What is an Operculectomy?
What is the Purpose of an Operculectomy?
The surgical procedure called an operculectomy is the surgical removal of the gum tissue which sometimes forms a flap over a partially erupted tooth. This gum tissue flap is called an operculum and is most often associated with an erupting wisdom tooth, especially the lower wisdom teeth. The tooth in the opposing arch will sometimes bite down on the operculum resulting in considerable inflammation, perhaps infection, bad breath, swollen lymph nodes under the mandible, pain in the jaw, pain in the throat, and general discomfort. With time, if the patient can withstand the discomfort, the operculum is slowly chewed away. If not, there are several other methods of treatment. One is to remove the opposing tooth, but only if it is a wisdom tooth and is and will be non-functional. Two is to remove the erupting and offending tooth, but only if it also is a wisdom tooth and is and will be non-functional. If there appears to be enough room for the wisdom teeth to come into proper occlusion (bite), then an operculectomy should be performed. This is a simple procedure of utilizing a small amount of anesthetic and incising away the operculum, or gum tissue. This immediately relieves the discomfort and the patient normally quickly forgets about it. The operculectomy procedure is usually less expensive than the removal of the wisdom tooth. And remember, you eventually also usually have to remove the wisdom tooth on the opposite arch.
Operculitis is the technical name for an inflamed operculum, or flap of gum tissue associated with an erupting tooth. It may even be called a pericoronitis which means inflammation of the gum tissue around the clinical crown (the part of the tooth that can be seen in the mouth). But it still requires the operculectomy treatment in most cases. This can easily and quickly be performed by using a scalpel, a laser, or electrosurgery. It is basically pain-free and only requires a very small amount of anesthetic. This condition is mostly found in young adults when they have wisdom teeth beginning to erupt, actually mostly between the ages of 17 and 23.
As soon as the patient realizes that he may have operculitis, he must make certain that the area beneath the gum flap does not trap bacteria and food debris. Vigorous rinsing with warm salt water may be used to help dislodge those items. If this is not done, swelling of the tissue occurs and discomfort results, as does a foul odor, and chewing food becomes uncomfortable. Failure to properly cleanse the area by removing the debris can also lead to decay.
The laser-assisted operculectomy not only removes the offending tissue, but it also provides its own hemostasis, or blood-clotting. This trait works extremely will when gum tissue needs to be removed to uncover an unerupted tooth for orthodontic banding or bracket attachment. The laser yields a field in which to work that is clean, dry, and bloodless. This is considered to be atraumatic (non-traumatic) surgery in that there is no trauma associated with the laser, and there is no pressure applied. The patient always and immediately notices that the area feels much better and is much easier to clean.
This is a common problem for young adults especially, very easily and successfully treated, and the patient usually feels immediately better. Of course, any soreness in the mouth should be checked due to the possibility of many causative factors. Pericoronitis is just one of them. There could be other causes present and the sooner the cause is checked and determined, then treated, the better the result for the patient.
Life Member American Dental Association, Emeritus Fellow Academy of General Dentistry, American Association of Implant Dentists.