Gum Surgery: What to Know About Periodontal Surgery (2023)

Medically Reviewed By Christine Frank, DDS

— Written By Carol Dawson Fehringer, MTC

Updated on November 3, 2022

Gum surgery is any surgical procedure performed on the upper or lower gums. Most gum surgeries aim to restore proper support for the teeth.Another name for gum surgery is “periodontal surgery.” Periodontists and oral surgeons are dental professionals who usually perform gum surgeries.

Read on to learn about types of gum surgery, the conditions they treat, and what to expect before, during, and after gum surgery.

What is gum surgery?

Gum Surgery: What to Know About Periodontal Surgery (1)

Gum surgery, also known as “periodontal surgery,” is a type of dental surgery. Gum surgeries aim to:

  • treat gum infections and remove bacteria
  • regenerate damaged or lost bone
  • regrow healthy gum tissue
  • reduce periodontal pockets, which are spaces under the gumline that can fill with bacteria, plaque, and tartar
  • prevent bone and tooth loss

There are several types of gum surgery. Gum surgery usually occurs in a periodontist’s office, although some procedures may require treatment in a hospital.

People who may require hospital care for gum surgery include:

  • young children
  • adults with dementia
  • anyone unable to remain still in a dental chair, regardless of sedation

What conditions does gum surgery treat?

Gum surgery may be necessary to reduce the risk of losing a tooth or teeth due to these conditions:

Gum recession

Gum recession due to periodontal disease exposes the tooth root. This affects the appearance of the teeth, making them look longer. The exposed root can also become sensitive and open to decay.

Gum graft surgery can reduce further gum recession and cover and protect exposed roots while improving your smile.


This periodontal or gum disease involves swollen and red gums. Gums may bleed easily when flossing, brushing, or crewing.

This stage of gum disease is usually reversible with professional treatments such as laser treatment and scaling and root planing, followed by dedicated home care. Gum surgery is the next step if these nonsurgical approaches do not restore periodontal health.


Periodontitis is an advanced form of gingivitis. At this stage, bacteria and plaque form below the gum line. Toxins from this bacteria cause chronic inflammation.

As the disease progresses, gum tissue separates from the teeth to form pockets, exposing more of the teeth. Inflammation can destroy gum tissue and bone structure that support teeth in place and lead to tooth loss and bone loss.

Facial trauma

Facial trauma involves physical injury to the mouth, teeth, face, or jaw. Another name is “maxillofacial trauma.” Sports, motor vehicle accidents, or accidents such as falling or tripping are common causes of maxillofacial trauma.

Cosmetic reasons

Sometimes, the gumline covers too much of the tooth or teeth. During gum surgery, the periodontist removes the excess gum tissue to expose more of the crown of the tooth and sculpt the gumline.

What are the types of gum surgery?

Here are the most common gum surgeries, the reasons for performing them, and what happens during the surgery.

Periodontal pocket procedures

With periodontal disease, the gum tissues and bone no longer snugly support the teeth. This forms pockets around the teeth. As these spaces become larger, bacteria can accumulate under the gum tissue. This leads to tissue and bone damage and loss.

Surgery may be necessary for periodontal disease when more conservative procedures, such as scaling and root planing, are ineffective. Scaling and root planing are deep cleaning procedures that dentists usually use as first-line treatments for gum disease.

The goal of this surgery is to save the tooth. The procedure has other names, including “open flap surgery” and “pocket reduction surgery.”

During a periodontal pocket procedure, the periodontist or surgeon:

  • pulls back an area of the gum
  • cleans the roots of a tooth and removes any bacteria
  • smooths out bumpy areas to reduce the chances of bacteria growing in crevices
  • repairs damaged bone, if necessary
  • sutures the gum back in place

Gum graft surgery

A gum graft or soft tissue graft treats gum recession. With gum recession, the roots of teeth are exposed. This can cause pain, especially when exposed to heat and cold. It can also lead to bone loss.

