Pre-Operative Instructions

What are the objectives of clinical crown lengthening?

Clinical crown lengthening is performed in order to elongate the exposed portion of the tooth for either esthetic purposes or to provide room to adequately restore a tooth.

How do we do the surgery?

The surgery is done painlessly with local anaesthetic. The gums and bone around the tooth/teeth are modified to further expose the crown of the tooth. Sometimes a dressing is placed over the surgical site. One site of surgery takes approximately 1 hour.

What happens after the surgery?

A soft diet is recommended and you will be prescribed pain medication and given an antibacterial rinse. You will be seen one week after surgery to check healing, to remove any remaining sutures and to show you how to clean the area. There may be temporary sensitivity to temperature. This is normal and will gradually subside over time. At a second post-operative visit, 3-4 weeks after the surgery, healing will be monitored. If satisfactory, you will make an appointment with your dentist for the crown preparation six weeks after the time of surgery (possibly longer for a front tooth).

What is a connective tissue graft?

A connective tissue graft is used to reinforce the gums around the teeth, stop the progression of recession, and cover the exposed root surfaces where possible. The coverage of roots may not be the focus of this surgery.

How do we do it?

A connective tissue graft is done painlessly with local anaesthetic. A small piece of tissue is taken from the roof of the mouth or purchased from a tissue bank and attached to the affected area. This means that there may be two surgical sites. Sometimes dressings are placed over the surgical sites. The dressings will remain in place for 1-5 days. The surgery takes approximately 1 hour per site.

What happens after surgery?

A soft diet is recommended for the first 6 weeks following surgery and you will be prescribed suitable pain medication. You will be seen two weeks after the surgery to check healing, to remove any remaining dressing and/or sutures, and to be given oral hygiene instruction. You will then be seen two weeks later to monitor healing. In six weeks, the site should be sufficiently healed for the continuation of your normal hygiene regime.

Why remove a tooth and what is a bone graft?

A tooth is usually removed due to extensive bone loss around the tooth or substantial loss of the tooth crown which does not provide sufficient remaining tooth material for restoration. Bone graft is placed immediately after the extraction to rebuild the site and is protected by a membrane held in place with sutures.

How do we do it?

The surgery is done painlessly with local anaesthetic. You will likely experience a feeling of pressure during tooth removal but should not experience any pain. The procedure usually takes approximately 1 hour.

What happens after the surgery?

A soft diet is recommended and you will be prescribed suitable pain medication. If an antibiotic is prescribed, it should be started as directed prior to the surgery, and the complete course of antibiotics must be completed. You will be seen for 2-3 post-operative visits:

1. One week following surgery to check healing and remove sutures
2. Possibly two-three weeks following surgery for further follow-up and suture removal
3. Four weeks following surgery to remove the membrane

An additional appointment will be scheduled for approximately 4 months following the surgery to assess the maturation of the bone graft. At this appointment, you will be given relevant information for tooth replacement.

Why remove a tooth and what is a bone graft?

A tooth is usually removed due to extensive bone loss around the tooth or substantial loss of the tooth crown which does not provide sufficient remaining tooth material for restoration.

How do we do it?

The surgery is done painlessly with local anaesthetic. You will likely experience a feeling of pressure during tooth removal but should not experience any pain.

What happens after the surgery?

A soft diet is recommended and you will be prescribed suitable pain medication. You may be required to return for a post-operative visit one week later.

What is a free gingival graft?

A free gingival graft is used to reinforce the gums around the teeth, and to stop the progression of recession. The coverage of roots is not the focus of this surgery.

How do we do it?

A free gingival graft is done painlessly with local anaesthetic. A small piece of tissue is taken from the roof of the mouth attached to the affected area. This means that there are two surgical sites. Sometimes pink dressings are placed over the surgical sites. The dressings will remain in place for 1-5 days. The surgery takes approximately 1 hour.

What happens after surgery?

A soft diet is recommended for the first 4 weeks following surgery and you will be prescribed suitable pain medication. You will be seen two weeks after the surgery to check healing, to remove any remaining dressing and/or sutures, and to be given oral hygiene instruction. You will then be seen 2-3 weeks later to monitor healing. In six weeks, the site should be sufficiently healed for the continuation of your normal hygiene regime.

What is an implant?

An implant mimics the root of a tooth and supports a replacement tooth or teeth. It is made from titanium, a metal that is not rejected by your body. Your bone will bond to the implant (termed osseointegration) and after healing your restorative dentist will place the implant-supported tooth.

Who is a candidate for implant surgery?

This is a healthy person without gum disease and with enough bone for implant placement (assessed by special radiographs).

How do we do the surgery?

The prescribed antibiotics should be taken one day before the surgery and the course must be completed. The surgery is done painlessly with local anaesthetic. A site is prepared in the bone where the implant is to be placed. The surgical site is closed with sutures. Depending on the type of implant, a second minor surgery may be required.

What happens after surgery?

A soft diet is recommended and usually there is only minor discomfort associated with this procedure. You will be prescribed appropriate pain medication. If you have a denture, you will be given special instructions. You will be seen for 3 post-operative visits.

1. One week following surgery to check healing and remove sutures.
2. 3-4 months after surgery to verify clinically and radiographically that the implant has integrated with the bone.
3. After your dentist has placed the tooth for a final assessment and to review oral hygiene.

What are the objectives of periodontal surgery?

Periodontal surgery is recommended because it will eliminate infection and improve the long-term stability of your teeth and bone. The objectives are:

1. Removal of deep plaque and tartar (calculus)
2. Elimination of the defects in the gums and bone caused by the disease
3. Reduction/elimination of pockets to prevent future infection

How do we do the surgery?

The surgery is done painlessly with local anaesthetic. The diseased roots are exposed and thoroughly cleaned. The diseased gums and bone are modified to eliminate the pockets. Bone regenerative material and bone grafting material may be placed around the teeth. Sometimes a dressing is placed over the surgical site. One site of surgery takes approximately 1 hour.

What happens after the surgery?

A soft diet is recommended and you will be prescribed pain medication and given an antibacterial rinse. You will be seen one week after surgery to check healing, to remove any remaining sutures and to show you how to clean the area. Eight weeks later, you will be seen for a maintenance and re-evaluation appointment. Regular three-month recall appointments will follow this.

What changes may be observed after the surgery?

1. Your teeth may appear longer with wider spaces.
2. There may be temporary sensitivity to temperature.
3. Your teeth may become more mobile. This is usually temporary. Try to ignore this and do not develop a habit of moving the loose tooth or teeth with your tongue or fingers, or grinding these teeth. It is possible to produce further loosening or movement of the teeth with such habits.
4. Although the sites may be generally sensitive, you should be able to continue your normal oral hygiene regimen after two weeks.