Gum Flap Surgery: Treatment Steps, Aftercare & Risks

What is Gum Flap Surgery?

Gum flap surgery, also called periodontal flap surgery, treats and repairs periodontal pockets. The procedure is also used to treat periodontitis.

Periodontitis (periodontal disease) is an advanced form of gum disease. It is caused by the long-term buildup of plaque and tartar below the gums.² 

Gum flap surgery can:¹

• Remove bacteria from beneath your gums
• Make it easier to clean your teeth
• Reshape the bones that support your teeth
• Prevent future gum damage

Who is a Candidate for Gum Flap Surgery?

Periodontal flap surgery is recommended for people with severe or advanced gum disease. Symptoms of gum disease might include:²

• Swollen, red, or bleeding gums
• Deep pockets between your gums and teeth
• Loose teeth
• Pain when chewing
• Bad breath
• Receding gums

Your doctor will let you know if you could benefit from periodontal surgery. Your dentist might recommend more conservative treatment if your gum disease isn’t advanced.

How to Prepare for Gum Flap Surgery

Before surgery, your doctor will provide specific instructions on how to prepare. Doctors will ask you to stop taking certain medications a couple of weeks before the procedure.⁴

These medications include:

• Aspirin (Bayer, Bufferin)
• Pain relievers
• Blood thinners

Avoid smoking or drinking alcohol at least 24 hours before the procedure.

Your doctor might give you an antibiotic to take before your procedure. This lowers the chance of infection.

During the procedure, you’ll receive anesthesia, sedation, or other medications. Because of this, you should arrange for someone to take you home after surgery.

Gum Flap Surgery Steps

If your dentist or periodontist catches periodontitis early, they may use non-surgical treatments. Periodontists typically perform scaling and root planing first before moving on to surgery.⁵

Depending on the severity of gum disease, gum flap surgery may be necessary. It’s important to know that gum flap surgery is not a cure for severe gum disease.⁷ 

However, surgery does help reduce the harmful effects of periodontitis by improving your oral health. 

Gum flap surgery is typically separated into four steps:^5,6

1. Local Anesthesia Administration

A local anesthetic is typically administered before gum flap surgery. The drug is injected into your mouth, numbs the treated area, and causes a loss of nociception (pain receptors).

You remain awake during the entire procedure but will not feel anything. Local anesthesia also eliminates pain for up to four hours post-op. 

Anti-anxiety medications or sedatives may also be used if needed.

2. Gum Tissue Incision

After the local anesthetic has taken effect, your periodontist or oral surgeon will make a small incision into your gums. This separates your gum tissue from your teeth.

Then, they will gently fold back the gum tissue. This provides easy access to the tooth roots, ligaments, and surrounding bone tissue.

3. Gum Tissue Removal

Next, they will carefully remove the inflamed gum tissue. Then, they will clean the roots and remove any remaining debris.

If there is significant bone loss, your periodontist may recommend bone grafts to regenerate new, healthy bone tissue.

4. Stitches

Once they’ve removed the infected gum tissue, they will close the incision with stitches (sutures). 

They may place either resorbable (dissolvable) or non-resorbable sutures, depending on the size and needs of the wound. They also recommend follow-up appointments to ensure your mouth is healing properly.

Gum Flap Surgery Recovery & Aftercare

After the surgery, a periodontal dressing is placed on the surgical site. This protects your gums from heavy forces like chewing or brushing.

You’ll also be prescribed mild pain medication and antibiotics to help with discomfort. You should only feel minor discomfort for a few days.

Gum surgery aftercare tips include:¹

• Refrain from brushing or flossing the surgical site until it heals
• Gently remove plaque from the healing teeth with a toothbrush
• Continuing to brush your untreated teeth as normal
• Rinse your mouth with warm salt water a few times each day
• Use ice packs to reduce swelling and inflammation
• Take over-the-counter pain relievers, such as ibuprofen
• Rinse your mouth with an antimicrobial mouthwash containing chlorhexidine 

Your periodontist will schedule a follow-up appointment a week after the procedure. This is to ensure that everything is healing properly

Swelling and minor bleeding are normal. However, if the swelling lasts longer than a few days, you can use an ice pack to control the swelling and pain.

What to Eat After Gum Flap Surgery

Many doctors recommend eating soft foods for a week or two after the procedure. Some examples of suitable foods include:¹

• Jell-O
• Pudding
• Ice cream
• Yogurt
• Scrambled eggs
• Cottage cheese
• Pasta
• Mashed potatoes

How Much Does Gum Flap Surgery Cost?

Non-surgical treatment can cost between $300 and $2,500. Periodontal surgery can cost anywhere from $1,000 to $3,000.

The price can vary depending on the type of procedure and the severity of your disease. Check with your dental insurance provider about plans that can help cover the cost. 

If you can’t afford the procedure, speak to your dentist. They may be able to offer better payment options. 

Gum Flap Surgery Complications

If you experience bleeding for more than two days, you can develop an infection. Call your periodontist right away if this occurs.

Other possible complications of gum flap surgery include:

• Gum recession
• Root decay
• Root hypersensitivity

Gum recession can increase the chances of root decay. Treating these conditions largely depend on how severe the problem is. 

Mild cases of gum recession may be improved with nonsurgical treatments. These treatments include topical antibiotics, dental bonding, or orthodontics.

However, in most cases, these conditions require surgery to correct. The best way to avoid gum recession and root decay is by maintaining good oral hygiene and proper brushing techniques.