The surgeon covers the exposed area with a skin graft during gum graft surgery. The graft may be taken from your palate (the roof of your mouth) or a type of donor tissue. The graft may involve one tooth or multiple teeth. As it heals, the graft forms a strong band. Gum graft surgery can help:

  • reduce tooth sensitivity
  • prevent additional gum recession in the treated area
  • prevent bone loss
  • improve the appearance of your smile

Bone graft

A bone graft is a type of regenerative tissue procedure. It treats bone loss due to:

  • periodontal disease
  • physical injury to the jaw, mouth, or teeth
  • lesion or tumor removal
  • congenital irregularities

A bone graph may also be necessary to repair the area for a dental implant or to prepare the jaw for dentures.

During a bone graft, the surgeon:

  • puts an incision in the gum to open the area
  • cleans all bacteria and removes destroyed bone
  • replaces missing bone with material from the patient or a synthetic bone option
  • puts the gum tissue back in place and sutures the incision.

The bone graft material is considered a mineral reservoir to facilitate new bone growth.

Dental crown lengthening

Excess gum tissue can make the teeth appear shorter than they are. Some people may call this a “gummy smile.” During dental crown lengthening, the periodontist removes excess gum tissue and bone, if necessary, to expose more of the teeth and make them look longer. This is usually considered a cosmetic procedure and may not be covered by insurance.

In some cases, this procedure may involve bone removal to access a decayed or fractured area of tooth to put a crown or bridge into place. This is not a cosmetic procedure and may be covered by insurance.

Who performs gum surgery?

Periodontists and oral surgeons are two dental professionals who usually perform gum surgeries.

A periodontist is a gum surgery specialist. They care for people who have gum disease, injured their gums through trauma, or are looking for plastic surgery to enhance their appearance.

An oral and maxillofacial surgeon also performs gum surgery, particularly when it involves bone grafts, tissue regeneration, or reconstruction surgery.

How do I prepare for gum surgery?

Your care team will most likely send you pre- and postsurgery instructions.The procedure instructions may include information about prescription and over-the-counter (OTC) medications or products you will need.

It is important to fill these prescriptions and purchase the necessary supplies a few days before surgery. This way, you will have everything you need to start your recovery.

What happens on the day of gum surgery?

If your periodontist plans to use light sedation, called “conscious sedation,” they will provide fasting instructions, such as not eating at least 6 hours before the procedure.

The dental team will insert an IV line into a vein in your arm or hand for light sedation.

Once you are sedated, the periodontist will apply a topical numbing agent to desensitize the gum area. Once the area is numb, the surgeon will inject lidocaine to numb the entire area. This takes about 5 minutes and lasts 1–2 hours.

Once the procedure is over, you should be able to go home. If you have a sedative, you will need someone to take you home. Even if you did not have conscious sedation, having someone with you is still a good idea.

The office will give you instructions on caring for your mouth and gums during the healing period.

What should I expect after gum surgery?

It can take a few days to a couple of weeks to recover from gum surgery, depending on the procedure and the extent of the work.

Aftercare instructions may include the following directions:

  • Stay upright but inclined by keeping your head above your heart. Do this for the first couple of days. Lying flat may increase pain and the risk of bleeding.
  • Change the gauze in your mouth when it is soaked with blood.
  • Brush your teeth gently, avoiding the area where the surgery took place.
  • Do not spit. If you must remove something from your mouth, such as after you brush your teeth, allow the liquid to drip out of your mouth. Use this technique with mouthwash only if your dentist instructs you to do so.
  • Do not suck on a straw or make any similar movement.
  • Do not smoke, as this inhibits proper healing and may lengthen recovery time.
  • For the first couple of days, consume only soft foods, such as soup or Jell-O. Make sure no small bits of food can get caught in your sutures.
  • Keep physical exercise to a minimum. Do not exert yourself, as this may cause more bleeding.
  • If you have a surgical dressing that you are to remove yourself, follow the care team’s instructions precisely.
  • Do not pull your lip out to check the sutures or the treatment area. This could dislodge the sutures and grafts.

