Surgery

You may need surgery for severe gum disease (periodontitis) if it cannot be cured with antibiotics or root planing and scaling. Types of surgery include:

• Gingivectomy. A gingivectomy removes and reshapes loose, diseased gum tissue to get rid of pockets between the teeth and gums. A gum specialist (periodontist) or oral surgeon often will do the procedure.
• Flap procedure. A flap procedure cleans the roots of a tooth and repairs bone damage caused by gum disease. A periodontist or an oral surgeon often performs this procedure.
• Tooth removal (extraction). If gum disease has loosened or severely damaged a tooth, your dentist may need to remove the tooth. If the procedure is complicated or risky, an oral or maxillofacial surgeon may do the extraction.

Other procedures may be needed to repair badly damaged gums:

• A graft moves healthy gum tissue from one part of the mouth to another.
• Guided tissue regeneration places a special lining between the gums and bone. The lining helps bone grow back and helps the gums reattach to the bone.

For surgery to be successful, you will need to:

• Practice good dental care. For information on how to care for your teeth, see:

  Dental care: Brushing and flossing your teeth.

• See your dentist regularly for checkups. Once you have had gum disease, you may need to see your dentist every 3 or 4 months for follow-up.
• Avoid smoking or using spit tobacco. Tobacco decreases your ability to fight infection and delays healing. While quitting is not easy, many people succeed by using a combination of medicine, a stop-smoking program, and counseling. For more information on how to quit, see the topic Quitting Smoking.

What to think about

Gum surgery can introduce harmful bacteria into your bloodstream. You may need to take antibiotics before and after surgery if you have a condition that puts you at high risk for developing a severe infection, such as:

• Damaged or artificial heart valves.
• A congenital heart defect.
• A lowered ability to fight infection (impaired immune system).
• Liver disease (cirrhosis).
• Artificial joints, such as a hip replacement.
• A history of bacterial endocarditis.