Oral and Maxillofacial Surgery

What Is Gum, Oral and Maxillofacial Surgery?

Periodontal, oral and maxillofacial surgery includes a range of specialized procedures used to manage advanced gum disease, jawbone problems, impacted teeth, jaw abnormalities, facial injuries and certain conditions affecting the tissues of the mouth.

Depending on the condition, treatment may be provided by a periodontist, an oral and maxillofacial surgeon, or through cooperation between several dental and medical specialists.

These procedures are not performed solely to treat disease. In appropriate cases, surgery may also help preserve teeth, rebuild lost tissues, improve chewing and jaw function, and restore balance to the smile and face.

When Might Gum or Oral Surgery Be Needed?

Conditions that may require specialist assessment include:

Advanced periodontal disease and loss of supporting bone
Deep periodontal pockets
Gum recession
Exposed tooth roots
A need for crown lengthening
Problematic impacted or partially erupted wisdom teeth
Jaw cysts or other lesions
Insufficient bone for certain dental implant treatments
Jaw or facial trauma
Significant upper or lower jaw discrepancies
Functional bite or chewing problems associated with jaw position
Certain temporomandibular joint conditions requiring surgical assessment
Abnormal soft-tissue lesions in the mouth

Having one of these conditions does not automatically mean surgery is required. An accurate diagnosis should be made first.

Types of Gum Surgery

1. Surgery for Advanced Gum Disease

Periodontitis can progressively damage the gum tissue and bone supporting the teeth.

Many patients are initially treated using non-surgical periodontal therapy, including deep cleaning below the gumline.

If deep periodontal pockets remain or certain areas cannot be adequately treated non-surgically, a periodontist may recommend periodontal surgery.

The goals may include:

Improving access to tooth roots
Removing deposits and diseased tissue
Reducing periodontal pocket depth
Making oral hygiene easier
Helping preserve teeth and their supporting structures

2. Periodontal Flap and Pocket Reduction Surgery

During periodontal flap surgery, the gum tissue is carefully moved back to allow access to the tooth roots and surrounding bone.

The area can then be thoroughly cleaned before the gum is repositioned and sutured.

This treatment may be recommended for selected patients with advanced periodontal disease.

3. Gum Graft Surgery

A gum graft may be used to treat certain forms of gum recession and exposed tooth roots.

Depending on the case, grafting may help:

Cover part of an exposed root
Reduce sensitivity in some patients
Increase gum tissue thickness
Reduce the risk of progression in certain recession defects
Improve the appearance of the gumline

Complete root coverage cannot be guaranteed in every case and depends on the type and severity of recession.

4. Periodontal Regeneration

Certain patterns of bone loss caused by periodontal disease may be suitable for regenerative treatment.

A periodontist may use:

Bone grafting materials
Regenerative membranes
Tissue-stimulating materials

to encourage regeneration of some of the lost supporting structures.

Not all bone loss can be completely regenerated, and results depend on the type of defect and individual patient factors.

5. Crown Lengthening

Dental crown lengthening involves reshaping the gum and, when necessary, the underlying bone to expose more of the tooth.

It may be performed to:

Make a damaged tooth easier to restore
Allow placement of a dental crown
Improve certain types of gummy smile
Create a more even gumline

6. Cosmetic Gum Contouring

The shape and level of the gums can affect the proportions of a smile.

In certain cases, gum reshaping may be considered to improve symmetry or expose more of the natural tooth.

However, not every gummy smile is caused by excess gum tissue. Lip movement, jaw position and tooth position may also contribute, so the underlying cause should be diagnosed before treatment.

What Is Oral and Maxillofacial Surgery?

Oral and maxillofacial surgery is a surgical specialty involving conditions of the mouth, teeth, jaws and related facial structures.

Procedures range from the removal of certain impacted teeth to complex corrective jaw surgery and reconstruction following facial trauma.

Wisdom Tooth Surgery

Wisdom teeth may fail to erupt fully when there is not enough room in the mouth. They can remain partially or completely impacted.

Wisdom tooth removal may be recommended when problems include:

Recurrent infection
Decay that cannot be predictably restored
Gum disease
Damage to a neighboring tooth
A cyst or other pathology
Pain or other disease associated with the tooth

Not every impacted wisdom tooth needs to be removed.

If a wisdom tooth is healthy and not causing problems, monitoring with routine dental examinations and appropriate imaging may be recommended.

What Is Corrective Jaw or Orthognathic Surgery?

Orthognathic surgery, also known as corrective jaw surgery, is used to manage certain skeletal discrepancies involving the upper jaw, lower jaw or both.

In these cases, orthodontics alone may not be able to correct the underlying jaw relationship.

For appropriate patients, corrective jaw surgery may help improve:

Jaw alignment
Bite and chewing
Facial symmetry
Facial proportions
Certain functional problems associated with jaw position

Treatment is often planned jointly by an orthodontist and an oral and maxillofacial surgeon.

Is Jaw Surgery Used to Treat TMJ Disorders?

