Guidelines for Gum Surgery
As a general dentist, I do offer some gum treatments to patients. These are in the form of deep cleanings with local anesthesia (in Georgia the dentist must give this) and delivered to the patient by the hygienist. The goal of this procedure is to remove the plaque and calcified plaque (known as calculus or tartar) from the deep parts of the root surface. It takes time and expertise to clean these areas where normal home care and dental cleanings don’t go. Most patients do need some form of local anesthetic to accomplish this goal without great discomfort. Keep in mind that patients needing this treatment have lost some bone between their teeth creating a bony pocket in the treated area. The guidelines for this procedure are pockets 4-5 mm., and we are looking for the gum tissue to tighten to 3mm. At this level, normal brushing and flossing daily (twice daily is better) without getting slack will maintain the expected healthy condition
In patients with 6 mm pockets or greater, the first step is, as always, to perform a deep cleaning. However, the result of the deep cleaning usually does NOT result in pockets of 3mm or less when the bone loss is this severe. This means that the patient will need to have a evaluation for periodontal surgery. This treatment can include the addition of bone to select areas and reshaping of the bone. The periodontist will also be able to see if there is any areas of tartar that remain and need to be scraped off.
If periodontal disease is left untreated, the bone less will become greater and at an increased rate. The patient may experience periodontal abscesses, increased bleeding and swelling of the gums, mobility of the teeth, and an increase in halitosis. From a systemic health view, the increase in bacteria associated with gum disease can get into the bloodstream and cause bacterial problems in other parts of the body.
So, it’s important to take oral health seriously. The longer it takes for a patient to realize this, the more damage can occur so that oral hygiene is more difficult and can take longer to achieve.