Periodontal
Surgery
in London

What is the Treatment Process?

At your initial consultation you may be made aware that some teeth may eventually require some periodontal surgery in order to reduce their ‘pockets’.
However, before proceeding to any surgical treatment, Dr Kalsi will always attempt to gain as much of an improvement in your gum condition with non-surgical periodontal therapy. Even if sites with deep pockets remain after Non surgical therapy, the benefits of this initial therapy include reduced number of sites with deeper sites, shallower pockets at these remaining deep sites (i.e. previously 8mm at baseline and now 6mm), and improved oral hygiene with less overall bleeding and inflammation meaning any surgical procedure is more likely to be successful.
On occasions where deep Periodontal pockets remain (more than 6mm), periodontal surgery may be recommended. Teeth with deep Periodontal pockets are more likely to suffer from progressive bone loss and may eventually lead to tooth loss. Other indications for such surgery include when the gap between roots (furcation) on back teeth has opened as a result of bone loss in this area creating a void where bacteria can invade.
Surgery is carried out under local anaesthesia and you can expect to be comfortable during treatment. If you are anxious, it is possible to arrange for Intra-venous Sedation to be provided. Typical surgery appointments are between 90-180 minutes long.

All surgery begins with careful incisions to allow Dr Kalsi to visually assess and access the disease affected roots. After thorough cleaning, Dr Kalsi will then decide upon the top approach to ensure we can achieve disease resolution. Dr Kalsi utilises the latest minimally invasive microsurgical techniques for all surgical procedures.
When possible, Dr Kalsi will attempt to regenerate the damaged bone/root and gum tissue. This may require the use of a biologic agent (such as enamel matrix derivatives) or a bone graft agent (synthetic/human/animal derived). to promote optimal healing.
In cases where regeneration is deemed to be unfavourable, Dr Kalsi can reshape the gum and bone around the disease affected teeth. This will allow for improved self-performed cleaning and disease stability. At the end of the procedure, the gums will be stitched back, and a dressing may be placed. You will be given verbal and written instructions on how to look after your teeth and gums following surgery.
The stitches will be removed after 1-2 weeks and you will be reviewed regularly over the following 12 months.

The benefits of surgery include:

The ability to reduce pocketing and stabilise teeth which would otherwise not respond to non-surgical therapy.
The ability to regenerate damaged root, bone and gum tissue around disease affected teeth.
Access to the roots of the teeth to allow for optimum debridement/ remove/cleaning.
Ability to reshape the gums and bone.
Ability to add bone grafts if appropriate.
Reduction in the depth/closure of the periodontal pockets.
Increased lifespan of teeth.

Common risks include:

Post-operative pain which will normally require the use of paracetamol/ibuprofen as instructed for 3-5 days.
Swelling and bruising may occur depending on the length and extent of the procedure.
Short-term bleeding from the gums, typically only for the first 24 hours following surgery.
Sensitivity to hot/cold food and drink. Sensitivity but this is short-lasting and can be managed with toothpastes designed to reduce sensitivity.
If the gums have been shaped, as they heal they may recede. This may mean your teeth look slightly longer and the spaces between them may be larger. Recession may be noted, particularly following surgery where regeneration is not possible.
Transient or permanent tooth looseness.
Pain can be managed using over-the-counter painkillers. These are usually required for 2-4 days.