Periodontitis is a serious dental infection that is caused by an excess of bacteria adhering to the teeth and affecting the gums and the bone supporting the teeth. This bacteria is known as dental plaque. An excessive buildup of plaque will eventually cause the surrounding gum tissue to become inflamed, and, if left untreated, this inflammation will spread beneath the gums. This can lead to the formation of periodontal pockets, which are spaces between the gums and the teeth. As a result, more plaque accumulates in these pockets causing more periodontitis, and will ultimately lead to bone loss around the teeth. When teeth lose too much bone, the teeth become loose and will ultimately fall out. Although this procedure receeds the gums and causes spaces between the teeth, osseous resective surgery will help eliminate the inflammation and infection and restore the gums to a healthy status preventing tooth loss.
Your dentist will complete a comprehensive periodontal and radiographic examination of your teeth, to determine that osseous resective surgery is the proper form of treatment for your condition.
The surgery is performed under local anesthesia. There is no pain during the procedure and patients are often awake. For anxious patients, sedation may be considered. The gum tissue is cut and pulled away from the teeth, allowing the dentist to remove the plaque that has adhered to the roots of the teeth. This procedure sounds and feels like a deep cleaning. The bone is then gently reshaped to eliminate pockets and the gum tissue is put back in place. At the end of the procedure, stitches will be placed. Gauze will be placed over the site for five minutes until the bleeding stops.
Bleeding is usually not a problem after surgery, especially if the patient avoids alcohol, hot fluids, aspirin and aggressive rinsing in the first post-operative day. If you experience minor bleeding, be reassured that this will stop with time. If you experience major, uncontrollable bleeding and your mouth is filling with blood, then you must see your dentist immediately.
In some cases swelling is to be expected. To help alleviate this, ice packs may be applied to the outside of the face over the area of surgery half an hour on, half an hour off, for the first 3 or 4 hours.
After the anesthesia wears off, you may experience moderate discomfort that may last from 3 to 5 days. 500 to 1000 mg of acetaminophen every 4 to 6 hours as needed or a non-steroidal anti-inflammatory medication such as 400 to 600mg of ibuprofen every 4 to 6 hours as needed, usually provides adequate control of the remaining pain.
Maintaining an adequate diet after surgery is recommended. Chewing on the opposite side of the mouth and avoiding extremely hard or spicy foods are also recommended.
Meticulous oral hygiene should be continued in all areas of the mouth other than the area of surgery site, which should be avoided for the first week. Gentle rinsing after meals with a glass of warm water or 0.12% chlorhexidine rinse will be sufficient. This gentle rinsing is important as it helps flush out debris which collects around the dressing.
You should see your dentist no more than two weeks following surgery for a post-operative visit and removal of the stitches if necessary. Professional cleaning is recommended every two weeks until healing is complete and the patient is able to maintain acceptable oral hygiene in the surgically-treated areas.
Osseous resective surgery is a highly effective procedure in the treatment of periodontitis and is the best way to ensure healthy gums and bones which support your teeth and prevent tooth loss. When there are no pockets left in the gums, it will make it easier for the patient to remove the bacteria by brushing, flossing and the use of interdental brushes. The long term health of your teeth will depend on you maintaining a high level of oral hygiene.