When we talk about dental health, we automatically shift our focus to teeth problems like cavities and tooth decay, but we ignore our gums completely. Gums usually play a huge role in dental health and also our overall well-being. Bleeding and swollen gums are a sign of gum disease. Brushing techniques can also damage your gums. If you brush your gums vigorously while brushing your teeth, it can cause scarring to your gums. Whether you use an electrical toothbrush or manual toothbrush, it is vital to select one with extremely soft bristles made of nylon so that it doesn’t damage your gums and cause swollen gums. Many people tend to brush in a back and forth motion which leads to friction and results in bleeding gums. Brushing your teeth in circular motion is safer and healthier for gum health. Most of the times, flossing vigorously can also make the flossing thread cause scars on your gums resulting to swollen gums. It is advisable to slide the thread following the curve of your teeth.
Gingivitis is the most common cause of swollen gums, this can later develop to Periodontitis. This disease destroys the bone which supports your teeth and also damages the soft tissues of your gums. Periodontitis can lead to teeth loss or loosening of the tooth. This is however preventable and develops due to poor oral hygiene. Apart from swollen gums, other symptoms of Periodontitis include, purplish, dusky red or bright red gums, tender gums, bleeding from the gums even with the slightest pressure, spaces between each tooth, pus between gums and teeth, loosening of the teeth, painful chewing and discomfort during clenching your mouth. Sometimes, a severe form of Periodontitis called necrotizing periodontal disease can occur due to malnutrition, cancer treatment and HIV infection. This condition can be cured by flap surgery or pocket reduction surgery.
Firstly diagnosis of Periodontitis is done by reviewing your medical history, examining your mouth to look for tartar and plaque build up and dental X-rays are also taken. Sometimes, diagnosis is also done by placing a dental probe beneath your gum line just beside your tooth. This is done at several sites inside your mouth. The depth of a healthy mouth is 1mm to 3mm, but if you have Periodontitis, the pocket depth of your mouth would be 4mm to 6mm. The goal of treating Periodontitis is to clean the pockets all around the teeth so that no further damage is inflicted to the surrounding bone.
Pocket reduction surgery or flap surgery is the most common surgery used if your Periodontitis is severe and other non surgical treatments like root planning, scaling and use of antibiotics doesn’t help. In this procedure, the surgeon makes small incisions in your gums to lift the gum tissue. This exposes the roots so that effective root planning and scaling can be performed. Since Periodontitis causes bone loss to a certain extent, the underlying bone can be re-contoured and then the gum tissue is sutured back in its original place. In this procedure, the bone can be reshaped and smoothened so that the plaque cannot develop further. The bone can also be grafted with bones made from another body part or some man-made prosthetics. The surgeon will place a lining on the graft to make sure the bone grows back normally, this lining is however removed later on.
Patients who have a weak enamel or severe Periodontitis are eligible for this procedure. When other alternatives to treat gingivitis or Periodontitis fail, flap surgery is the last and most effective resort. People have bone damage in the gum or teeth due to excessive use of tobacco and unhygienic oral health develop Periodontitis later in life. Such people should opt for flap surgery.
Those who have a mild form of Periodontitis which can be treated with antibiotics, scaling and root planning need not go for flap surgery.
Flap surgery can have some risks, such as increased sensitivity of your teeth, change in the shape of your gums, infection after the surgery, etc. However, the chances of these risks can be decreased by consuming antibiotics. After the surgery you might feel dizzy and nauseas due to the effect of the anesthesia. Pain and swelling will also be felt soon after the effects of the anesthesia wears out.
After the surgery, painkillers are prescribed to reduce the pain caused due to the procedure. After 24 hours, you should rinse your mouth will lukewarm salt water to relieve pain and reduce swelling in the mouth. Gauze pads have to be changed as soon as they are soaked with blood. Strenuous physical activity or chewing solid foods has to be avoided. Soft foods like light soup, pudding and gelatine has to e consumed for a few days after the surgery. Since the gums remain sensitive for a few days after the surgery, it is recommended to brush your tongue and teeth gently. It is advised not to smoke to promote good oral health.
It usually takes a few days to recover from this procedure. It is mandatory to follow certain home care instruction which is given by your oral surgeon or dentist. After a few days, symptoms of Periodontitis will slowly decrease and your teeth will start to feel healthier. You will also be able to chew food without any pain after going through flap surgery.
The price of this treatment is India is approximately Rs. 15,000 to Rs.75,000.
The results of the treatment are usually permanent if oral hygiene is followed and use of tobacco is gradually stopped.
The alternative option for flap surgery include, soft tissue grafts, bone grafting, guided tissue regeneration and applying tissue stimulating proteins. For less severe forms of Periodontitis, scaling, root planning and antibiotics can treat this disorder and help to achieve healthier gums.