Periodontal surgery is not the first course of action for treating gum problems. Most often, it is an intervention that comes after many less-invasive and nonsurgical treatments. Although individuals seeking treatment late in the progression of their gum disease may face surgical options sooner, it is not likely to be a surprise or sudden recommendation from a dentist. Often, a dentist will be the first to notice signs of gum distress such as gingivitis or more advanced gum disease, and a treatment plan may then progress from deep cleanings to get at the roots, called scaling and planing, to complementary treatments by a periodontist, or gum specialist.
A periodontist will assess how deep areas of gum recession go and how far areas of the gums have pulled away from the teeth. They'll chart progression, usually in millimeters, by performing root cleanings, using antibiotics, antimicrobials or other medications to combat bacterial growth below the gum line, and outline a course of home care that steps up hygiene in frequency and with specialized rinses, pastes and brushes. If the depths of gum tissues, or pockets, surrounding teeth don't decrease in size and begin to tighten around teeth after treatment and over time, surgery may then be the next course of action.
It's estimated that half of the cases of severe gum disease in the U.S. are caused by smoking cigarettes, but the other half occur from poor oral hygiene, family history of gum disease and health issues or mouth injuries affecting oral care. Smokers are three times more likely to develop gum disease than those who have never smoked, but among those nonsmokers, there are individuals with meticulous oral hygiene who are just predisposed to gum recession due to genetics, others who have brushed too hard, causing damage, and some who are just born with thin or weak tissues [sources: CDC; CUCDM]
No matter the cause or source of periodontal troubles, once identified, gums can be healed and repaired with professional intervention and by following all recommendations for maintaining healthy gums once treatment is finished [source: NIDCR]. If preventative measures didn't work and if you are at the point of needing gum surgery, damage can't be reversed but it can be corrected by a dentist, periodontist or oral surgeon -- and sometimes two or more working together. Whether or not the gum correction is long-lasting, however, depends on having very conscientious hygiene once repairs are made.
Next we'll look at what happens during gum surgery and how it might feel before and after.