Treatment - Surgical | Thomas J. Kepic, DDS, MSD
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Treatment – Surgical

Overview

Many patients have some concerns when periodontal surgery has been recommended. It’s important to find answers to questions patients frequently ask before surgery. Knowing what lies ahead will enable you to actively participate in your health care decisions.

Why is periodontal surgery necessary?
The gum and bone tissues around your teeth are unhealthy and cannot be repaired with non-surgical treatment.

Will periodontal surgery hurt?
Several new treatment options using refined techniques can be performed as an in-office procedure. There have been improvements in local anesthesia, anxiety and pain control medications, and conscious sedation. A certified anesthetist can come into the office to put you to sleep during the procedure if you wish.

How long will it take to heal?
Most patients resume their normal routine the following day. Please see “post-surgical instructions” for an instruction sheet given out after the procedure.

Will my surgery be covered by my insurance?
Most insurance carriers cover a portion of periodontal service. Please discuss insurance with the administrative staff in our office so that you are perfectly clear regarding your benefits. There are also various payment options.

Gingivectomy

An overgrowth of gum tissue is removed in this procedure.

Flap (Pocket depth reduction) Surgery

This procedure allows access to the infected pocket. The gum tissue is folded back creating a flap so the disease-causing bacteria can be removed. Irregular surfaces of the damaged bone are smoothed to limit areas where bacteria reside. The gum tissue will then reattach to healthy bone. The pocket is reduced and little or no gum tissue is removed.

Regenerative Periodontal Surgery

This therapeutic modality is one of the most exciting in health care. These procedures can, in selected cases, reverse some or all of the damage by regenerating lost bone and tissue. Standard therapy as described in the flap surgery mentioned above is first carried out. Membranes, bone grafts or tissue-stimulating proteins are then placed to encourage your body’s natural ability to regenerate the bone and soft tissues.

Post Surgical Instructions

Ice 30 on 30 off

Place an ice bag on your face 30 minutes on and 30 minutes off for the rest of the day until bedtime. If you do not have an ice bag, put ice in a plastic bag and wrap a towel around it. The ice will help to:

  • Slow down the bleeding. There may be a slight amount of bleeding the rest of the day. Do not worry.
  • Take the edge off the discomfort. So the better you are with the ice, the less pain medication will be needed.
  • Minimize the swelling and black and blue. Tomorrow there will be some swelling in the area of the surgery and some black and blue.
  • Also today, periodically let an ice cube dissolve in your mouth.

No Talking – No talking the rest of the day because you will slightly jiggle the gum tissue causing bleeding and compromise your results.

No Smoking – At least the day of the procedure. Smoking adversely affects initial healing and decreases the long-term results..

Soft foods – Eat soft foods like macaroni and cheese or scrambled eggs. You must eat more than soup because if that’s all you have you will get sick to your stomach from the medication.

Two Pillows – Put two pillows under your head and lie down all day.

Clean the surgical dressing – Brush and floss all teeth except the area in which the surgery was done. Use a damp cotton ball or Kleenex to gently wipe the dressing once a day to remove the debris. If the dressing falls off, do not worry. You can then gently brush and floss. However, if we did a soft tissue (gum) graft or a bone graft, and the dressing falls off, please call. We may wish to place a new dressing.

Antibiotics – Most often, antibiotics are prescribed. Follow the instructions on the vial and complete the entire dose.

Medication for discomfort – Options will be presented depending on your medical and systemic conditions and the extent of the procedure.