What Is Osseous Surgery?
Osseous surgery is performed when gum disease has destroyed the bone and soft tissue supporting your teeth. It’s also known as pocket depth reduction or gingivectomy. The term osseous comes from the Latin for bone – oss.
Osseous surgery is carried out by a periodontist in cases of severe gum disease (advanced periodontitis) that have not responded to other treatments such as scaling and root planing. It’s a fairly straightforward procedure and not overly invasive.
Gums and bone should fit snugly around teeth, creating a barrier against germs. Osseous surgery strengthens the gums after gaps (pockets) have developed between the teeth and gums, which poses the risk of aggravating periodontal disease by further infection through difficulties in oral hygiene.
Left untreated, periodontal pockets will become even deeper and provide a haven for bacteria to thrive. As these microbes spread, they can advance beneath the gum line, destroying further bone and tissue. One solution is to remove the affected teeth but osseous surgery can avoid the need for extractions.
When Osseous Surgery Becomes Necessary
Periodontal disease – the most common cause of tooth loss among adults – occurs when bacteria attack the gums, causing inflammation and bone loss around the teeth. It can affect one tooth or several.
Eight in ten adults in the U.S. suffer some form of periodontitis, according to the National Institute of Health (NIH). The NIH says smoking significantly raises the risk of periodontal disease, which is also higher in individuals with diabetes.
Periodontitis begins as gingivitis (inflammation of the gums). The sooner a gum infection is detected, the better the chances of effective treatment. However, the early stages of gum disease may be painless and show few if any significant symptoms. This is why gingivitis can progress to periodontal disease and then advanced periodontitis requiring osseous surgery.
Indications of the possibility of a gum problem that can often be ignored include:
- Bleeding gums.
- Bad breath.
- Tooth sensitivity.
- Mouth sores.
- A change in your bite function.
How Can I Find Out Whether I Need Osseous Surgery?
A periodontal specialist will be able to determine whether you require an osseous surgical procedure.
Using a periodontal probe, they measure the depth of the pockets around each tooth, which should be no more than three millimeters. Measurements of four millimeters or more can indicate the beginning of bone loss.
Periodontitis is classed as being severe when two or more tooth pockets measure six millimeters or more, and one or more teeth have a five-millimeter space around the area of an adjacent tooth.
If a tooth pocket doesn’t respond to treatment such as scaling and root planing, osseous surgery will be necessary to reduce the pocket depth, fortify your gums and prevent future accumulations of bacteria.
The Osseous Surgery Procedure
The amount of time osseous surgery takes depends on how large a section of your mouth needs to be treated. Osseous surgery takes about 90 minutes per quadrant of the mouth (upper right, upper left, lower right, lower left). It will take longer if you need a bone graft.
You will remain awake for the procedure – local anesthesia will numb the area being worked on.
During osseous surgery, your periodontist will:
- Fold back gum tissue.
- Remove bacteria.
- Stitch the healthy tissue back in place.
The procedure also includes deep cleaning of tooth root surfaces. If the underlying bone has been damaged, the resulting uneven surface will be smoothed to restrict access by bacteria. This will also enable your gums to reconnect to healthy bone more effectively. In some cases, a bone graft may be required to encourage the body to rebuild the bone and other structures that attach the jaw to the teeth.
You may experience swelling after osseous surgery. Applying an ice pack to your face can ease discomfort. In some cases, antibiotics are administered before, during and after treatment to prevent infection. You may notice some teeth appear to be longer. This is because of the bone loss and removal of tissue.
Your periodontist will prescribe pain relief for the post-surgical healing period, along with an antibacterial mouthwash and antibiotic medication. Your stitches will either dissolve or be removed one to three days after your surgery. After a couple weeks, your periodontist will assess the surgical area and make sure your mouth is healing properly.
Benefits of Osseous Surgery
Your oral health plays an important role in your general wellbeing. As gum disease attacks your teeth, gums, and bone, colonies of bacteria within your mouth can easily spread to other areas of your body, including vital organs. The main benefit of osseous surgery is that it eliminates these bacteria.
Other benefits of osseous surgery include:
- Reduced periodontal pocket depths.
- Avoiding extractions.
- Halting infection and the progression of periodontal disease.
- Prevention of future bacterial accumulation.
- Helping to maintain a healthy smile.
- Easy and fast recovery.
- Easier oral health hygiene at home.
Are There Any Risks with Osseous Surgery?
Osseous surgery – like any other surgical procedure – entails some risks, mainly infection. The likelihood of infection can be minimized by following your periodontist’s oral hygiene guidance on aftercare.
Gum tissue around the teeth that have been treated may recede, resulting in the teeth appearing longer than other teeth. Your periodontist will be able to treat this problem.
Overall, the benefits of osseous surgery far outweigh the risk of relatively minor complications.
Taking Care of Your Teeth and Gums After Osseous Surgery
Osseous surgery can restore your diseased gums to a healthier, more natural state, helping you to maintain a healthy mouth and body – and a healthy smile!
To keep your teeth and gums healthy after osseous surgery requires a routine of:
- Effective daily oral hygiene at home.
- Regular professional cleanings to remove any tartar, which brushing and flossing cannot shift.
The AAP (American Academy of Periodontology) recommends an annual comprehensive periodontal evaluation (CPE) for adults.
If you want to find out more about surgical and non-surgical gum disease treatments, ask a dentist specializing in periodontics.