what is gum surgery and do i need it

"Surgery" sounds alarming, but most gum procedures are done under local anaesthetic in a dental chair, take about an hour per area, and allow you to go back to normal routine within a day or two. The more important question is whether you actually need one, and the honest answer is that many people do not.

When gum surgery is considered

Gum surgery is almost never the first step. Gum disease is treated first with scaling and deep cleaning, along with better home care. A few weeks later the gums are measured again. Surgery comes into the picture when:

• Deep pockets remain around certain teeth despite good cleaning, so bacteria keep hiding where no instrument can reach blind.
• The bone around a tooth has an irregular shape that traps plaque.
• Gum recession is causing sensitivity, keeps progressing or affects your smile.
• The gums have overgrown, for example due to some medicines.
• A tooth broken or decayed below the gumline needs more tooth exposed before a crown can be fitted (crown lengthening).

The main types

• Flap surgery: the most common. The gum is gently lifted back, tartar and infected tissue are removed from the roots under direct vision, the bone is smoothed if needed, and the gum is stitched back closer to the tooth so the pocket is shallower.
• Regenerative procedures: during flap surgery, a bone graft or membrane may be placed in certain bone defects to encourage some support to rebuild. This only suits particular defect shapes.
• Gum grafts: tissue, often from the palate, is moved to cover exposed roots or thicken thin gum.
• Gingivectomy: trimming overgrown gum.
• Crown lengthening: reshaping gum and sometimes bone to expose more tooth.

What recovery is like

Expect some soreness and mild swelling for two to four days, usually controlled with the painkillers you are prescribed. You eat soft food, avoid brushing the operated area for a short period as advised, and use a prescribed mouthwash. Stitches are checked or removed at a follow-up, usually around eight days later. The gums may look slightly shorter afterwards, and some teeth can be more sensitive to cold for a while. Tobacco slows healing considerably; our working policies ask patients to avoid smoking, alcohol, tobacco and mishri for 48 hours before and 72 hours after surgery, and longer is better.

Questions to ask before agreeing

1. Which teeth need it, and what were the pocket readings after deep cleaning?
2. What happens if I do not have it?
3. Is the tooth worth saving in the long term?
4. How many sittings and what will each cost?

How it works at our clinics

Dr Avinash Bamane or Dr Rashmi Bamane assesses your gums first. If surgery is worth considering, a visiting consultant from our MDS periodontics department sees you at Kharadi by prior appointment; the Kharadi clinic has a dedicated operatory for surgery and implants. Our current published fee for flap surgery is ₹8,000, and the final cost depends on how many areas are involved and is confirmed after examination. See the online fee catalogue and our pre- and post-operative instructions.