Osseous surgery: Why is it reliable?

Is osseous surgery really necessary?

What is osseous surgery?

Osseous surgery is a surgical procedure to remove bacteria living in the gum pockets. The gum pockets are the spaces between the gum and the teeth.

The main aim of osseous surgery is to get rid of pockets between the gum and teeth. It is a simple surgery with a high successive rate. Osseous surgery keeps the gum clean and healthy after removing all the debris from the spaces between the gum and teeth. It is one of the best treatments for periodontal disease.

Periodontists are expert dental surgeons, especially for osseous surgery. After removing the tarter stick to the teeth, the outer surfaces become smooth. So it reduces the spaces allowing for bacteria to enter and live. Ultimately it cleans the gum and the teeth and keeps them healthy.

What are healthy gum pockets?

Gum pockets or pseudo pockets are the spaces forming between the gum and teeth.

These pockets or spaces are built by the deposition of dental plaque along the gum line and the teeth.

  • The normal size of the gum pocket is about 1mm-3mm. This is a normal condition and doesn’t cause bone loss
  • Mild periodontitis has a gap between 3mm-5mm. This stage is also known as gingivitis. This doesn’t cause bone damage.
  • Moderate periodontitis has a gap between 5mm-7mm. Periodontitis can damage the jaw bone and lead to tooth loss if not treated at the right time.
  • Severe periodontitis has gaps above 7mm.
  • Periodontal pockets larger than 4mm can cause inflammation of the gum. This is not normal and you have to consult for dental advice.

You can easily clean Periodontal gum pockets which are 3mm wide. But you need more technical and aggressive methods to clean gum pockets wider than 5mm.


How do periodontal pockets cause gum disease?

Initially, dental plaque builds up in the spaces or gum pockets. Then if you don’t remove them by proper cleaning they will progressively deposit more and more plaques and tartar sticks to the teeth.

Bacteria enter and live in those spaces and cause gum inflammation. Continuous inflammation leads to an increase in the space or size of the gum pocket. So now those spaces are called periodontal pockets. They are deeper than normal gum pockets.

Next, it allows more and more bacteria to enter and live there. Those bacteria cause inflammation or gum disease. At this stage, you need expert support to remove the debris and reduce gum disease.

What are the risk factors for periodontal disease?

  • Poor oral health
  • Smoking
  • Alcohol intake
  • Certain medications
  • Genetics
  • Stress

Is osseous surgery safe?

Osseous surgery is usually a safe dental procedure. It has a high success rate from the patients. Especially if you take good care of your surgery site after the process you can save your beautiful smile for a long time. Many people who had this procedure have gained lots of benefits in their lives.

What are the benefits of osseous surgery?

Osseous surgery provides more advantages.

  • Keep your smile and better confidence.
  • Stops the infection and inflammation in the mouth.
  • Since our body is an interconnected system, oral health directly affects overall health.
  • Reduce the risk of getting heart or respiratory problems.

Who can have osseous surgery?

If you have gum disease, but it is already progressive and if you cannot reverse it by simply cleaning by yourself you may need osseous surgery. Your dental surgeon decides you need to have this procedure if he cannot reverse periodontitis by other treatments. For instance scaling, root planing, or using antibiotics.

How to prepare for osseous surgery?

Before you take the osseous surgery you need to prepare for at least a couple of weeks. Once you discuss with your dentist, he will give you the advice to stop certain medications and food habits for preparing.

  • You need to stop medicines such as blood thinners, pain relievers.
  • Stop taking alcohol and smoking
  • Your doctor may prescribe you some antibiotics before the surgery. This will prevent getting infections.
  • Follow the medical advice from your dentist.

Can you eat before osseous surgery?

You do not need to avoid food before osseous surgery if you are going to have local anaesthetics. Your dentist will inform you not to take any food or drink before surgery if you need to have general anaesthesia.

Do not drink alcohol or any alcoholic beverages the night before the surgery. This reduces bleeding during the surgery.

How is osseous surgery performed?

Osseous surgery needs the patients to use anaesthetics. You need specialized service often from a periodontist for this procedure.

The periodontist will give you anaesthetic medication. Then you may need to stay for some time until anaesthetics work. You will not feel any pain after this. Once you feel numb, your doctor will start the surgery.

Your doctor will make a small cut or incision at your gum line at the inflammation area. Then he will fold back the gum and clean all the debris and bacteria that lie under the gums. After the cleaning process, he will repair the gums.

If any bone is damaged, periodontists will reshape them to reduce the opportunities for bacteria to enter again into those spaces. If your bone has been damaged significantly you may need another bone regenerative technique. For example bone grafting, and guided tissue regeneration. This will need an artificial membrane to induce bone regeneration.

