This patient’s chief complaint was the unesthetic two front crowns. They obviously needed to be replaced. She told me that she was seeing a periodontist and that she was scheduled to have periodontal surgery the next day. When I examined her periodontal tissues I saw no inflammation and  minimal pocketing. The gums appeared healthy. Of course this was after her having had full mouth initial therapy  ( deep scaling/curettage and hygiene instruction ) at   the periodontist’s office. Her radiographs showed minimal bone resorption*. Her teeth were not mobile. So, why periodontal surgery ? My experience visiting periodontists with my patients indicates that this need for surgery in these type of cases is “normal” at the specialist’s office. Does that mean that they judge pathology on a higher level ? I guess so. But I disagree with the need for surgery. Just the initial step in the surgical procedure whereby a flap is raised causes bone resorption in itself not to mention the time, expense and morbidity of these procedures. So, is the surgery really necessary in the eyes of the periodontist or this just a matter of making money ? The decision is yours .

* There does appear to be a bone defect around the lower right first molar which may be amenable to a surgical procedure and possibly bone graft but why perform surgery on the upper arches ?