Ridge Expansion Procedure: Everything You Need to Know

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A ridge expansion, also known as ridge splitting, is a type of surgical procedure that is performed to restore the natural form of the bone width following a tooth extraction. It is often used to help re-form the gums to prepare them for a bone graft or dental implant.

This article reviews what you can expect from a ridge expansion procedure.

Dentist examining patient's mouth in dental office

Javier Zayas Photography / Getty Images

What Is Ridge Expansion?

After a tooth extraction, the empty space can collapse, making it difficult to fit a new tooth implant. A ridge expansion can be performed to remedy that.

There are various instruments that can be used to perform the procedure following the removal of the tooth, including:

  • A chisel and mallet
  • Scalpel blades
  • Spatula
  • Osteotomes (instruments used to cut bone)
  • Lasers
  • Fissure burrs (cutting tools that can widen small tears in a tooth)
  • Piezoelectric surgical tools that use high-frequency vibrations and a metallic tip to cut bone

The overall process involves cutting a green-stick fracture into the bone that surrounds the tooth's roots. A green-stick fracture is a type of fracture that occurs when the bone bends and cracks, as opposed to breaking into two or more pieces. What is left after the breakage is an empty socket that can be filled in with an implant or bone graft.

While getting the procedure, you will be put under intravenous (IV) sedation so that you are not awake. Most dental specialists will have a nurse anesthetist or dental anesthesiologist administer the IV sedation. Oral surgeons are certified and may do their own sedation without assistance.

Contraindications

While almost anyone can get a ridge expansion, there are some exceptions. If a person has less than 2 millimeters of bone available to cut into, they are unable to have the procedure.

A lack of space in the marrow of the bone between the cortical plates will also render someone unable to get a ride expansion. Cortical plates are types of bones that can be found on the surface of alveolar bone, which is the bone that cobtains the tooth sockets.

Ridge Expansion in Children

Although children may be able to get a ridge expansion to have an implant placed, it will depend on the state of their alveolar bone and is done on a case-by-case basis.

Potential Risks

As with any other surgical procedure, the most notable risks associated with a ridge expansion are infection and bleeding. Other complications that can occur include:

  • Fracture of the buccal plate, which is part of the alveolar bone
  • Neurosensory complications (though rare)

Purpose of Ridge Expansion

The main purpose of a ridge expansion is to prepare the area for a dental implant. Without the ridge expansion, the dental implant is unlikely to fit into the area.

How to Prepare

Prior to getting a ridge expansion, there are some ways you can prepare for the procedure.

Location

Most ridge expansions will be performed by dental specialists such as a periodontist (a dental professional who works specifically with dental implants and gum diseases) or an oral surgeon. However, any dentist trained in this procedure can perform it.

If necessary, you will likely be referred to a periodontist by your primary dental care provider.

What to Wear

On the day of the surgery, you will want to wear loose-fitting and comfortable clothing. Since an IV will be placed into your arm, wearing a T-shirt or a shirt that can be rolled up over your elbow is best. Avoid wearing makeup and jewelry.

Food and Drink

Prior to your procedure, you will be asked to refrain from eating for roughly six hours. Drinking usually also should be avoided for the same amount of time, but in some cases, you may be told that you can drink liquids up until two hours before the procedure.

This decision will be up to your periodontist, and they will provide you with specific timelines for eating and drinking before a ridge expansion.

Why Can’t You Eat Before Surgery?

Eating prior to getting anesthesia can increase the likelihood that you will vomit while unconscious. This is because anesthesia temporarily blocks your body’s reflexes.

When the reflexes are stopped and there’s food or water in the stomach, it can make its way out of the stomach and up into the esophagus and even the lungs, causing issues with breathing.

Medications

All medications that you take on a regular basis can be continued regularly as long as your healthcare provider has not instructed you otherwise. If you have to take medications and are not supposed to eat or drink, take them with only a very small sip of water.

What to Bring

On the day of your surgery, you should be sure to have any important forms or medical information with you to bring to your appointment, such as insurance information.

While you will not need to bring much with you, you will need someone to transport you home on the day, as you will not be able to drive for at least 24 hours following surgery.