Once the cleaning process is over periodontists will sew back the gum area and place a dental dressing to cover the area. This manages to bleed.

Is osseous surgery painful?

Usually, osseous surgery is not painful. Your dentist will give you local anaesthetics most often. If you need to have general anaesthesia your doctor will decide. If you are going to have general anaesthesia you may need to avoid food and drink before the surgery.

When you get the anaesthetic medication it can be topical application or injection. If you have to take an injection you will feel a little pain like a pinch while injecting. After that, you feel numb in that area. So don’t worry.

During the surgery, you have no significant pain.

After the surgery, your doctor will give you pain relievers or analgesics. Usually, most patients recover fast with normal pain relief medications. If your pain persists, immediately call your dentist.

Do gums grow after osseous surgery?

Naturally, gums cannot grow by themselves after the surgery. Instead, you need to have a gum tissue graft to replace the damaged gum tissue.

What can I expect after osseous surgery?

After a successive osseous surgery procedure, you need to take good care of your mouth. Otherwise, certain complications might arise.

Your dentist will advise you to change some food and lifestyle habits after this surgery. But don’t worry. They are not very difficult adjustments.

Please do not eat anything until the anaesthesia action stops.

General oral care

  • Clean your mouth properly. Brush and floss daily as described by the dentist.
  • Rinse your mouth with salt added lukewarm water

What can you eat after osseous surgery?

  • Take a nutritious meal. Make sure food is soft, not hard to crush or bite.
  • Add foods rich in nutrients good for oral health for instance minerals like calcium and phosphorus. In addition, add Vitamin-C rich foods like fruits in the citrus family.
  • Avoid eating snacks frequently.
  • Do not take surgery, sticky foods such as foods that contain caramelized sugar.
  • Do not drink carbonated drinks and highly sweet soft drinks
  • Brush your teeth after taking foods
  • Drink a sufficient amount of water.
  • You can have foods such as,
  • Soups
  • Smoothies
  • Mashed potatoes
  • Pasta
  • Chicken cooked
  • Fish cooked
  • Cheese
  • Ground beef
  • eggs.

Lifestyle habits

  • Do not smoke
  • Do not take alcohol or alcoholic drinks for the next 24 hours.
  • Avoid using straws to drink beverages. The suction moment can cause blood clots.
  • Do not do physical activities right after the surgery
  • Place ice pack therapy to reduce swelling on the area if you have. Take some ice cubes into a freezer bag or any container bag and cover it with a soft towel. Apply it in the area of surgery.
  • Put some extra pillows to elevate your head above heart level. This reduces swelling.
  • Do not sleep or lay down pushing the affected part of the surgery.

When can I brush my teeth after osseous surgery?

You can brush your teeth after 24 hours. Use a soft-bristled brush and do not brush that surgery area. Use gentle motions. You have to be careful until your stitches remove or dissolve. Your doctor will inform you whether you have removable stitches or absorbable stitches.

How soon can I floss after osseous surgery?

Do not floss the area for 2 weeks. In contrast, it is okay to floss other parts of the mouth regularly. But be sure to be gentle when handling floss around your mouth.

When can I remove the periodontal dressing?

Usually, the dentist puts a surgical periodontal dressing over the surgical site. This is to protect the area and to provide quick healing and for your comfort.

You may need to keep that dressing for about 7 to 14 days. In between, you have to go to the dentist to check the status of the surgery site.

So try to keep that dressing at the original place until your next dentist meeting. If it is placed off do not try to remake it by pushing or changing it. Contact your dentist for instructions.

Follow normal oral hygiene habits during this period. Softly and lightly brush only the chewing sides of the teeth. Do not try to brush the surgery site harshly.

Will I bleed after osseous surgery?

Normally little bleeding will occur after the osseous surgery. You may feel pinkish fluid in your mouth. That’s normal. Be careful when eating, not chewing from the side that the surgery was done. Do not drink or eat any hot food.

If the bleed persists for a long time, take a wet clean gauze and place it over the surgery site. Leave it for about 20-30 minutes. Do not spit or rinse too much.

If the bleeding doesn’t stop, please call your dentist for further advice.

When can I drink coffee after osseous surgery?

You need to avoid hot coffee until the first 24 hours. Dentists’ advice is not to get any hot drinks in the first 24 hours.

Do I need regular checkups after having osseous surgery?

After the osseous surgery, you need to visit your dentist often for regular checkups. But of course, this depends on your condition as well. You may have to go to the dentist several times a month initially. After That, you need to visit at least two times a year.

