An operculectomy is a minor surgical procedure which removes excess gum flap tissue known as an operculum. Operculectomies are most commonly performed on lower wisdom teeth (third molars). When a tooth erupts partially through the gums, it creates a gap between the crown of the tooth and the gum flap tissue. This creates a dark space where bits of food can get stuck easily.

As this creates the perfect environment for bacteria to breed, this will cause inflammation, swelling, pain and infection in the area. Dentists refer to this as pericoronitis. An operculectomy is performed to remove the excess tissue so there is no place for bacteria to get stuck and the area can be cleaned properly.

What Is an Operculum?

An operculum is small piece of gum flap tissue, which partially covers the chewing surface of newly erupted teeth. Normally teeth erupt fully so the gum tissue retracts. However, sometimes there isn’t enough room in the jaw or the tooth has come through at an angle meaning it doesn’t erupt fully.

  • Food gets stuck in the flap of gum tissue creating a blind pocket which your toothbrush bristles can’t reach.
  • Upper teeth often hit the swollen gum flap causing extreme trauma, bleeding and pain.
  • Bits of food become trapped, causing the flap to rot and cause regular painful inflammation.

What Are the Common Signs and Symptoms of Pericoronitis?

Pericoronitis is the main reason dentists would recommend an operculectomy. Knowing the signs and symptoms can help you get treated quickly.

  • Pain and Swelling: The area will begin to throb and the gums will look bright red, sore and swollen.
  • Difficult to Open Mouth Wide: Swelling will cause the muscles to tighten making it difficult to open your mouth wide. This is known as trismus.
  • Bad Taste and Odor: Bacteria get trapped causing a bad taste in your mouth. Pus will leak from the area also causing a bad odor.
  • Pain Radiates: Pain can travel towards your ear, temple and neck. This will make chewing and swallowing very painful.
  • Mild Fever, Swollen Lymph Nodes and Fatigue: If the infection gets severe you may feel a slight fever, your lymph nodes underneath your jaw will swell and you may feel generally tired.

When Would a Dentist Recommend an Operculectomy?

Dentists and oral surgeons will carry out an assessment on various factors to decide whether an operculectomy would be the best option to remove the infection whilst keeping your teeth intact.

  • Straight Vertical Eruption: The tooth should erupt vertically and have enough room to fully erupt.
  • Functionality: The tooth should be functional and line up with the upper teeth.
  • Less Invasive Option: An operculectomy is a less invasive option to having the whole wisdom tooth removed, which can be risky.
  • Preference: Patients often choose to have an operculectomy as they want to keep their natural teeth. If there is no decay to the tooth structure this is a good option.

How Is an Operculectomy Performed?

An operculectomy is a fast procedure which can be completed in 15-30 minutes by an experienced dental practitioner. It is an outpatient procedure.

  • X-rays: The dentist will take digital x-rays of your teeth to see the angle, root position and bone density.
  • Local Anesthetic: The area will be numbed with local anesthetic.
  • Excision: The surgeon will precisely excise the excess gum flap using a scalpel, laser or electrocautery.
  • Antiseptic: The area will be flushed with antiseptic saline.
  • Clotting: The dentist will apply firm pressure using sterile cotton gauze to help the area clot.

What Is the Difference Between Scalpel and Laser Operculectomy?

There are various ways dentists can perform an operculectomy.

  • Scalpel: The dentist will use a scalpel to remove the tissue. This is an effective, cheap and readily available option. However there will be mild bleeding.
  • Laser: The dentist will use a soft tissue laser to remove the tissue. This will cause minimal bleeding and reduce swelling. The tissue will heal quicker.
  • Electrocautery: Electrocautery instruments use high frequency electricity to remove tissue and stop bleeding. It is a precise procedure.

What Aftercare Is Needed Following an Operculectomy?

Following the correct aftercare will help you heal quickly and reduce the risk of infection. Most people will fully recover within 7-10 days.

  • Apply Pressure: Bite onto the gauze firmly for 30-45 minutes after the operation to help with clotting.
  • Rinse With Warm Salt Water: Rinse gently with warm salt water 24 hours after the procedure to reduce bacteria.
  • Soft Foods: Eat soft foods such as yogurt, apple sauce, smoothies and warm soups for a few days.
  • Don’t Use a Straw: Don’t drink through a straw as this can cause the fragile clots to come loose and cause bleeding.
  • Brush Carefully: Brush your remaining teeth carefully. Don’t brush directly over the surgical site for the first 48 hours.

What Are the Risks of an Operculectomy?

An operculectomy is a safe and simple procedure however there are slight risks involved with any surgery.

  • Bleeding: There will be mild oozing from the area for the first 24 hours. If there is constant heavy bleeding you should seek clinical assistance.
  • Regrowth: Sometimes the gum flap can regrow over the tooth. This may require another procedure or removal of the whole tooth.
  • Infection: If you don’t follow correct aftercare bacteria can enter the wound causing infection.
  • Numbness: In rare cases there can be temporary numbness to the tongue and lower lip due to nerve irritation.

What Are the Key Takeaways About an Operculectomy?

  • An operculectomy removes excess gum tissue which is covering a partially erupted tooth. This removes any places bacteria can get stuck.
  • This removes pericoronitis so there is no more pain, tightness in your jaw, swelling, bad breath or recurrent gum infections.
  • If the underlying tooth is growing straight and has enough room to fully erupt dentists will prefer an operculectomy.
  • Laser procedures will cause less bleeding, less swelling and faster healing than using a scalpel.
  • Follow correct aftercare, eat soft foods, rinse with warm salt water and don’t use a straw.
  • See a licensed dental practitioner to get an accurate diagnosis using digital x-rays and thorough examinations.

What Are the Frequently Asked Questions About an Operculectomy?

Is an Operculectomy Painful?

No, there is no pain during the procedure. Your dentist will numb the area using strong local anesthetic. During the procedure you will feel slight pressure but no pain. After the anesthetic has worn off you may feel slightly sore. This can be easily managed using over the counter pain relief.

How Long Will I Be Off Work or School?

The soft tissue will begin to heal after 3-5 days. Most people will be able to return to work/school the day after. The gums will fully heal after 7-10 days if you follow correct oral hygiene.

Can My Gums Regrow?

Sometimes the gums can regrow. If the tooth doesn’t fully erupt or there isn’t enough room in the jaw the operculum can regrow. If this happens regularly your dentist may recommend the tooth to be extracted permanently.

What Is the Difference Between an Operculectomy and Extraction?

An operculectomy only removes the soft gum tissue covering the tooth. An extraction removes the whole tooth including the roots from the socket in your jawbone.

An operculectomy is a safe, effective and minimally invasive procedure to treat recurrent gum flap infections caused by partially erupted teeth. Removing the excess tissue will remove any dangerous areas for bacteria to get stuck and stop painful inflammation. If you are experiencing pain, swelling or bad breath around a back tooth which is coming through contact a licensed dentist for a professional examination.