Oral surgeons usually do alveoplasties, but some general dentists also perform them.

Some people who have been missing teeth for many years have lost quite a bit of bone from their jaws. The top of the jawbone (which dentists call the ridge) becomes very thin. Other people may have a lip of bone that juts out from the rest of the jaw. In these cases, a denture will not fit properly.

Dentists use alveoplasty to smooth lumps in the jawbone, to flatten the jaw's ridge or to taper the ridge.

Usually, alveoplasty is not done if only one tooth is being extracted. In this case, the area will heal normally on its own. However, if a sharp edge of bone remains after the tooth is removed, alveoplasty can be done to remove it.

Besides smoothing the jawbone, alveoplasty also speeds healing after multiple teeth are extracted. If your dentist removes a tooth, he or she leaves an open socket that fills with a blood clot. Eventually, the gum heals 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.

Faster healing is important for certain people, such as cancer patients. They may need to have decayed teeth extracted before they receive radiation therapy to the head or neck. Radiation can dry up the salivary glands and reduce blood flow to the jaw, increasing the risk of further decay. Once the teeth are removed, radiation therapy cannot begin until the sockets are healed. Alveoplasty will help the area heal faster so therapy is not delayed. In this case, alveoplasty may need to be done even if only a single tooth is removed.

For some patients, a dentist will make a model of the jaw that shows the surgeon where to remove bone and how much to remove. The dentist takes an impression of the teeth and jaw, and uses it to create a cast. The cast is then ground down in areas where bone should be removed. Then a plastic model of the cast, called a stent, is made. The stent looks like a denture base, except it is clear. The oral surgeon will use the stent during surgery to make sure the right amount of bone has been removed.

If the alveoplasty is done in conjunction with extractions, the teeth will be removed first.

To start the alveoplasty, the surgeon makes an incision in the gum tissue and peels it back to expose the bone. The surgeon then uses instruments and a rotary drill to remove the necessary bone and uses a file to smooth it.

Once the bone has been smoothed, the surgeon irrigates the area to remove bone particles. If a stent is required, 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 he or she has removed the correct amount of bone. If the stent does not fit well, more bone will be removed and the bone will be reshaped until the stent fits. Then the gum tissue will be replaced and stitched closed. The surgeon often uses a locking-suture technique that minimizes bleeding and seals the tissue closed.

You may have some swelling, which should peak after about 24 hours and then taper off. You can use ice on your face to keep the swelling down. You also may notice bruising under your jaw line, on your chin and cheeks (depending on the location of the surgery), or inside your mouth.

Your surgeon may prescribe antibiotics to prevent infection of the area, particularly if you are elderly or had many teeth removed. An antibacterial rinse may be provided. You also can rinse with a saline solution.

Until the stitches dissolve or are removed, you should eat a soft diet and avoid using a straw because the suction can encourage bleeding.

After 7 to 10 days, the surgeon will evaluate you again so he or she can see how the area is healing.

Excessive bleeding — This is a rare complication. The area may have some oozing for the first 24 hours after surgery, but then should taper off.

Infection — Because the mouth contains many bacteria, there is always a risk of infection when surgery is done. This risk is relatively low, however. Your surgeon may prescribe antibiotics to help prevent infection.

The wound opening — The stitches may come loose, which can open the wound and expose the bone. If this occurs, contact your surgeon.

Trauma to the nerve that provides sensation to the lips and chin — This rare complication can occur when alveoplasty is done on the lower jaw. If the nerve becomes bruised, your lip and chin may feel numb long after the local anesthetic has worn off. Your lip will not droop and no one else will be able to tell that your nerve is bruised. Nerves heal slowly. It can take three to six months for them to heal completely. In a very small percentage of people, there may be some permanent numbness.

• Significant bleeding or increased swelling after the first 24 hours
• Any indication of an infection — fever, chills, inflammation of the area
• The stitches loosening or the wound opening to expose the bone