An alveoplasty (a.k.a. bone leveling or alveoloplasty) is an oral surgery procedure used to smooth and shape the jawbone, improving the contours, evening out high and low places, flattening or tapering the jaw’s ridge, or removing any sharp edges of bone.  It is normally done in areas where teeth have been removed or lost.  This surgery can make chewing, speaking, smiling, and wearing restorations like dentures or placing dental implants easier, because the lack of a level surface makes it difficult to fit an implant.

While your dentist will always try to save your natural teeth, damage, infection, and disease often mean that an extraction may be the only option, and when that happens, there will be a small hole in the alveolar jawbone (the part of the jaws where the teeth arise) where the tooth’s root was.  Unfortunately, these holes in the bone do not always heal properly, making the alveolar bone uneven or leaving behind sharp ridges. These malformations can cause gum tissue soreness, increase your risk for periodontal disease, and interfere with the fit of restorations such as dentures.

Oral surgeons usually do alveoplasties, but some general dentists also perform them.  Alveoplasty is usually done at the same time as an extraction, but it can be done alone sometimes in complex cases.  The surgery is done with local aesthetic or in combo with IV/Conscious sedation.  Usually, if only one tooth is being extracted, an alveoplasty will not be recommended, and the area will heal normally on its own.

When a tooth is removed it leaves an open socket that fills with a blood clot.  The gum will eventually heal over the socket.  In an alveoplasty, the gums are sutured closed over the hole. Not only does this cause the area to heal more quickly, but it also allows for better control of bleeding, because there is no open socket, and will also prevent a painful dry socket, where the blood clot has failed or dislodged.

Faster healing is important when there is a health problem like cancer.  The patent may need to have decayed teeth extracted before receiving chemotherapy or radiation therapy to the head or neck, because it can dry up the salivary glands and reduce blood flow to the jaw, increasing the risk of further decay, meaning these therapies cannot begin until the sockets are healed.  Because alveoplasty helps the area heal faster, therapy need not be delayed.  In such a case, alveoplasty may need to be done even if only a single tooth is removed.  Another condition where an alveoplasty after a tooth extraction may be recommend, is an autoimmune disorder.

DENTURES

Wearing dentures does not need to be a painful experience, but without a good fit it’s often the case.  When people have been missing teeth for many years, they have lost quite a bit of bone in their jaw.  Then the top of the jawbone (called the ridge) becomes very thin, and it is difficult to fit a denture on it, or there may be a lip of bone that juts out from the rest of the jaw.  In these cases, a denture will not fit properly.

Likewise, when there has been an extraction, even after the gums have healed, there will be high and low points in the bone, making it difficult for a denture to be properly fitted.  A bad fit can cause the denture base to rub against the high points, resulting in sore spots.  An alveoplasty, to reshape the alveolar ridge, will make your dentures fit better, feel secure, and reduce the aggravation of an ill-fitting denture, because, you jaw will have a nice even surface for the denture to rest on instead of sitting on a lumpy or jagged one.

THE PROCEDURE

A model or mold of your teeth may be made from impressions to determine where and how much bone will need smoothing and reshaping after the extraction(s).  Then a clear plastic model, called a stent, is made shaped like a denture base. The oral surgeon will use the stent during surgery to make sure the right amount of bone has been removed.

Next the gum is cut open and laid back to expose the jawbone.  The dentist then uses instruments to remove any excess bone and files down the surface to make it smooth and level, with a healthy curvature. The dentist then uses a sterile solution to wash the wound.

If a stent is being used, the surgeon replaces the gum tissue over the bone and sets the stent on top. Because the stent imitates the shape of a denture, the surgeon can tell if the correct amount of bone has been removed. If the stent does not fit well, more bone will be removed and/or reshaped until it does.

The gum tissue is then replaced and stitched closed. Surgeons often use a locking-suture technique that minimizes bleeding and seals the tissue closed.

Procedure time will depend on how much of the bone will need to be smoothed down.

WHAT TO EXPECT AFTER THE PROCEDURE

You will probably feel somewhat sore and tender around the affected area for a week or so. Prescribed strong painkillers can be taken for the first few days, and then over-the-counter medications will be sufficient.  There is usually some swelling for the first day or two, but, an ice pack can help minimize this and any pain.

Normal symptoms may include some bruising to a surprisingly large area of your face and neck, under the jaw line, on your cheeks, inside your mouth, and even as far down as your chest.  If the bruises become more painful or swollen, tell your dentist immediately.

Antibiotics and an antibacterial rinse are usually prescribed to help cut the risk of infection.  A dentist will take out your stitches, unless absorbable stitches that dissolve were used.  In either case, cold and liquid or soft foods are recommended the first two or three days, and soft foods warm (not hot) for a few more days until the stitches disappear, and avoid using a straw because the suction can encourage bleeding.

Alveoplasty is a relatively common surgical procedure.  It is effective to tackle any problems with the jawbone after a tooth or teeth extraction.  Without this surgery, your dentist may struggle to fit vital dentures or dental implants.

If you are interested in alveoplasty in Costa Rica, fill out the “Find a Dentist” form on this page.  One of our patient advocates will reply to your needs.