Understanding Gum Surgery

Here’s what you need to know about having periodontal work done in Singapore.

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Written by NoFrills Dental

This dental article has been curated by the clinical team @ NoFrills Dental 🙂

April 22, 2021

Oral Surgery in Singapore

Overview – What is Gum Surgery?

Periodontal surgery, commonly called gum surgery, is a vast topic. As a whole, these kinds of surgeries are mostly considered restorative work. Their aim is to prevent further disease which can lead to bone loss, pain, and the need for more invasive restorative surgery further down the timeline.

While the prospect of choosing gum surgery might feel a little daunting, it can save you discomfort, money and worry in the future. So let’s look at the different types of gum surgeries, what each procedure treats and prevents, and when it might be an appropriate choice.

We will also cover the downsides, including healing time and costs, so you have the full picture. Here’s what you need to know about having periodontal work done.

When might somebody need gum surgery?

The most common reason for gum surgery is to reverse the effects of gingivitis, which is mild gum disease, or periodontitis, which is the more severe gum disease that occurs when gingivitis worsens.

Gum disease can occur from poor dental hygiene, a long-term bad diet or even smoking. But it isn’t always caused by these things. Some people who have a good oral hygiene routine and who take care of their oral health can still suffer if their immune system is compromised due to a medical condition.

There is also a cosmetic branch to the world of gum surgery. Patients with a very low gum line, making the teeth appear small, may opt for a surgical correction.

gummy smile

How gingivitis and periodontitis lead to surgery?

Over time, gum disease causes inflammation in the gums. This inflammation can lead to the gum separating from the teeth, leaving pockets of space open.

Bacteria gather in these pockets, leading to infection and potentially bone loss too. This is the beginning of losing teeth to gum disease, as teeth become weak, unstable and loose.

If gingivitis is treated early, then often this can be avoided. A good oral hygiene routine, regular dentist visits for descaling and deep cleaning, and general good health can all reverse the early stages of this process.

But if you are unable to fight gingivitis, then it can progress to periodontitis and ultimately require surgery to prevent pain and tooth loss.

The good news is that periodontal surgery can give your natural teeth a second chance at becoming healthy again, preventing future tooth loss. So don’t fear the worst. Always share your concerns with your dentist – there may be options you weren’t aware of.

receded gums due to gum disease

Types of surgery for gum disease

Before or after any surgery, there are two deep cleaning procedures that your dentist may use.

Deep scaling can remove bacteria and dental calculus (tartar) from both the teeth and the gums. When scaling is carried out, the gum line is gently pushed back to allow cleaning just behind the natural gum line.

The other procedure is root planing. With this procedure, your dentist will use a very small tool to smooth any rough surface areas of your roots. Doing this allows the gum to grow back and reattach to the root more easily.

Both of these procedures can improve your healing after the surgery has taken place.

flap gum surgery

Flap surgery (pocket reduction)

Gingival flap surgery requires your dentist to cut a small flap so that they can lift the gum and access any pockets that need cleaning and closing. Tarter will be removed, and if needed, the bone may be slightly reshaped too. Then the flap of gum is stitched back in place and left to heal.

This procedure reverses those pockets caused by inflammation, and gives your gums a better chance to heal from gingivitis.

dental bone grafting required before dental implant placement due to bone loss in the jaw

Bone grafting (regeneration)

If there is damage to the roots of your teeth, then bone grafting can help your roots to regenerate.

There are a few different approaches to bone grafting. As well as different procedures, there is also a choice to be made when it comes to the graft material.

Some patients choose to have bone grafted from a donor site on their own body, often the iliac crest of the hip. Bone grafts can also come from a donor, such as a human cadaver or an animal.

There is a synthetic graft option too, which is the least costly. You can talk these options through with your dentist to help you decide on your best option.

soft tissue gum graft

Soft tissue grafting

If you have a receding gum line, then more of your teeth are exposed closer to the roots. This can leave you open to greater risk of inflammation and tooth loss in the future.

Soft tissue grafting is a procedure that lowers the gum line, giving more protection to your teeth by adding tissue from a donor site. This is typically the roof of your mouth.

This procedure is recommended primarily to prevent tooth loss, but also has a cosmetic angle to it. It can give you an improved cosmetic appearance almost instantly, after you have recovered from the surgery, as well as saving your teeth in the long term.

guided tissue regeneration gum surgery

Guided tissue regeneration

Guided tissue regeneration helps your natural gum tissue to regrow and strengthen, letting your gum line do its job well again.

The affected area of the gum line is lifted back, and a mesh-like material is placed between the gum and the teeth. This mesh contains tissue-stimulating proteins, or bone or membrane graft material. Sometimes, combinations of all these materials are used.

This stimulates tissue regrowth within 6 months, and allows a tighter seal to form between the teeth and gum, protecting the teeth for the future.

gummy smile

Crown lengthening

This procedure is used to treat gum disease, and to improve the cosmetic appearance when the gum line is too low.

