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Periodontal disease is extremely common around the world — in fact, it is much more common than tooth decay or any other form of dental affliction. It is, however, often detected quite late in its progression, at a time when the only option remaining is the extraction of affected tooth. This is because periodontal disease does not cause pain. Situations that arise from periodontal disease can lead to pain, but the disease process itself is not painful. It is quite likely that the first time people discover they have some form of periodontal disease is when their teeth start becoming mobile or drift away from their physiological positions.
One of the treatment modalities that doctors will put in front of you for the treatment of moderate to advanced periodontitis is gum surgery. This article will look at the reasons why you might need surgery, the various available options and the benefits you will have from these procedures.
Who Needs Periodontal Surgery?
Not every patient needs periodontal surgery. In fact, every patient will first be put on a course of non-surgical treatment and then evaluated after a couple of months to see how well that patient is responding.
Typically, "pockets" that act as niches for pathogenic bacteria form around the teeth. These periodontal pockets are formed at the expense of supporting structures of the teeth, including the alveolar bone. As the pathogenic bacteria continue to release harmful substances in this micro-ecosystem, the bone becomes increasingly damaged, eventually unable to support the tooth — which then needs to be extracted.
Non-surgical therapy involves scaling and root planning which will attempt to mechanically disturb this ecosystem by removing all the plaque, calculus and diseased cementum from the surface of the tooth and its roots.
If successful, this will allow the normal healthy bacterial population to thrive and recolonize the surface of the teeth, resulting in a decrease in pocket depth. Now this reduction in bacterial depth may not occur at every affected site in the mouth equally or even at all. The dentist has to evaluate the conditions of the gums and the teeth. If the patient is able to remove plaque from the area sufficiently to prevent periodontal disease from recurring, then there is no need for surgery. However if the patient is unable to maintain proper hygiene due to persistent difficult to reach periodontal pockets, periodontal surgery is advised.
Another patient who will not be advised periodontal surgery is a patient with advanced periodontitis where surgery will be unable to achieve a significant improvement. A patient who is unable or unwilling to maintain proper oral hygiene for any reason is not a good candidate for periodontal surgery as maintenance is as important as the actual procedure.