Is gum surgery painful?

Most people feel some level of pain following gum surgery after the anesthetic wears off. You can often manage the pain with OTC medications, although your periodontist may prescribe stronger medications if necessary.

You may hear the phrase, “Keep ahead of the pain.” This means taking pain medication as prescribed even if you are not feeling strong pain. This is especially important the first day or two after surgery.

Applying an ice pack to the area from the outside can help reduce swelling and pain. Remember not to put ice directly on the skin because it can damage it.

When should I call my doctor?

Your periodontist or oral surgeon will discuss the next steps with you before surgery or with your caregiver after surgery. You will likely have a follow-up appointment, but it’s important to know when to call them in case of unexpected symptoms.

Call the office or the after-hours number right away or seek immediate medical care at a hospital emergency department for:

  • bleeding that won’t stop or that extends beyond the time indicated on your aftercare instructions
  • signs of infection: fever, increasing pain, discharge from the wound
  • difficulty breathing

What are the risks and potential complications of gum surgery?

Any surgery, no matter how minor, has risks and potential complications. Here are some of the most common ones and those related to periodontal surgery.

The general risks of surgery include:

  • anesthesia reaction, such as an allergic reaction and problems with breathing
  • excess bleeding
  • swelling
  • pain
  • infection

Most people who have gum surgery do not experience problems afterward, but potential complications include:

  • hypersensitivity of the roots
  • teeth becoming unstable or moving
  • limited jaw motion, called “trismus”
  • changes in taste
  • nerve or blood vessel damage

Reducing your risk of complications

You can reduce your risk of certain complications by:

  • following instructions regarding mouth care, including what types of food to avoid during recovery
  • informing your periodontist about any medications or supplements you take
  • notifying your doctor immediately of any concerns, such as bleeding, fever, or increase in pain
  • taking your medications exactly as directed
  • telling all members of your care team if you have allergies

Other frequently asked questions

Here are a few other common questions about gum surgery. Christine Frank, D.D.S., has reviewed the answers.

Where is gum surgery performed?

Gum surgery usually occurs in the dental office or clinic. There are some situations where it is necessary to perform the treatment in a hospital. For example, some people may require deeper sedation and recovery in a hospital.

Does gum surgery use anesthesia?

The type of anesthetic necessary for gum surgery depends on the procedure and the person needing the surgery. If your periodontist plans to use light sedation, called “conscious sedation,” you must follow your surgeon’s instructions for fasting before the procedure. Light sedation is given by IV.

A topical anesthetic is used to numb the spot where they will inject a local anesthetic, typically lidocaine. Lidocaine numbs the entire area and lasts 1–2 hours.

How long does it take to recover from gum surgery?

Recovery from gum surgery can take a few days to a few weeks. It all depends on the procedure performed and the amount of repair needed. Your surgeon can provide more guidance on what to expect with recovery.


Gum surgery is a type of dental surgery to treat periodontal disease and injuries or congenital irregularities of the mouth, teeth, face, or jaw.Periodontists and oral surgeons usually perform gum surgeries. Another name for gum surgery is “periodontal surgery.”

Gum surgeries aim to treat gum infections, regenerate bone or gum tissue, and prevent bone or tooth loss. There are several types of gum surgery. Procedures include tissue grafts for gum recession and plastic surgery to enhance smiles.

Depending on the type of surgery, recovery after gum surgery can take days to a few weeks. Carefully following aftercare instructions can speed recovery.


How long does it take to recover from periodontal surgery? ›

Recovery usually takes one week to two weeks, but it may take longer. Gum grafting has a good success rate and can reduce your risk of severe gum disease.

What to expect when you have periodontal surgery? ›

The procedure involves lifting the gums off of the teeth to remove tartar buildup. After the surgeon has cleaned the area and removed the tartar, they will stitch the gums into place to fit around the teeth. Sometimes, the bone may require reshaping during this procedure.

