When a dentist decides that a patient may need gum surgery, the patient is referred to a periodontist. This is a dentist who specializes in diagnosing and treating conditions that affect the gums.

During the initial consultation, the periodontist reviews the patient’s medical and dental history, including current medications, as well as the patient’s dental x-rays, to determine the most appropriate form of gum surgery. A date will then be scheduled for the surgery.

Prior to the procedure, patients are urged to follow any preparatory recommendations made by the periodontist. In addition, the periodontist is likely to outline any temporary changes to oral hygiene methods that should be made following the procedure.

Patients may be asked to undergo a thorough cleaning of the teeth prior to the procedure. This may include scaling and root planing to remove buildup of tartar (calculus). Patients scheduled to undergo crown lengthening on a tooth that needs an artificial crown may have a temporary crown placed on the tooth prior to the lengthening procedure. This helps protect the tooth and gives the dentist a clearer view of how much soft tissue or bone needs to be removed during the lengthening procedure.

Depending on a patient’s medical condition (e.g., immune system deficiency, certain heart conditions, artificial joints), a dentist or periodontist may prescribe antibiotics to be taken before and after the procedure. This may prevent infection in patients with an increased risk of infection. However, some medications may need to be avoided prior to gum surgery. For example, certain painkillers that may increase the amount of bleeding during the surgery typically are avoided.