Dentists expect Patients who had the treatment to follow good oral care habits at their home. Otherwise, it will be nothing because the surgical correction of your periodontal pockets needs regular cleaning for their long survival.

Improperly cleaned and maintained surgeries can again get the condition. 

It will further allow the bacteria growth and inflammation can happen.


What are the Osseous surgery side effects?

Although osseous surgery is a completely safe treatment it has some side effects.

●      Tooth sensitivity

You may feel sensitive, especially to cold foods and beverages. This can cause discomfort. This reduces several weeks after surgery. You can reduce by your own by keeping that area plaque-free as much as possible. Most patients tend to don’t clean that area when they feel sensitive to brushing also. You should clean that area as directed.

However, if you still feel extreme sensitivity to hot or cold consult your doctor.

Why do you get tooth sensitivity?

In the surgery, the dentist removes or reduces the gum pockets by opening the gum closer to the bone. Because of that, the teeth are more exposed to the outside. So the teeth may look longer. In addition, the spaces between the teeth become wider.

As a result, you may get temperature sensitivities after the surgery. This is very common and after several weeks this reduces gradually.

●      Gum recession

This is another side effect of osseous surgery. Although gum pockets are reduced from the treatment, those gum pockets widen over time. Gum recession means the gum area surrounding the tooth pulls away. It exposes more of the tooth or tooth root. It can allow more bacteria to enter the expanded gums. More bacteria cause inflammation of the area.

●      Bleeding

After the surgery, you may experience little bleeding. This could be due to the damage to the gum area during the surgery. If it persists for a long time you need to consult your dentist.

●      Tooth loss

Some patients may lose their teeth after the osseous surgery. Especially if they don’t maintain proper oral health they are more likely to lose their teeth.

According to a retrospective study based on patients who got osseous surgery and without proper care after the surgery, patients lost 44 teeth. At the starting point, patients had 2184 teeth. All of those teeth were lost due to periodontal reasons.

This indicates how important it is to maintain good oral health even after the surgery.

What are the alternatives to osseous surgery?

●      Antibiotics

At the primary stage of periodontal disease or gum disease, doctors prescribe antibiotics. These medicines can reduce bacteria in the mouth. Thus they reduce the disease progression.

●      Bone grafting

Bone grafting is a replacement of damaged bone by your own bone. This new bone part is the grafted bone. It can also be an artificial bone. The dentist uses this technique when the bone is damaged around the affected part.

The new bone grows around the grafted area and keeps the tooth in place.

●      Soft tissue grafting

Due to gum recession, you may need to have soft tissue grafting around the surgical area. This protects the tooth roots from over-exposure to the outside.

●      Guided tissue regeneration

In this process, the dentist uses a special membrane that helps bone growth. The dentist put this fabric between your bone and tooth. So it increases bone growth.

A New alternative for osseous surgery

Periolase millennium dental laser is a new successive alternative for osseous surgery. Unlike normal surgeries, this new treatment has more benefits.

  • It is a less invasive
  • more comfortable
  • patient-friendly process
  • Less painful
  • Patients can go back to their normal life quickly compared to surgery.

Periolase millennium dental laser is a laser that has a diameter of about 3 hairs. Similarly, like osseous surgery first, you need to get anesthetic medications. The dental surgeon inserts the laser between the tooth and the gum. After that, by using the laser he can completely remove the infection.

The treatment has five main steps.

  1. A perio probe is used to know the depth of the gum pocket.
  2. The laser opens and destroys the damaged tissues.
  3. An ultrasonic scaler and hand tool are used to remove any infected tissues in the area.
  4. Coagulation. In this step, any damaged tissues are removed before bleeding stops. Coagulation means stopping bleeding.
  5. Seal the uncovered tissues against the root surfaces.

Osseous surgery vs scaling

Scaling or root planing means deep cleaning of the roots of the teeth. It is the normal standard teeth cleaning procedure. Instead of the deep teeth cleaning process, osseous surgery cleans your teeth even deeper. It removes the tarter and the debris in the deep parts of the teeth roots.

How to prevent inflammatory gum disease?

At the early stages, gum disease is known as gingivitis or inflammation of the gums. To prevent this condition you may need to follow simple but highly effective remedies.

  • Brush your teeth twice daily
  • Floss daily
  • Replace your toothbrush every three months.
  • Use a toothbrush that has soft bristles.
  • Keep careful when brushing uneven surfaces between teeth.
  • Use a natural but antibacterial mouthwash
  • Have a checkup from your dental doctor at least once a year.

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