What is the most common problem patients experience after periodontal surgery? ›

What is the most common problem patients experience after periodontal surgery? Pain, swelling, infection, and bleeding are all possible side effects of any surgical procedure. Root hypersensitivity and gingival recession are also possible after surgery.

How do you prepare for dental surgery for periodontal treatment? ›

A couple of weeks before your procedure, you may need to stop taking certain medications, such as aspirin (Bayer, Bufferin), pain relievers, and blood thinners. Most dentists advise not smoking or drinking alcohol at least 24 hours before the procedure.

What are disadvantages of periodontal surgery? ›

Postoperative complications of surgical therapy can include bleeding, pain, and infection. Long-term negative outcomes may include a loss of periodontal attachment, gingival recession, and tooth sensitivity.

How long after periodontal surgery can you eat? ›

No straw for the next 2-3 days! 3rd day until 2 weeks after surgery: A very soft food diet should only be eaten (Pasta, soups, eggs, fish, cooked soft vegetables, oatmeal, rice, beans etc.) Avoid any hard, spicy, crusty, coffee or acidic foods. Chewing should be done on the side opposite the surgical site.

How painful is periodontal surgery? ›

The actual gum grafting procedure is painless. This is because a local anesthetic is used to numb the affected area. A periodontist, who is a dental specialist in gum disease and the gums, typically performs this procedure. You may instead feel some movement or pressure as your periodontist performs the procedure.

Are you awake for periodontal surgery? ›

Anesthesia. A local anesthetic will be used near the affected gum area. Your periodontist may recommend conscious sedation. You will be awake, but will have no anxiety during the surgery.

How painful is a periodontal cleaning? ›

Deep teeth cleaning can be uncomfortable, but it shouldn't be painful. You dentist will give you a local anesthetic, either in the form of a gel or an injection, so you shouldn't feel any pain during the procedure.

How long do stitches stay in after gum graft surgery? ›

DO NOT manipulate any stitches at the GUM GRAFT SITE. These stitches are resorbable and will dissolve in 4 to 7 days. The HARVEST SITE will have either a liquid band-aid or resorbable stitches. The liquid band-aid will chip away over the next 1-2 weeks.

Should I have periodontal surgery? ›

If the gingivitis is minor in nature, it may be possible to heal the gums by simply performing a cleaning. If the gum disease is left untreated, it may be necessary to schedule surgery. This is why it is important to visit a dentist at the first sign of a problem and seek treatment right away.

How long does pain last after periodontal surgery? ›

It is not unusual to have discomfort for at least the first week following your surgical procedure. If necessary you will be given a prescription for medication to help you tolerate the post-surgical recovery period. Please take your medications as directed.

What kind of anesthesia is used for periodontal surgery? ›

Medications most commonly used are Fentanyl (opiate), Versed (benzodiazepine), Ketamine, and Diprivan. Supplemental oxygen is delivered through a nasal breathing apparatus and the patient's vital signs are closely monitored. Usual Indications General anesthesia is available for all types of oral surgery.

What can you not do before gum surgery? ›

Nothing to eat or drink for eight (8) hours prior to surgery. Please take regular medications prescribed by your physician as usual with very little water as early in the day as possible, unless instructed otherwise.

What can you not do after a periodontal treatment? ›

Don't eat anything while your mouth is still numb. Don't eat sharp, crunchy, grainy, or challenging foods on the first day. Don't drink hot beverages for about 48 hours. Don't rinse your mouth for about 48 hours.

What is the success rate of periodontal surgery? ›

Periodontal Treatment Success Rate

The overall success rate of both surgical and nonsurgical options is at around 87%.

Can periodontitis be cured with surgery? ›

Surgical treatments

If you have advanced periodontitis, treatment may require dental surgery, such as: Flap surgery (pocket reduction surgery). Your periodontist makes tiny incisions in your gum so that a section of gum tissue can be lifted back, exposing the roots for more effective scaling and root planing.

