgery

You will be given a local anaesthetic injection to numb your gum. This means that you will be awake but not feel any pain during the procedure.

• A cut will be made around the edge of your gum.
• We will carefully lift the gum away from the teeth so that we can see the roots.
• This allows us to remove more plaque and tartar.
• When we have cleaned the roots, the gum is held in place with a few stitches.
• The stitches will be removed in 1 to 2 weeks.

The procedure involves the careful use of cleaning instruments on the tooth surfaces. Sometimes we will re-shape gum and bone to allow for better cleaning.

We might be able to apply some material to try and regenerate (re-grow) bone and attachment on your teeth .

After periodontal surgery

After the procedure, you will not be able to brush the treated teeth immediately. You will need to use an antiseptic mouthwash, such as Corsodyl^®, for at least 1 to 2 weeks.

You can go home after the surgery, but you will need to follow the aftercare instructions given to you by the dentist. This will vary depending on the treatment you have.

The gums will feel sore after the surgery. You might need to take regular painkillers, such as paracetamol, for a few days (as prescribed on the packet).

• Sometimes the gums bleed after surgery.
• You might have bruising and swelling of the gums or the face near the treated teeth.
• The teeth might feel looser after the surgery, but this is usually temporary.
• The teeth might become sensitive to hot, cold or sweet foods or drinks.
• You might notice that spaces appear between the teeth and the teeth might also appear longer.

Follow-up appointments

You will need a follow-up appointment 7 to 10 days after surgery. This is often needed to remove stitches.

You might have more appointments for reviews and gentle cleaning. The routine you will need to follow is often decided about 3 months after surgery.

These appointments will be organised before you leave hospital, or sent to you by post.

Other treatment options

Regular scaling by the dentist or hygienist

This might still be necessary, but it is usually needed on fewer teeth after having periodontal surgery.

Removal (extractions) of some teeth

Having teeth taken out might be a treatment option if your gum disease is severe. This might mean that you need replacement teeth, such as a denture or bridge, or implants, and you would probably need to return to your own dentist for this treatment.

Some people find it easier and more enjoyable to eat with natural teeth than a denture. If your front teeth have a poor appearance, a denture might look better.

Extractions would reduce the time spent treating your gums now and in the future and remove a painful tooth quickly. It is also a suitable option if your teeth are loose.

No treatment

The result of not having treatment will depend on how severe your gum disease is. With no treatment the gum disease could get worse, your teeth might become painful and you might lose your teeth sooner.