When is gum surgery needed?
Gum surgery is needed when conservative treatment such as scaling and root planing is not enough: when deep gum pockets remain, or when there is severe recession or significant bone loss around the teeth.
Chronic gum inflammation, pus and persistent bad breath that do not respond to standard treatment may also lead to gum surgery, to treat the infection thoroughly and remove diseased tissue.
Leaving advanced gum problems untreated can lead to tooth loss and irreversible damage. An examination as part of gum disease treatment in Jerusalem allows an accurate diagnosis and a personal plan. Gum surgery may also be needed for excess gum tissue (gingival overgrowth), lumps or cysts in the gum, or before extensive restorative work.
Exposed roots that cause sensitivity or affect the smile can also be treated with root coverage procedures such as a gum graft.
The main types of gum surgery
"Gum surgery" covers several procedures. The choice depends on the problem being treated: pockets and bone loss, recession, or the shape of the gum line.
Flap surgery and regeneration
Flap surgery (pocket reduction) gives direct access to the roots and bone to clean deep pockets. When bone has been lost, a bone graft or guided tissue regeneration may be added to help the supporting tissues rebuild.
Gum grafts and gum line surgery
Gum grafts cover exposed roots caused by gum recession. Gingivectomy (removing excess gum) and crown lengthening reshape the gum line, for example before a crown or to treat a gummy smile.
What about laser gum surgery?
Lasers are sometimes used in gum surgery, mainly on soft tissue: they cut and remove tissue while sealing small blood vessels, so bleeding is usually limited and stitches are sometimes unnecessary. According to a systematic review by the American Dental Association (ADA), however, most types of laser add only a small benefit, with low certainty, compared with standard scaling and root planing for treating gum pockets; lasers are an adjunct, not a replacement. Laser treatment may also cost more than conventional methods.
What the clinic offers instead of a laser, and why
The clinic does not use a laser: gum surgery there is done with conventional surgical techniques, under local anesthesia. Deep pockets are treated with flap surgery, recession with a gum graft, and soft tissue with crown lengthening or gum contouring. The reason: for gum pockets, the ADA guideline does not recommend lasers as a routine addition to scaling and root planing, while flap surgery lets the dentist see the roots and bone directly, clean them, and add a bone or tissue graft in the same procedure.
| Technique | When | Anesthesia | Stitches | Recovery |
|---|---|---|---|---|
| Flap surgery | Deep pockets or bone loss, after scaling and root planing was not enough | Local | Yes, removed at a follow-up visit or dissolvable | Swelling and discomfort in the first days, first stage of healing in the first week |
| Laser (not used at the clinic) | Soft tissue: gingivectomy, gum contouring; for pockets only as an adjunct, with a small, low-certainty benefit | Local | Depends on the procedure | Bleeding is usually limited |
| Gum graft | Gum recession and exposed roots | Local, sometimes with light oral sedation | Yes | The longest of the three: the final shape of the tissue can take several months to settle |
How is gum surgery performed?
Gum surgery is usually done under local anesthesia and starts with a thorough assessment of your gums.
01
Opening the gum (flap)
Traditional gum surgery starts with a small incision and the lifting of a gum flap, giving direct access to the roots and jawbone below the gum line. The roots are then thoroughly cleaned of tartar and bacterial plaque, a step known as root planing.
02
Closing
If the supporting bone is damaged, a bone graft or guided tissue regeneration may be needed. The flap is then put back in place and secured with fine stitches, which dissolve or are removed at a follow-up visit. The exact technique depends on your situation and the goals of treatment. You receive detailed home-care instructions and, if the dentist decides it is needed, a prescription.
Examination, treatment plan and price quote
detailed and personalized
During the consultation, Dr Haim Aseriel examines your teeth, explains all the options and gives you a transparent price quote, with no obligation. The clinic is at 12 HaTnufa Street, Jerusalem.
How to prepare for gum surgery
The dentist sets the extent of surgery and the technique after the examination, and explains the procedure, its possible risks and the expected results before you decide.
- Examination and planning: X-rays and pocket-depth measurements, and a personal treatment plan.
- A cleaning beforehand: tartar is removed above and below the gum line to reduce bacteria in the area.
- Your medications: bring a full list. Never stop blood thinners on your own: any change is made only on your physician's instructions, in coordination with the dentist.
- Smoking: stop before surgery if you can, because smoking slows healing and can compromise the result.
- On the day: a light meal beforehand (unless told otherwise), comfortable clothes, no makeup or creams on the face.
- Light oral sedation (a prescribed pill), if offered for a complex procedure: come with someone and do not drive afterwards.
Aftercare: instructions after gum surgery
- Cold: a cold compress on the cheek in the first hours, with breaks, reduces swelling.
