What are the other Names for the Procedure?
- Gingival Curettage
- Surgery for Pyorrhea
- Surgery for Periodontitis
What is the Periodontal Surgery surgical procedure?
- Periodontal Surgery is a procedure that involves the removal of diseased tissue and reshaping of the underlying bone of the infected gums
- Inflammation and bacterial infection of the gums may occur due to poor oral hygiene leading to a condition called periodontal disease (periodontitis) or pyorrhea
- Periodontitis can cause destruction of the gum bones and surgery is a means of treating the condition
What part of the Body does the Procedure involve?
The Periodontal Surgery involves the gums, teeth, surrounding tissue, and blood vessels.
Why is the Periodontal Surgery surgical procedure Performed?
A Periodontal Surgery is performed to treat gum disease (periodontitis) and prevent the gum infection from spreading.
What are some Alternative Choices for the Procedure?
A Periodontal Surgery is performed when medical therapy has failed. There are no alternatives to a surgery to treat periodontitis.
What are the Recent Advances in the Procedure?
Currently, there are no advancements to the procedure.
What is the Cost of performing the Periodontal Surgery surgical procedure?
The cost of Periodontal Surgery procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.
In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.
When do you need a Second Opinion, prior to the Procedure?
- It is normal for a patient to feel uncomfortable and confused by the information regarding a Periodontal Surgery procedure and on what needs to be done
- If the patient needs further reassurance or a second opinion, a physician will almost always assist and also recommend another physician, if required
- Also, if the procedure involves multiple surgeries or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently
What are some Helpful Resources?
Complete Guide to Symptoms, Illness & Surgery; Written by H Winter Griffith, M.D.; Revised and updated by Stephen Moore, M.D. and Kenneth Yoder, M.D.; The Berkley Publishing Group, 5th Edition, New York, 2006
Prior to Periodontal Surgery surgical procedure
How is the Periodontal Surgery surgical procedure Performed?
- The Periodontal Surgery is performed under local anesthesia
- In Gingival Curettage, the dentist numbs the surgical area with anesthesia and removes the diseased tissue
- In Gingivectomy, the dentist numbs the surgical area with anesthetic medication. After making an incision on the gum, a flap is raised to expose the root of the contained tooth and bone. The diseased tissue is removed and reformed. The flap is sutured in place again
Where is the Procedure Performed?
A Periodontal Surgery is usually performed in an out-patient surgery center facility, a dentist’s or periodontist clinic/office, or a hospital.
Who Performs the Procedure?
A dentist or a periodontist performs a Periodontal Surgery.
How long will the Procedure take?
The procedure takes anywhere between one to two hours.
What do you need to tell your Physician before the Procedure?
It is very important to provide the following information to your healthcare provider. This enables your healthcare provider in assessing the risks for the Periodontal Surgery and helps avoid unnecessary complications.
- Provide a complete list of medications you are currently taking to your physician. This information is useful for a variety of reasons. For example, it can help your healthcare provider prevent complications due to a drug interaction
- If you are allergic to any specific medication or food items
- If you are taking blood thinners such as aspirin, warfarin, herbal supplements, or any other such medications
- If you or your family members have a history of bleeding disorders, or if there is a tendency to bleed more than normal
- If you have diabetes, high blood pressure, chest pains, or have previously suffered from a heart attack
- If you have ever been diagnosed with blood clots in your leg (deep vein thrombosis) or lung (embolism of lung)
- If you have a history of frequent bone fractures (this may affect bone-healing if bones are involved as part of your procedure)
- A list of all previous surgical procedures you have undergone, for example: Removal of appendix, gallbladder, or any other part, of your body; surgical repair of any body part, such as hernia repair, perforation of bowel wall, etc.
What Preparations are needed, prior to the Procedure?
- The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient including information related to the medications that are currently being taken
- Some medications increase a person’s chances of bleeding and it may be recommended to discontinue them for a period of time before the procedure is performed
- Blood tests may be performed to determine if there is a bleeding tendency or any other medical conditions that prevents the person from undergoing the procedure
- Inform the physician if you are allergic to any local anesthetics, lidocaine, etc.
- Avoid application of any cosmetics, deodorant, or topical medicines on the area prior to the procedure
- It is advisable to quit smoking and the use of any nicotine based products for a while before the surgery
- Consumption of alcoholic drinks must also be avoided for a period of time, as instructed
- The patient must avoid eating or drinking at least 8 hours prior to the surgical procedure, depending on when the procedure is arranged
- For individuals suffering from diabetes, it is important that the blood sugar stays within the normal range; if not, their diabetologist may have to control blood sugar by recommending insulin and/or a combination of oral medicines
What is the Consent Process before the Procedure?
A physician will request your consent for Periodontal Surgery using an Informed Consent Form.
Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.
You must sign the forms only after you are totally satisfied by the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.
What Tests are needed, before the Periodontal Surgery surgical procedure?
Before a Periodontal Surgery, the patient has to undergo certain tests such as:
- Routine blood and urine analysis
- X-rays of the mouth
What are some Questions for your Physician?