Pre-Op Lifestyle Changes

You will not need to make any lifestyle changes unless you smoke. It is advised that people who smoke refrain from smoking for at least 12 hours prior to surgery, or quit altogether as soon as possible before they have their ridge expansion performed.

What to Expect on the Day of Surgery

When the day arrives for your ridge expansion, you can expect a few things to occur before, during, and after surgery.

Before the Surgery

Prior to the ridge expansion, you will fill out any necessary forms to ensure that you consent to the procedure and know what is being done.

When you are escorted into the room, you will then be given IV sedation so that you are not awake during the procedure.

During the Surgery

During the surgery, the dental professional will use their tool of choice and cut into the gums and remove them away from the bone. Once that is complete, they will use their tool to cut into the bone to help widen it.

After the cutting and widening have taken place, healthy bone from another area may be placed into the newly widened area. Or, a bone substitute may be placed so that it can heal properly in preparation for a dental implant.

After the Surgery

After the surgery, you will be put into a recovery room while you wake up. There will be some bleeding and pain in the area, so it’s important to refrain from touching your mouth or face.

Once you have woken up, you will be allowed to go home with the person who brought you.

Recovery

Recovery from a ridge expansion can be a lengthy process. However, the time it takes to heal will vary depending on the person.

Healing

Typically, the healing process after a ridge expansion can take up to six months. During this time you will have to take the appropriate steps to ensure that the healing process goes smoothly. This can include:

  • Taking antibiotics: If you were prescribed antibiotics, you have to take them as directed to lower the risk of infection.
  • Use a salt rinse: Following the surgery, you will have to practice good oral hygiene. This involves using a warm saltwater mouth rinse the day of and after surgery and repeating the rinse up to five times a day for at least five days.
  • Brushing and flossing: Use a soft bristle toothbrush and be gentle on the area when both brushing and flossing your teeth.
  • Eating: For the first week, you should eat only soft foods, and avoid using the area to chew your food for at least four months.

Avoid Alcohol and Smoking

You should not drink alcohol for at least one week following surgery. Smoking should be avoided for a minimum of two weeks because it delays healing and can lead to infections. In fact, it's suggested that a person quit smoking for the entire six-month duration that it takes to heal.

Coping With Recovery

Since the healing process can take some time, it’s important to know how to cope. For any pain you may experience, you can take over-the-counter (OTC) pain relievers, such as ibuprofen. Icing your jaw area may also help to relieve pain.

Since you will be unable to use that part of your mouth to chew, you can either use only one side of your mouth to chew or stick to softer foods as much as possible.

Possible Future Surgeries

Once the area has healed, you will be ready to get a dental implant placed into the area. A ridge expansion is typically the first step when it comes to getting dental implants.  

Summary

A ridge expansion procedure is designed to widen a tooth socket when a tooth extraction has taken place. It is used in the event that a person needs a dental implant but the area is not large enough to accommodate. The surgery itself is done with IV sedation, so the patient will not be awake during the procedure.

Although the risks are low, there is some chance of infection after this type of surgery, so it’s important to take any prescribed postoperative antibiotics and avoid anything that could increase the risk of infection, such as smoking.

The healing process can take as long as six months. During that time, the patient will have to practice good oral hygiene and avoid things that could slow the healing process.

A Word From Verywell

If you have to get a ridge expansion, it’s important to remember that it is performed to improve your overall oral health now and for the long term. Though getting a ridge expansion may seem scary at first, remember that you will be sedated, so you will not feel any pain. Ridge expansions can take some time to heal, but they will be worth it in the end.

Frequently Asked Questions

  • How long do you have to wait to get dental implants after a ridge expansion?

    Typically, you will have to wait until the area is fully healed before getting implants after a ridge expansion. This could take as long as six months. However, in some cases, there is only a three-month waiting period. 

  • Is ridge expansion painful?

    During the procedure, you will be unconscious. Because of this, you will feel no pain. However, you may experience some mild pain or discomfort following the procedure that can be eased with OTC pain relievers or ice.

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.
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