Is periodontal maintenance forever? ›

Instead, you will require special ongoing gum and bone care procedures, known as Periodontal Maintenance Therapy, to keep the disease under control and keep your mouth healthy. In most cases, Periodontal Disease is a lifelong disease that never goes away.

When can I brush my teeth after periodontal surgery? ›

A: You may resume brushing and flossing all teeth except the surgical area 24 hours after surgery. Avoid brushing the surgical area until your stitches are removed or have dissolved depending on the type of stitches placed for your procedure.

Can I drink coffee after periodontal surgery? ›

Cold or warm temperature foods are recommended for the first day. Coffee or tea can be consumed if it is not hot. After the first day, stay on a soft but balanced diet.

Can you talk after periodontal surgery? ›

Your periodontist will ask you to keep the gauze in place for the first 40 to 50 minutes, reducing the risk of bleeding. You should also refrain from speaking. While you may feel up to chatting, it's best to wait 2 or 3 days unless otherwise advised by a dentist.

How will I feel after gum surgery? ›

Pain. The area of the gum graft will be tender for a day or two, and sensitive to hot or cold drinks and hard foods for a several weeks afterward.

Do they numb your mouth for periodontal cleaning? ›

Deep cleaning typically doesn't require numbing your mouth; the dentist will decide whether to numb your mouth based on the condition of your teeth's roots and the depth of the pockets. If you do feel any discomfort or pain, let your dentist know.

What not to do after gum graft surgery? ›

AVOID PEROXIDE, ALCOHOL, CARBONATED BEVERAGES, AND DRINKING THROUGH A STRAW. After 24 Hours. You may have soft foods, such as cooked vegetables, fish, pasta, and meatloaf, which are easily chewed. You should use utensils and avoid chewing at the surgical site for 2 weeks.

Can you eat before periodontal surgery? ›

If you're going to have anesthesia, your dentist will recommend that you do not eat or drink anything for at least eight hours prior to your surgery. If you need to take medication, only use a small sip of water if necessary. Doing so will help you to avoid any risk of aspiration during surgery.

How much does periodontitis treatment cost? ›

Periodontal Disease treatment cost ranges from $1,700 - $8,000, and teeth extractions average $200.00-$300.00 per tooth. The first treatment option is root scaling and planning. If this is not effective, surgery is needed, potentially using pocket reduction and bone grafting.

How long does a periodontal cleaning take? ›

This is a difficult question to answer, as it depends on the severity of your gum disease. You may need only a one-hour long office visit, or you could need a two-hour appointment; some patients need multiple appointments because we determine it's best to do one quadrant of the mouth at a time.

How long should a periodontal cleaning take? ›

The cleaning process typically takes less than 30 minutes to finish, with some lasting up to an hour. The cleaning appointment's duration is largely determined by the teeth's and gums' condition and the type of cleaning needed by the patient.

How long does periodontal teeth cleaning take? ›

A deep dental cleaning session lasts approximately 45 minutes. Gum disease that has advanced beyond this stage is called periodontitis, which affects the bones and tissues that keep your teeth in place. Your gums may recede, and pockets may develop between teeth and gums.

Does removing stitches from gums hurt? ›

Does getting stitches out hurt? No, if you don't squirm around and just stay still, you really shouldn't feel anything at all except the little tug as each stitch is lifted up and cut. And actually, if your stitches have sagged or loosened up any at all, you may not even feel that.

How do you sleep after a gum graft? ›

Following oral surgery, we recommend that you sleep with your head and shoulders propped up above your heart level. Add an extra pillow or two to your bed or to the place where you will be resting. If you have a recliner, this is also an excellent way to keep your head elevated.

Is periodontitis a big deal? ›

Periodontitis is a severe gum infection that can lead to tooth loss and other serious health complications. Periodontitis (per-e-o-don-TIE-tis), also called gum disease, is a serious gum infection that damages the soft tissue and, without treatment, can destroy the bone that supports your teeth.

