If it is not possible to heal the gums with the conservative ways of treatment, or when the condition is extremely severe, a surgical manipulation might be necessary. Your doctor will assess your condition carefully, note the results of your modern periodontal treatment, and will work out an individual plan for your future therapy. The patient’s motivation and dedication to maintaining perfect oral hygiene during and after the periodontal treatment is of extreme importance for the final result.
Generally speaking, these are procedures for the treatment of recessions and for enhancement of the aesthetic beauty of your smile. They include soft-tissue grafts (for recessions) and clinical crown lengthening (for enhancement of aesthetics or for severely damaged teeth).
Recession means the receding of the gums of the teeth. In such cases, a part of the tooth root becomes exposed. Depending on the cause for the exposure, there is usually sensitivity and bleeding, sometimes even pain and reddening. The progression of this process leads to tooth mobility which may result in tooth loss. The gum and bone are mutually connected and root exposure reduces the bone level.
A “slightly lengthened” look of the tooth caused by recession can be rectified through connective tissue graft. The soft-tissue graft prevents further exposure or development of an already existing recession, improves aesthetics, and decreases or eliminates sensitivity.
Excessive gingival tissue visible when smiling is described with the term “gummy smile”. It can be corrected by changing the level of the gum line through aesthetic lengthening of the tooth crowns. This technique is also used for the leveling of a slightly irregular gum line of adjacent teeth. Lengthening of the clinical crown can help in cases of severely damaged teeth: when the tooth is fractured under the gum line and there is not enough tooth tissue for placing.
As a result of periodontal disease inflamed gums “get detached” from the teeth, forming a periodontal pocket – a gap between the tooth and the gum which might be infected more easily. As the disease progresses, the pockets become deeper, and the bone in this area is destroyed. This process of destruction often has mild symptoms. However, during the final phase the teeth get loose and may have to be extracted. When the pockets are very deep, the so called open curettage is applied. The gum is detached, the infected tissue and the subgingival tartar are cleaned, and the bone is smoothed and covered again with the gingival.
For the periodontal treatment to be successful, it is very important to maintain good oral hygiene, and to visit your periodontist regularly for prevention.