Some of the basic questions that you might ask your physician are as follows:
- What is a Periodontal Surgery?
- Why is this procedure necessary? How will it help?
- How soon should I get it done? Is it an emergency?
- Who are the medical personnel involved in this procedure?
- Where is the procedure performed?
- What are the risks while performing the procedure?
- What are the complications that might take place during recovery?
- How long will it take to recover? When can I resume normal work?
- How many such procedures have you (the physician) performed?
- Are there any follow-up tests, periodic visits to the healthcare facility required after the procedure?
- What are the costs involved?
During the Periodontal Surgery surgical procedure:
What kind of Anesthesia is given, during the Procedure?
Local anesthesia by injection or occasionally general anesthesia by injection and inhalation is administered prior to the procedure.
How much Blood will you lose, during the Procedure?
The blood loss during a Periodontal Surgery is usually negligible.
What are the possible Risks and Complications during the Periodontal Surgery surgical procedure?
There are general factors that increase the risk of getting complications during surgery and they include:
- Obesity: Generally, the greater the degree of obesity, the greater the surgical risk
- Smoking: The longer the smoking history (in pack years smoked), the greater the surgical risk
- Advancing age
- Poorly controlled diabetes, as evidenced by a high hemoglobin A1c and a high fasting glucose
- Poorly functioning kidney, as evidenced by increased BUN (blood urea nitrogen) and blood creatinine
- Poorly functioning liver, as evidenced by increased blood liver function tests
- Hypertension (increased blood pressure), especially if it is poorly controlled
- Poor nutritional status (malnutrition with mineral and vitamin deficiencies)
- Poor lung function, as evidenced by abnormal lung function tests
- History of bleeding disorders
- Longstanding illness, such as autoimmune disorders and chronic infections
- Poor immune system due to a variety of causes
The possible risks or complications that may arise during the Periodontal Surgery are:
- Excessive bleeding
- Infection of the surgical wound
- Anesthetic complications
What Post-Operative Care is needed at the Healthcare Facility after the Periodontal Surgery surgical procedure?
At the healthcare facility, usually there is no requirement for any post-procedure care, unless any complications arise
After the Periodontal Surgery surgical procedure:
What are the possible Risks and Complications after the Periodontal Surgery surgical procedure?
The possible risks and complications that may arise after Periodontal Surgery are:
- Excessive bleeding
- Infection in the surgical wound
- Cold or heat sensitivity due to exposed roots
What is the Prognosis after the Surgery?
A complete recovery from Periodontal Surgery procedure is usually achieved. The prognosis is excellent without any serious complications being observed. However, the procedure is not a cure for periodontal infection and proper oral hygiene following surgery is essential.
When do you need to call your Physician?
Do contact your physician if you notice any of the following symptoms:
- Worsening pain and swelling of the surgical wound
- Bleeding or fluid drainage from surgical wound
- The dressing falls off
- The occurrence of any symptom that causes uneasiness such as nausea or vomiting
- Prolonged excessive bleeding after the surgery
- Numbness or cold sensation of the gums
- Signs of an infection
- Headache, muscle aches
- Fever, feeling sick
- Complications associated with prescription medications used in treatment
What Post-Operative Care is needed at Home after Periodontal Surgery surgical procedure?
At home, the following post-operative care is recommended after a Periodontal Surgery:
- Use ice packs to relieve pain
- Brush and floss your teeth thoroughly under the direction of your physician
- Complete the course of prescribed medication as advised by the physician
- Individuals are advised to have to clear liquids after surgery, until a complete healing occurs. They may then proceed to have a well-balanced diet, which can aid in a faster recovery
How long does it normally take to fully recover, from the Procedure?
A complete healing and return to normal color of the affected gum tissue should take between 2-3 weeks after the surgery.
What happens to tissue (if any), taken out during the Procedure?
The tissue is taken for further examination and later disposed as per the standard medical procedure.
When should you expect results from the pathologist regarding tissue taken out, during the Procedure?
- The tissue removed is processed in the laboratory under a pathologist's supervision
- Slide(s) are prepared once the tissue is processed and is examined by a pathologist and a pathology report issued
- Depending on the complexity of the case, issue of the report may take anywhere between 72 hours to a week's time
Who will you receive a Bill from, after the Periodontal Surgery (Pyorrhea Treatment) surgical procedure?
It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers.
Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:
The outpatient facility, dentist’s or periodontist clinic/office, or a hospital
- An anesthesiologist (if anesthesia was administered)
- A dentist or a periodontist
- A pathologist (if the tissue was sent for analysis)
The patient is advised to inquire and confirm the type of billing, before the Periodontal Surgery is performed.
Thanks and Gratitude:
We sincerely acknowledge and thank Dr. Douglas J. Jones for reviewing the article. His valuable input and feedback has helped enrich the contents of this article.
Douglas J. Jones, MD FACS
Board Certified General Surgeon and Faculty Member
University of Illinois, College of Medicine at Urbana-Champaign
506 S. Mathews Ave., Urbana, IL 61801, USA