Opposite to the way that guided tissue regeneration adds to the gum line,crown lengthening actually takes tissue away and moves the gum line higher. Some people naturally have a low gum line. This can make the teeth appear quite small, so they may choose this surgery for cosmetic reasons.

But equally, if you have periodontal disease plus an excess of gum tissue, then crown lengthening can be a restorative procedure to regain your oral health. The affected gum can be removed to create a healthier gum line.

What to expect from gum surgery

Before or after any surgery, there are two deep cleaning procedures that your dentist may use.

Deep scaling can remove bacteria and dental calculus (tartar) from both the teeth and the gums. When scaling is carried out, the gum line is gently pushed back to allow cleaning just behind the natural gum line.

The other procedure is root planing. With this procedure, your dentist will use a very small tool to smooth any rough surface areas of your roots. Doing this allows the gum to grow back and reattach to the root more easily.

Both of these procedures can improve your healing after the surgery has taken place.

scaling & polishing in Singapore ~ Professional dental cleaning in Singapore

Will gum surgery be painful?

Many people are anxious when visiting the dentist, because they expect it to be a painful experience. But in truth, living with toothache and decaying teeth long-term is much worse than a couple of hours in the dentist’s chair.

It helps to know what to expect, so you are not imagining the worst. During your surgical procedure, you will be numbed with a local anaesthetic. Most patients report that the needle from the local anaesthetic is the only uncomfortable part.

After the anaesthetic goes in, there is no pain experienced from the procedure. You may just feel some pressure or vibration from the instruments, but this is all normal and nothing to worry about.

After the surgery, as the anaesthetic wears away you may need to take normal over-the-counter painkillers for a couple of days. You may have a little swelling too, which can be reduced with an ice pack for your face.

Dental check up with Dr Li Kexin

How long will I need to heal from gum surgery?

If you have had gingival flap surgery, or a grafting procedure, then there will be stitches in your gums. In some cases dissolving stitches can be used. If you need to have stitches removed then a follow-up appointment will be made for you in 7 to 10 days time.

Your surgeon may also place a periodontal pack (special dressing) over the surgical site. In this case, you will be given instructions on when to remove it.

Generally patients report swelling and discomfort in the first few days after surgery, then things settle down. You should be back to eating and drinking normally after a few days too, as long as you are mindful of your stitches.

happy patient waiting for gums to heal

Aftercare protocols

As with any surgery, the most important part of your recovery is keeping the surgical site clean. Your dentist will give you an aftercare plan. This may include using an antiseptic mouthwash, and taking extra care when you eat.

You will need to keep to a soft diet for a few days, and avoid sucking drinks through a straw. Although a straw might seem like a good idea to keep fluids away from your stitches, the suction it causes in your mouth can make your surgical site bleed. So just stick to being gentle, and eating and drinking with care.

You will also be advised to refrain from high intensity exercise for several days, and of course, to avoid smoking. If you are a regular smoker then have a nicotine patch ready to put on after your surgery.You will not want to chew nicotine gum as this could hurt your surgical site.

teeth brushing

What does gum surgery cost in Singapore?

In Singapore, the prices for periodontal treatments begin at around $800 and go up to $2000 plus, depending on the complexity of your case.

The simpler procedures of root planing and tooth scaling begin at the lower end of the scale, around $800. Gingival flap surgery costs from $1000, and grafting procedures begin at around $1500.

While Medisave does not cover all gum surgery, some elements of your treatment plan may be claimable. It is always worth asking us about this in your consultation, so we can guide you on where to claim.

male dentist ready to perform surgery

How long will the results of gum surgery last?

Assuming that you are generally healthy, gum surgery can be a turning point in your oral health. If your gums had been suffering from gingivitis, and you were able to correct the lifestyle habits that caused it, then you have a good chance at keeping your mouth healthy in the long-term.

In other words, the positive effects of gum surgery could last a lifetime, with good oral care habits and a good diet in place.

However, if your gingivitis was caused by a medical condition, then you have less control over your gum health. Surgery can certainly bring you improvements, but the results may not be as long-lasting.

Ultimately, these cases will each be unique, so speak to your dentist for more personalized advice.

So what’s next?

If you are concerned about advancing gum disease and are thinking about your next steps, then please do reach out to ask us anything. Our dedicated team members are always happy to talk. We know it is important for you to have all the information before you make any decisions about your dental health.

So please feel free to call and talk through the options with us, or fill in the contact form on this page. We are always happy to advise you, and you should feel comfortable making your decision. Choosing periodontal surgery is a big decision, and a long-term investment in your health. 

The best dentist for you is one who will provide you with all the information, and help you to reach a well-informed decision that you are comfortable with. Good communication between you and your dentist is vital for a successful outcome.

In addition, please only proceed with the treatment if you are fully comfortable with the treatment plan proposed by your provider.

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