At Metropolitan Dental Care, we believe in keeping treatment as conservative as possible. That being said, there are times when surgical intervention is necessary to preserve the health of your teeth and gums. Here, your Denver dentists discuss gum surgery and explain when this type of treatment may be necessary.
What is gum (periodontal) disease?
The mildest form of periodontal disease is gingivitis. This begins with the build-up of bacterial plaque that hardens into calculus. Also known as tartar, calculus irritates the gums, causing them to become inflamed and easily bleed. With gingivitis, the symptoms are mild, and the teeth remain stable. Many people are unaware they have it.
Regular dental checkups are for more than looking for cavities and cleaning your teeth. Your hygienist and dentist look for signs of gum disease. When caught early, gingivitis can be treated before deteriorating into the more serious periodontitis.
With periodontitis, bacteria break down the normal, healthy bond between teeth and gums. This causes gum tissue to pull away from the teeth, forming pockets of bacteria along the gum line. Treatment for gingivitis includes good home hygiene, including daily flossing and twice-daily brushing at a minimum.
Left untreated, the infection causes increased damage, including gum loss (recession) and destruction of bone surrounding the teeth.
Periodontitis will not go away on its own. Even a rigorous home hygiene regime won’t take care of it. When it has reached this stage, professional dental treatment is needed. Most often, this deep cleaning involves scaling, which removes tartar and plaque from below the gum line. It is then following by root planing, which is a smoothing of the tooth root to allow the gums to reattach.
After deep cleaning, you will be placed on a periodontal maintenance plan. Keeping up with your dental appointments allows your dentist to make sure your gums are reattaching. The goal is for your gums to become healthy, pink, and tight.
If, however, this does not solve your issues, you may need gum surgery.
Gum Flap Surgery for Periodontal Disease
If you have an advanced case of periodontal disease, the infection is too deep to reach, no matter how much you brush or floss. Even professional scaling and root planing cannot go deep enough.
Without treatment, bone and gum loss will continue, putting you at great risk for tooth loss. The only way to halt the progression and keep your teeth is through surgical intervention.
Before this procedure, Dr. Mike Norouzinia, our onsite periodontist at Metro Dental, will use an anesthetic to numb your gums. He will then make an incision along the gum line and gently move the tissue out of the way. This allows visualization and more thorough cleaning with removal of the plaque and bacteria. Next, he will smooth the root surface and reshape the surrounding bone. Once completed, he will close the incision with stitches.
To maintain results, you will be placed on a more frequent cleaning schedule.
Gum Surgery for Recession
Gingival recession is when the margin of gum tissue wears away or pulls back from the teeth. This exposes the tooth root, forming gaps between the teeth and gums, allowing more bacteria to build up. Increased bacteria puts you at a higher risk of periodontal disease, which leads to more gum recession.
Since the roots do not have the protective enamel coating, exposed roots are more prone to sensitivity and decay.
Gum recession is most often caused by periodontal disease, but other factors can come into play.
Some other common causes for recession include:
- Misaligned teeth
- Bite disorders
- Hormone fluctuations
- Certain medications
- Teeth grinding or clenching
- Aggressive brushing
- Injury, such as trauma or ill-fitting dentures
- Tongue and lip piercings
If the recession is caused by gum disease, scaling and root planing followed by a maintenance plan can allow gums to reattach, but gum loss will not grow back. No matter what the reason, recession should be addressed promptly to avoid future problems from developing.
There are three different techniques used to perform gum grafts. The type performed will depend on what your dentist recommends for your specific needs. While the techniques differ, each option creates a strong band of tissue across the root surfaces, protecting them from decay, notching, and further bone loss.
After a thorough examination of your teeth and gums, a treatment plan is established. Before beginning the procedure, the doctor will inject a local anesthetic to the affected areas.
Option #1 Connective Tissue Graft
A connective tissue graft is the most common procedure, and it involves either removing connective tissue from the roof of your mouth or using harvested tissue purchased from a tissue bank. Dr. Norouzinia then positions the tissue over the receded gums and stitches it in place.
Option #2 Free Gingival Grafts
As with the connective tissue graft, healthy tissue is either harvested from the patient or purchased from a tissue bank. While this procedure is effective, the results are not as aesthetically pleasing. Because of this, this procedure is performed when thin gums outside the smile zone require added thickness.
Option #3 Pedicle Graft
This procedure is for patients who have maintained sufficient gum tissue and do not require a harvest. This treatment involves making a small flap in the gum tissue near the affected tooth. This flap, or pedicle, is then folded over and stitched in place.
This procedure is sometimes combined with a connective tissue graft for patients with severe root exposure.
Surgery for Bone Loss
As stated above, periodontitis destroys the bone that surrounds teeth, which can lead to tooth loss. When a tooth is lost, the bone that surrounded the now absent tooth begins to erode even more. The bone erosion continues as long as the socket that held the tooth is empty. As bone loss continues, the face begins to sag, giving an aged appearance.
The only way to stop the erosion is with a dental implant. But because implants require healthy, dense bone, the bone must be built back up before the implant can be placed. This is done with a bone graft.
In a bone graft, the dentist gains access to the bone by making an incision into the gum. Grafting material is then placed, and the gum is closed with stitches. Once in place, the body deposits new bone cells onto the grafting material, building even more bone.
Learn More about Gum Surgery in Denver
Do you need gum surgery in Denver? At Metropolitan Dental Care, we have a periodontist on staff who can diagnose and treat many gum conditions, including periodontal disease and recession. If you live in Denver, Parker, Centennial, or Highlands Ranch, our dentists can meet the dental needs of your entire family. To learn more, schedule a consultation. Call us today at 303-534-2626 or contact us online anytime.