Deanna M. Neff, MPH
Periodontal disease refers to bacterial plaque and infections around the gum and tooth root. It can happen around one or several teeth. In its more advanced stages, surgery may be needed to fix damaged gums.
During flap surgery, the periodontist makes a small incision in the gum, pulls back the gum flap, cleans out the infected, plaque-filled pocket, and stitches the gums back in place.
This surgery is needed when:
This surgery slows the progression of periodontal disease by reducing deep pockets and bacterial growth. Periodontal disease can cause other health problems if not treated.
Problems from the procedure are rare, but all procedures have some risk. Your dentist will review potential problems, like:
Before your procedure, talk to your dentist about ways to manage factors that may increase your risk of complications such as:
On the day of the surgery:
A local anesthetic will be used near the gum disease.
Your dentist may recommend conscious sedation. You will be awake, but will have no anxiety during the surgery.
This surgery is usually done in an outpatient setting. You do not need to stay overnight. If you are undergoing sedation, you will have an IV placed in your arm to deliver medication. Your heart rate, blood pressure, and breathing will be monitored during and after the surgery.
The periodontist or dentist will numb the affected area using a local anesthetic delivered through a needle. They will make a small cut in the gum line near the tooth root. The gum flap will be pulled back, and he will clean out and scrape the infected area. The gum flap will be repositioned to minimize the deep pocket size that formed. The gum will be stitched back into place. A dressing will be applied.
The time it takes to complete the procedure depends on how bad the damage is and how many gum areas are affected.
You may feel mild discomfort while the dentist numbs the affected area or places an IV in your arm. You will not feel pain during the surgery. Medications can help control pain and anxiety before, during, and after the procedure.
During your stay, the dental staff will take steps to reduce your chance of infection, such as:
There are also steps you can take to reduce your chance of infection, such as:
When you return home, do the following for 24 hours to help ensure a smooth recovery:
Call your dentist if any of these occur:
If you think you have an emergency, call for medical help right away.
American Academy of Periodontology
National Institute of Dental and Craniofacial Research (NIH)
Canadian Dental Association
The Canadian Dental Hygienists Association
American Academy of Periodontology website. Available at:
http://www.perio.org/. Accessed April 19, 2010.
Carson De-Witt R. Periodontal disease. EBSCO Patient Education Reference Center website. Available at:
http://www.ebscohost.com/thisTopic.php?marketID=16&topicID=1034. Published September 1, 2009. Accessed April 21, 2010.
National Institute of Dental and Craniofacial Research (NIH). Periodontal (gum) disease. National Institute of Dental and Craniofacial Research (NIH) website. Available at:
http://www.nidcr.nih.gov/OralHealth/Topics/GumDiseases/PeriodontalGumDisease.htm. Accessed April 19, 2010.
Pre and postoperative instructions for periodontal surgery. Kathie L. Davis website. Available at:
http://www.kldaviesperiodontist.com/images/WEB_PRE__AND_POST_OP_INSTRUCTIONS.pdf. Accessed April 19, 2010.
University of Maryland Medical Center. Periodontal disease. University of Maryland Medical Center website. Available at:
http://www.umm.edu/patiented/articles/what_procedures_treatment_of_periodontal_disease_000024_8.htm. Accessed April 19, 2010.
6/6/2011 DynaMed's Systematic Literature Surveillance
Available at: http://www.ebscohost.com/dynamed: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis.
Am J Med.
Last reviewed September 2013 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © EBSCO Publishing. All rights reserved.