Osseous Surgery: Everything You Need to Know

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Dental health is strongly linked to the health of our bodies overall. If you have gum disease, gum pocket reduction surgery can clear tartar from your mouth and prevent infection from spreading throughout your body.

As part of the procedure, your healthcare provider will perform osseous surgery to smooth irregularities in the jaw bone. Here's what to expect from this oral surgery.

Women in dental chair speaking with dentist

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What Is Osseous Surgery?

Osseous surgery is part of an effective treatment plan against periodontal disease. Beyond removing cavities and pulling damaged teeth, gum pocket reduction surgery removes debris from the crevices that form as a result of gum disease. Cutting out the infected tissue keeps the rest of your mouth and body healthy.

Once the gums are pulled back and tartar buildup is removed, the tooth is smoothed out to reduce hidden spaces where bacteria like to hide. Osseous surgery is typically performed under local anesthesia by a board-certified periodontist as part of an outpatient procedure.

The benefit of osseous surgery is that it will be easier to keep your mouth clean by brushing afterward. When gum pockets become too deep (greater than 3 millimeters), it becomes impossible to reach the areas that need to be cleaned, making infection more likely. These preventative procedures halt the progression of advanced gum disease.


Treating advanced gum disease is essential to prevent more dangerous issues from arising. If a patient is pregnant or has allergies to certain medications, additional precautions will need to be taken during oral surgery. Always let your healthcare provider know about your full medical history to ensure your safety.

Potential Risks

Even if you have the most qualified dental surgeon, there's always the possibility of complications. With osseous surgery, you should be aware of the following risks:

  • Cavities: You're more likely to develop root-based cavities in the teeth that were treated with gum pocket reduction surgery. Maintaining regular dental cleanings and check-ups, along with proper care at home, will help protect more vulnerable teeth.
  • Infection: It's possible that you'll end up with an oral infection after surgery. If left untreated, an infection in the mouth can spread to the rest of your body, producing a serious health concern. Following your aftercare instructions will help minimize the chance of infection.
  • Receding gumline: After surgery, your gums around the treated teeth may start to recede faster than the rest of your gums, making these teeth look longer than the others. Treatment is available to correct this issue if it occurs.
  • Sensitive teeth: Your teeth may feel more sensitive to hot and cold. Using a straw with beverages and waiting for your food to cool down before eating will help you avoid discomfort.

Purpose of Osseous Surgery

Osseous surgery improves the success of gum pocket reduction surgery for patients with advanced gum disease. When the bacteria from gum disease starts to infect areas of the bone, the infected area must be removed before it continues to spread.

After gum disease infects the tooth, it can migrate to other areas of the body, putting your organs and heart at risk.

Before surgery is considered, your dentist will attempt to treat gum disease with treatments like root-planing and scaling. However, by the time your dentist recommends gum pocket or osseous surgery, you probably don't have less invasive treatment options.

According to the American Dental Association, scaling removes plaque and tartar from underneath the gums. Root planing helps the tooth and gum reattach by smoothing the root.

The sooner you're able to treat the infected area, the less tissue will need to be removed. Taking good care of your oral hygiene going forward will help prevent you from having the same surgery done again for other teeth.

How to Prepare

Here's what you can do to get ready for osseous surgery.


A specialist, called a periodontist, will do your osseous surgery. You'll need to go to their office for the operation.

What to Wear

Wear comfortable clothes for surgery that you don't mind getting stained. Your chest will be covered with a smock during the surgery, but it's still possible to get some splatters of blood or fluid on your clothing during the procedure.

Food and Drink

There's no need to limit your food or drink intake prior to osseous surgery since you'll be given a local anesthetic. If your surgery is more extensive and will be performed under general anesthesia, your healthcare provider will provide you with more detailed instructions on when to begin fasting.

Make your healthcare provider aware of all your medications to avoid potential complications during surgery.