- Pain: ask your dentist or pharmacist which medication and dose suit you; take any prescribed medication exactly as instructed.
- Food: soft, cool foods in the first days, nothing hot, spicy, hard or grainy, then a gradual return to your usual diet.
- Smoking and alcohol: avoid them during healing, as your dentist advises.
- Brushing: do not brush the surgical area at first, then use an extra-soft brush gently. Floss the area only when the dentist says you can.
- Rest and follow-up: no strenuous exercise, heavy lifting or strong heat (sauna) in the first days; come to the follow-up visits and have the stitches removed, unless they dissolve.
Gum surgery recovery: what to expect
Healing after gum surgery happens in stages, with the first stage in the first week. Swelling, discomfort and light bleeding in the first days are normal as long as they ease gradually; swelling usually peaks in the first few days and then subsides. If bleeding or swelling gets worse after the first few days, or you develop a high fever, contact the clinic immediately, as these may be signs of infection or another complication.
During this period the tissue starts forming new collagen, which is why exercise and strong heat can restart bleeding. Full healing takes several weeks, and follow-up visits check that it is on track.
8%
of US adults aged 30+ have severe periodontitis (Eke et al., 2018)
Over the following months the tissue keeps maturing, although most patients are back to their usual activities well before that. Full maturation, especially after complex surgery or grafting, can take several months, during which the final shape of the gums settles.
Swelling spreading toward the eye or neck, or difficulty swallowing or breathing, requires going to the emergency room immediately. Once the tissue has stabilized, a strict maintenance plan helps prevent gum disease from returning: regular visits to the dental hygienist and dentist, at a frequency set according to your gum condition and personal risk, plus daily oral hygiene. Good maintenance is what protects the result and avoids repeat surgery.
Gum surgery cost: what goes into the price?
The cost of gum surgery varies with the type of surgery, the complexity of the case and the techniques needed. Gum surgery ranges from crown lengthening and cosmetic gum contouring to more complex treatment of advanced gum disease. The number of teeth or areas treated also matters, as do the materials used when they are indicated, such as graft materials or biological products.
The clinic does not publish a price list: after a full examination and a personal treatment plan, you receive a detailed written estimate, and itemized receipts that you can submit to your insurer (coverage depends on your policy). What the written estimate should detail:
- The number of areas or teeth treated, and the type of surgery for each.
- Materials: a bone or tissue graft, or PRF (platelet-rich fibrin from your own blood, prepared at the clinic), when the case calls for them.
- Follow-up visits and stitch removal.
Gum surgery: consultation in Jerusalem
Gum surgery calls for professional knowledge, surgical skill and a personal approach. It includes root coverage, crown lengthening and surgery for advanced gum disease, chosen according to your clinical situation; it is carried out at the clinic by the practitioners who treat gum disease there, with Dr Haim Aseriel coordinating your overall plan. At the first consultation, held in English, your mouth and gums are assessed, the suitable options are explained, and you leave with a detailed treatment plan and written estimate. The clinic is at 12 HaTnufa Street in Talpiot, south Jerusalem.
Gum surgery: frequently asked questions
Gum surgery is usually considered when deep gum pockets remain after non-surgical treatment (scaling and root planing), or when there is severe gum recession or significant bone loss around the teeth. It is also used to cover exposed roots, remove excess gum tissue and lengthen teeth before a crown.
Gum surgery is usually performed under local anesthesia. In traditional flap surgery, the gum is gently opened and lifted to reach the roots and bone below the gum line, the roots are cleaned, and the gum is put back in place with fine stitches, which dissolve or are removed at a follow-up visit.
Laser gum surgery uses a beam of light to cut and remove soft tissue while sealing small blood vessels, so bleeding is usually limited. However, according to a systematic review by the American Dental Association, most lasers add only a small benefit, with low certainty, compared with standard scaling and root planing for gum pockets. The clinic does not use a laser and performs gum surgery with conventional surgical techniques.
Some swelling, discomfort and light bleeding are normal after gum surgery as long as they ease gradually. Call the dentist promptly if bleeding or swelling gets worse after the first few days or if you have a fever. Swelling spreading toward the eye or neck, or difficulty swallowing or breathing, requires going to the emergency room immediately.
The cost of gum surgery depends on the type of surgery, the number of teeth or areas treated, the complexity of the case and the materials needed, such as graft materials. It is set only after an examination and treatment planning, and given as a detailed written estimate.
Sources
- Eke PI et al., Journal of the American Dental Association, 2018 – View the study
- Smiley CJ et al., Journal of the American Dental Association, 2015 – View the study
- Carrasco-Labra A et al., Journal of the American Dental Association, 2024 – View the study
- MedlinePlus (National Library of Medicine), Tooth extraction (aftercare) – View the page