What is the best pain reliever after gum surgery? ›

For most procedures, most patients report 2-3 ibuprofen( Motrin or Advil) or 1-2 extra-strength acetaminophen (Tylenol) is adequate to control pain.

What type of antibiotic would be used after periodontal surgery? ›

It is concluded that pre operative prophylactic administration of antibiotic is a pre requisite to prevent the postoperative bacteremia and its possible sequelae following periodontal surgery. Amoxicillin is highly effective in preventing such post operative bacteremia.

How painful is anesthesia injection in gums? ›

Your dentist will then inject the anesthetic into the area he/she wants numb. You will rarely ever feel the needle. The only sensation most people feel is the sting of the medicine moving into your tissues. These anesthetics can last as long as several hours.

Does anesthesia in gums hurt? ›

Intraoral local anesthesia is essential for delivering dental care. However, it is often perceived by some patients as the most painful and in some instances as the only painful part of the treatment, leading in extreme cases to avoidance of dental care.

How do you clean your mouth after gum surgery? ›

Your dentist will recommend salt water rinses with warm salt water, 4 to 5 times a day for 7 to 14 days. Gently rinse your mouth with a mixture of a half teaspoon of salt in an eight ounce glass of warm, not hot, water. No swishing - this can disrupt healing.

How can I prevent infection after gum surgery? ›

How Do I Help Prevent Infection After Oral Surgery?
  1. Avoid smoking or tobacco use. ...
  2. Use prescribed rises or salt water rinses to help keep your mouth clean while the operation site heals.
  3. Avoid sucking on straws or anything that could cause the healing clot to dislodge.
Mar 14, 2022

How long does it take for gums to heal after periodontal cleaning? ›

Within a week the gums will start to heal and reattach to the roots of the teeth. The initial discomfort should be gone. Full recovery and reattachment can take up to 6 or 8 weeks, but patients are usually back to normal eating, drinking, brushing, and flossing within the first week.

Can I eat a burger after deep cleaning? ›

Your gums and teeth will be healing and sensitive after a deep cleaning, so avoiding certain foods is recommended. These are some foods that could interrupt the healing process and should be avoided following the procedure: Acidic foods like oranges and tomatoes. Challenging foods like steaks or large burgers.

Can you keep your teeth with periodontitis? ›

Saving teeth from periodontal disease is possible if you detect the signs and symptoms early or regularly visit your dentist for cleanings and exams. Let the condition progress unhindered, and tooth loss should be considered as an eventuality.

Does periodontal surgery hurt? ›

Throughout your surgery, you can expect to feel no pain whatsoever, as the anesthesia will ensure you are thoroughly numb. However, once you are home and the effects have worn off, it is not uncommon to experience some soreness and discomfort.

How painful is periodontal treatment? ›

The short answer is no, the procedure is not painful. You will experience discomfort upon completion but the actual process can be completed with the administration of a local anesthetic to the soft tissue to minimize any unpleasant feelings during the process.

What are the restrictions after gum surgery? ›

DO NOT chew or bite in the area. Generally, there are no restrictions on your diet, but depending upon the location of the graft, this may modify your usual biting and chewing patterns. AVOID hard, chewy or spicy foods, since they will aggravate bleeding, especially in the donor site (palate).

Are you awake during periodontal surgery? ›

Anesthesia. A local anesthetic will be used near the affected gum area. Your periodontist may recommend conscious sedation. You will be awake, but will have no anxiety during the surgery.

Is periodontal treatment worth it? ›

Periodontal treatment is very important. It does prevent tooth loss, which can be caused by periodontitis. This treatment also prevents other issues caused by periodontitis, like heart attack risks. You should talk to your dentist if you suspect periodontitis.

Can you get new teeth after periodontitis? ›

The simple answer is no. You need healthy, strong gums to get a dental implant. Like we mentioned before, gum disease weakens and dissolves this tissue and bone. So even after you've treated the disease, your gum tissue and jawbone may not be strong enough to support an implant.

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