Not every temporomandibular joint disorder, or TMD/TMJ problem, requires surgery.

TMJ disorders have many possible causes, and many patients are initially treated using non-surgical approaches.

Surgery is considered only for selected conditions after an appropriate diagnosis and evaluation of the severity of the problem and the response to other treatments.

Jaw pain, clicking or limited movement alone does not necessarily mean surgery is required.

What Is Jawbone Grafting?

A jawbone graft is used to increase or rebuild bone in a particular area.

One common indication is preparing a site for dental implant treatment when there is insufficient bone volume.

Depending on the case, bone grafting may be performed:

Before implant placement
At the same time as an implant in selected cases
As part of another reconstructive procedure

Not every dental implant patient requires a bone graft.

What Is a Sinus Lift?

In the back of the upper jaw, the maxillary sinus may leave insufficient bone height for certain dental implants.

For suitable patients, a sinus lift or sinus augmentation can be performed to increase the available bone in this area.

The need for the procedure is determined using clinical examination and appropriate dental imaging.

Surgery for Oral and Jaw Cysts or Lesions

Cysts, lumps and other lesions can develop in the jawbone or soft tissues of the mouth.

Some are discovered during routine examinations or dental imaging.

Depending on the nature of the lesion, a biopsy, surgical removal or another diagnostic or therapeutic procedure may be required.

A persistent ulcer, lump or unexplained change in the mouth should be evaluated by a dental or medical professional.

Treatment of Jaw and Facial Injuries

Accidents, falls, sports injuries and other forms of trauma can cause fractures of the jaw or facial bones.

Treatment may aim to:

Restore the normal position of the bones
Maintain or restore the bite
Restore jaw function
Reconstruct normal facial form as much as possible

Whether surgery is necessary depends on the type and severity of the injury.

What Is Checked Before Oral Surgery?

Preoperative assessment may include:

Medical history
Current medications
Relevant medical conditions
Teeth and gum health
Dental X-rays
CBCT imaging when appropriate
Jawbone condition
Smoking and tobacco use
History of abnormal bleeding or medication allergies

Patients should tell their clinician about all medications, supplements and medical conditions before undergoing surgery.

Is Gum or Jaw Surgery Painful?

Many procedures can be performed under local anesthesia, while certain operations may require sedation or general anesthesia.

After surgery, temporary pain, swelling, tenderness or difficulty opening the mouth may occur.

The severity and duration of these symptoms depend on the procedure and the individual patient.

Care After Gum and Oral Surgery

Instructions vary according to the procedure, but general recommendations may include:

Take prescribed medication as directed
Avoid disturbing the surgical site
Follow instructions for brushing and mouth rinsing
Eat softer foods during the initial healing period
Avoid smoking and tobacco
Limit strenuous activity when advised
Attend follow-up appointments

After tooth extraction, protecting the blood clot at the surgical site is especially important for normal healing.

When Should You Seek Help After Oral Surgery?

Contact your dental or surgical team if you experience:

Heavy or uncontrolled bleeding
Severe or increasing pain
Swelling that is getting significantly worse
Fever or signs of infection
Difficulty breathing or swallowing
An unusual reaction to medication

How Much Does Gum, Oral or Jaw Surgery Cost?

The cost varies depending on factors such as:

Type of surgery
Complexity of the procedure
Number of areas requiring treatment
Need for gum or bone grafting
Materials used
Imaging and diagnostic requirements
Type of anesthesia or sedation when required
Additional treatment

An accurate cost estimate can usually be provided after examination and treatment planning.

Specialist Treatment for Oral Health and Function

Surgery is not always the first treatment option. However, when surgery is clinically indicated, timely treatment can play an important role in controlling disease, preserving oral tissues and restoring function.

Book a Gum, Oral or Jaw Surgery Consultation

If you have gum bleeding or recession, a problematic wisdom tooth, swelling, jaw pain, difficulty chewing or another oral or jaw concern, book an assessment at [Clinic Name] in [City].

Following an examination and any necessary imaging, your clinician can determine whether surgery is required and discuss the most appropriate treatment options.

Frequently Asked Questions

Does gum disease always require surgery?

No. Many cases are initially treated non-surgically. Surgery may be considered when the extent of disease or response to initial treatment makes it appropriate.

Do all impacted wisdom teeth need to be removed?

No. A healthy wisdom tooth that is not causing problems may simply be monitored. Infection, decay, gum disease, cysts or damage to neighboring teeth may be reasons to consider removal.

What is a gum graft used for?

Gum grafting may be used for certain types of gum recession, to increase tissue thickness and to cover part of an exposed tooth root.

Does everyone need a bone graft before a dental implant?

No. Bone grafting is considered when the available bone is not sufficient for the planned implant treatment.

Is corrective jaw surgery cosmetic surgery?

Not primarily. Orthognathic surgery is generally performed to correct structural and functional jaw discrepancies, although it can also change facial balance and appearance.

Do TMJ disorders always require surgery?

No. Many TMJ disorders are managed without surgery. Surgical treatment is reserved for selected patients after specialist assessment.