Gum Surgery Guide: When It Is Done, Types of Surgery and Aftercare
Gum surgery is a treatment used when scaling and root planing have not controlled inflammation and deep periodontal pockets remain. The gum is opened so the dentist can see the root and gum bone directly and remove tartar and diseased tissue. Besides the standard flap surgery, there are bone grafts that fill areas where gum bone has collapsed and guided tissue regeneration that uses a barrier membrane. In Korea, whether it is covered by insurance and its cost vary with the type of surgery and materials, so it is good to get item-by-item information before surgery.
Key facts
| Flap surgery (periodontal flap surgery) | Chosen for deep, wide destruction of periodontal tissue at moderate or greater severity (source: Korea Disease Control and Prevention Agency (KDCA, 질병관리청) National Health Information Portal) |
|---|---|
| Bone graft | Bone is grafted onto areas where gum bone has been lost to encourage regeneration (source: KDCA National Health Information Portal) |
| Guided tissue regeneration | A barrier membrane secures space for the periodontal ligament and gum bone to regrow (source: KDCA National Health Information Portal) |
| Range of possible regeneration | Tissue regeneration is possible only in very limited cases; in most, the aim is to stop or slow progression (source: KDCA National Health Information Portal) |
| Outpatient patient share for covered items | 30% at a dental clinic, 40% at a dental hospital in a dong area, 50% at a general hospital in a dong area (source: National Health Insurance Service (NHIS, 국민건강보험공단)) |
When is gum surgery needed?
The KDCA explains that deep periodontal pockets are hard to eliminate completely with non-surgical methods alone, so surgical treatment may be needed. Surgery is considered when a recheck after root planing still shows deep pockets, or when the gum bone has dissolved unevenly and leaves many places for bacteria to hide.
Even with surgery, not all of the dissolved bone returns. The goal of gum surgery is to remove the source of infection and create a gum shape that is easy to maintain at home so the teeth can be kept longer. If inflammation is so severe that it is likely to spread to neighboring teeth or tissue, extraction may be recommended instead of surgery.
What types of gum surgery are there?
Whether one surgery is done alone or several together is decided from the shape and extent of the dissolved bone and from tooth mobility. For example, while the gum is open for flap surgery, a bone graft may be added to a bone defect. The gum surgeries introduced by the KDCA are as follows.
- Flap surgery: the gum is cut and folded back, then deep tartar and necrotic tissue are removed and the bone is smoothed
- Gingivectomy: overgrown gum is cut away and shaped so it is easy to clean
- Bone graft: bone graft material is placed in a defect in the gum bone to encourage regeneration
- Guided tissue regeneration: a barrier membrane keeps gum tissue from growing in first, securing space for the periodontal ligament and bone to fill in
- Gingival and alveolar mucosa surgery: surgery that covers receded gum areas or builds firm gum
What does the process before and after surgery involve?
Usually, inflammation is first reduced with scaling and root planing, and then a surgery date is set. Under local anesthesia the gum is opened, and after tartar removal and bone smoothing or grafting, it is sutured. If the area is wide, the mouth is divided and surgery is done over several days.
The surgical site can be swollen and uncomfortable for several days, so take prescribed medicine as directed and do not touch the stitches with your tongue or fingers. Avoid chewing on the operated side and eat low-irritation food. Smoking reduces the effect of periodontal treatment, so avoid it before and after surgery.
What if medication has caused the gums to overgrow?
Some drugs, such as blood pressure medicine, anticonvulsants and immunosuppressants, can cause gums to grow thick. Gums grown this way collect plaque easily, and a gingivectomy is sometimes used to tidy them.
The KDCA explains that when drugs have caused gum overgrowth, it is likely to recur even if cut away, so changing the medication is considered. Do not stop a drug on your own; it is good to share the treatment details so the prescribing doctor and the dentist can consult together.
How do I check the cost and health insurance?
The cost of gum surgery varies greatly with the type of surgery, the number of sites, and whether bone graft material or a barrier membrane is used, and coverage differs by item. For covered items, the outpatient patient share is 30% at a dental clinic, 40% at a dental hospital in a dong area and 50% at a general hospital in a dong area.
Regeneration surgery that uses materials has its own application criteria, so even the same surgery name can split into covered and non-covered. Getting an estimate split into covered and non-covered items before surgery makes it easier to compare with other clinics.
Common myths and facts
Myth: After gum surgery, the dissolved gum bone returns to its original state.
Regeneration surgery can fill part of it, but the KDCA explains that tissue regeneration is possible only in very limited cases.
Myth: Once you have gum surgery, no further care is needed.
Even after surgery, if tartar and bacteria build up again, periodontitis can return, so checkups and scaling every 3 to 6 months are recommended.
Frequently asked questions
Do I have to be hospitalized for gum surgery?
Most is done as an outpatient procedure under local anesthesia. If you have a systemic illness or the surgery is extensive, the dentist may plan the schedule and setting separately.
How should I eat after gum surgery?
Do not chew on the operated side and eat soft, low-irritation food. Hot or hard food can irritate the stitches, so it is best to avoid it until the dentist says it is fine.
Can gum disease be treated with medicine instead of surgery?
The KDCA explains that antibiotics alone do not cure periodontal disease and that drugs are used as an aid in acute or severe cases. Tartar in deep pockets must be removed directly with instruments. Local drug treatment that places an antimicrobial in the pocket is also used as an aid after gum treatment.
Can I have gum surgery if I have diabetes?
Yes, but the surgery schedule and healing course may vary with blood sugar status. Tell the dentist about your medical care and medications, and set the timing of surgery together.
Why are my teeth more sensitive after gum surgery?
Once inflammation subsides and the gum is reshaped, root surfaces that had been covered can be exposed and become sensitive to cold. If sensitivity lasts, ask the dentist whether the sensitive area can be treated.
Related topics
- Gum Disease Treatment
- Gum Disease Treatment
- Periodontal Curettage and Root Planing
- Gum Graft
- Implant bone graft