What to Bring

Since you'll be heading home from surgery as soon as it's over, you won't need to bring a lot of stuff with you. Bring any necessary paperwork, dental insurance information, and personal identification. Arrange for someone to drive you home after the surgery, as you'll need some time to get your bearings as the pain medication wears off.

What to Expect on the Day of Surgery

As you're heading in for osseous surgery, here's what you can expect on the day of your procedure.

Before the Surgery

You'll have a thorough dental cleaning before osseous surgery is performed. Arrive at your appointment on time to fill out any last-minute paperwork.

During the Surgery

A periodontal specialist will numb the infected area with a local anesthetic and begin cutting around the teeth. Once the bone and roots are accessible, the area will be cleaned through scaling. Using hand tools and a drill, your healthcare provider will cut into the bones around the teeth to perform osseous surgery to create a smoother and more uniform shape.

If the bone is severely infected, your healthcare provider may perform a bone graft. A bone graft will help your body rebuild bone in areas where it has deteriorated to help maintain the shape and structure of the jaw.

After your healthcare provider finishes removing the infected tissue, the gums are pulled back over the bone and sutured together. Your practitioner will bandage the area to keep it covered as it begins to heal.

After the Surgery

Once your surgery is complete, you'll be ready to head home. Follow your aftercare instructions carefully, including taking your pain medication as prescribed, removing your bandages carefully, and cleaning the area as advised.


Avoid smoking or drinking alcohol for at least the first seven days after osseous surgery to give your mouth the best chance at recovery. If you wear dentures, talk to your healthcare provider about when you should place them back in.

You'll be required to visit the periodontist within seven to 10 days after your surgery to check on healing and get stitches removed. You should feel fully healed in about two to four weeks.


Some swelling and bleeding are normal following oral surgery. You'll be provided with aftercare instructions including pain medication to ease discomfort and mouth rinses to keep the area clean. You may also be prescribed antibiotics to reduce the risk of infection. Using an icepack will help control swelling and numb the area.

Coping With Recovery

Putting extra pillows on your bed will let you keep your head elevated above your heart. This can reduce swelling and help you feel better faster. When bleeding starts, bite down a piece of gauze to apply pressure and stop the bleeding.

Stock up on soft foods to enjoy after your surgery. You'll need to avoid hard or sticky foods and carbonated beverages. Drink plenty of water to stay hydrated and don't use a straw until your mouth has fully healed.

Possible Future Surgeries

If your advanced gum disease has spread to other sections of your mouth, it's possible that you'll need to have osseous surgery again for another tooth, or you may require a dental implant.

Maintaining regular follow-up visits and staying diligent about your dental health at home will help prevent you from having to continue to require surgical intervention. Scaling and root planing may be used to control advanced gum disease before it gets to the point of surgery in other teeth.

Lifestyle Adjustments

In addition to cleaning your teeth and flossing, changing your eating habits can help improve your dental health. Optimal nutrition for dental health includes foods that are high in minerals, like calcium and phosphorus. Vitamin C from fruits and vegetables will help keep your gums in good shape.

Frequent snacking, especially on sugary and sticky foods, attracts bacteria and promotes cavities. Remember to brush after eating sweets and drink plenty of water to help keep sugar from sitting on your teeth and gums.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Dentaldiseases.org. Pocket depth reduction - periodontal (gum flap) surgery.

  2. Periodontal Disease Treatment. What is periodontal osseous surgery? Risks? Costs? Care?

  3. Periodontal Medicine, Dental Surgical Specialists, LLC. Osseous surgery - a solution.

  4. American Dental Association Mouth Healthy. Scaling and root planing.

  5. Periodontal Medicine, Dental Surgical Specialists LLC. Bone grafting opens the door for dental implants.

  6. Midtown Dentistry. Postoperative instructions.

  7. Klemm S. Kohn J. Healthy nutrition for healthy teeth. Academy of Nutrition and Dietetics.

By Anastasia Climan, RDN, CD-N
Anastasia, RDN, CD-N, is a writer and award-winning healthy lifestyle coach who specializes in transforming complex medical concepts into accessible health content.